RALEIGH — In response to the successful efforts of the North Carolina General Assembly to secure a restraining order against Gov. Roy Cooper’s attempts to expand Medicaid, Cooper said he was frustrated that Republicans are fighting his unilateral move.
“North Carolina will miss out on more jobs and better health care without Medicaid expansion and it’s frustrating and disappointing that we’re having our own legislature in court to get it done,” said Cooper in a statement. “Tax dollars already paid by North Carolinians are funding Medicaid expansion in other states and we want to bring that money back home to work for us here.”
Leadership at the General Assembly filed for and were granted an order from a United States District Court prohibiting Cooper from submitting, or the Centers for Medicaid and Medicare Services (CMS) accepting, an amendment to the State Medicaid Plan that expanded eligibility thresholds with out legislative consent.
While the lawmakers contention rests squarely on existing statutes and constitutionally prescribed balances of power, the governor points to money and jobs left that would be left on the table by not expanding Medicaid.
When announcing plans to expand the entitlement program, Cooper predicted the decision could result in 20,000-40,000 healthcare and support jobs and bring billions in federal funds back to the state.
Katherine Restrepo, Director of Healthcare Policy at the John Locke Foundation and a Forbes contributor agrees that the federal funding influx is tempting in the near term, but highlights a litany of fiscal negatives over the long term such as a $600 million annual cost beginning in 2020.
“North Carolina federal taxes do help pay for other states’ Medicaid programs since the program is jointly funded,” said Restrepo in an interview. “Looking at the situation from a fiscal point of view, because North Carolina did not expand, the state is doing our nation a favor by not adding to the federal deficit.”
“States that have expanded are adding to the deficit,” she added. “A pot of money was never set aside for states’ Medicaid expansions when Congress passed the [Affordable Care Act (ACA)] in 2010.”
Restrepo said the “gap population”, mostly able-bodied single adults who are not currently eligible for Medicaid, but unable to obtain private insurance, is a real issue that could be addressed by anticipated reforms under a Trump administration.
“It looks like many of the ACA repeal and replace plans aim to achieve broader coverage by extending universal, refundable tax credits for people who are not covered by Medicaid, Medicare, other government health insurance programs, or their employer,” said Restrepo. “This includes the ‘gap’ population.”
The court order blocking expansion without the General Assembly approval does not expire until after President-elect Donald Trump takes office. The legislature reconvenes on January 25 at which point the biennial budgeting process begins.