RALEIGH (AP) — Gov. Pat McCrory said Thursday he is withholding judgment on whether North Carolina should expand Medicaid coverage under the federal Affordable Care Act, even as fellow Republicans in the state legislature move to block the expansion.
McCrory spoke Thursday as State Auditor Beth Wood, a Democrat, released a 70-page critique of the Division of Medical Assistance, which oversees state spending on the health insurance program for low income families that’s jointly funded by the state and federal government.
The Republican who took office Jan. 5 said he doesn’t intend to make a decision on Medicaid expansion until his administration has an opportunity to fix management issues discussed in the audit. States can choose whether to accept federal money to expand Medicaid rolls under the federal health overhaul signed into law by President Barack Obama in 2010.
“This audit reinforces the fact that we cannot expand Medicaid and put more North Carolinians into this system without first addressing many of the underlying issues costing the taxpayers millions of dollars every day,” McCrory said. “My total focus is going to be on reforming Medicaid. After we fix the system that we have we will go through a thorough review of other options that are available for us.”
The audit found that administrative spending for North Carolina’s Medicaid system is significantly higher than nine states of similar size. The audit also found state Medicaid administrators used flawed or incomplete budget forecasting methods, helping contribute to a $418 million shortfall with the program last year. Legislators ordered the audit to examine whether the state’s Medicaid program is effective and complies with federal regulations.
Medicaid provides health coverage for more than 1.5 million North Carolina residents — most of them poor children, older adults and the disabled. The program spends about $13 billion in state and federal funds.
If North Carolina were to expand Medicaid, another 650,000 uninsured state residents could qualify for government health coverage.
On Thursday, a panel in the GOP-controlled state Senate moved ahead with legislation that seeks to rule out expanding Medicaid. The measure set for a Senate vote next week also would leave it to the federal government to build the state’s online marketplace for private health insurance. Democrats complained the move contradicted a common GOP insistence on local control.
The health overhaul law requires the establishment of health exchanges — online marketplaces where people can shop for health insurance, much of which would be government-subsidized. If a state doesn’t set up an exchange, the federal government will run an exchange for that state.