Now, not next year, is the time to implement Medicaid expansion in North Carolina.  I am writing as the twice-Secretary of the Department of Health and Human Services, which houses the Medicaid program.  I was honored to serve as the head of this important department in the final year of the Governor Holshouser administration and the first two and one half years of the Martin administration before the governor moved me to his chief of staff position.

We were fortunate to have as the head of our Medicaid program, the nation’s top Medicaid director, the late Barbara Matula.  I had few worries about the integrity and efficiency of the program as long as Barbara was in charge.  However, at various points after  we left office, the Medicaid program became inefficient and riddled with waste, fraud and abuse.

I initially opposed Medicaid expansion if anyone cared what I thought for at least two reasons. One was that the North Carolina program could not effectively administer this growing program and second, with the federal government’s $20 trillion debt at the time, I could not justify expansion.

At least two issues have changed my opinion.  A positive is that I believe the NC Medicaid program is being operated efficiently.  Second, I don’t believe that the leaders of either party in Washington care about the growing national debt with is now surpassing $30 trillion.

The North Carolina Senate is to be commended and especially Senator Phil Berger for his superb leadership for passing Medicaid expansion. Now the House must show similar enlightened leadership and place this item in the budget, without the other controversial issues.  How many more of our state’s most vulnerable citizens will die without needed health care if we wait seven or more months until the next session.

We also need Medicaid expansion to address the many mental health needs and substance abuse needs of  our citizens, in addition to primary care.

I admit my change for support of Medicaid expansion.  Will others be willing do to the same?

Phil Kirk is former Secretary of NC Department of Human Resources, former Republican state senator and former chief of staff for Governors Holshouser and Martin and U.S. Senator Jim Broyhill.