RALEIGH (AP) — North Carolina legislators on Wednesday renewed the four-year-long national dispute over whether the federal health overhaul law now being rolled out is a common-sense effort to hold down medical costs or a march toward socialized medicine.
The state House tentatively approved legislation that would refuse federal dollars to expand Medicaid coverage to an estimated 500,000 low-income residents. The measure also leaves it to Washington to manage an online marketplace for private health insurance policies for those who now have the hardest time finding coverage.
The measure passed 75-39 along party lines. Republicans who want to limit the state’s contact with President Barack Obama’s health care law have a veto-proof majority. Final House approval is expected Thursday. The Senate passed an earlier version last week.
Democrats argued that the Republican governors of a half-dozen states have opted to expand Medicaid coverage which is scheduled to be paid 100 percent by the federal government between 2014 and 2016, then falling to 90 percent by 2020. Dollars of preventative care the Medicaid money would mean for people who now can’t afford doctors would save thousands of dollars of emergency room treatment in the future, advocates said. “Why are we turning this down?” asked Rep. Deborah Ross, D-Wake. “I think it’s fear and loathing” of the federal law.
Republicans emphasized they were taking a stand against the overhaul law often nicknamed Obamacare that would prove too costly for states and nation alike.
“This is a financial Armageddon,” said Rep. Bob Steinburg, R-Chowan.
Expanding Medicaid coverage “would simply build more dependency on government among a widely expanded segment of our citizens. It’s simply another step toward the goal of socialized medicine controlled by the federal government,” said Rep. Bert Jones, R-Rockingham,
Gov. Pat McCrory joined House Republicans on Tuesday by saying the federal government can’t be counted on to pay almost all the costs for new Medicaid recipients in the future and that state Medicaid problems should be fixed before any expansion.
Local health care officials seemed largely unfazed by the state government’s looming rejection of federal money for Medicaid expansion.
Falon Nye, spokeswoman for Novant Health and Rowan Regional Medical Center, released this statement: “Above all else, Novant Health and its medical facilities, including Rowan Regional Medical Center, recognize the tremendous need to expand access to quality health care.
“While expanding Medicaid would be an opportunity to greatly expand this access and offset a portion of the cuts we and other providers have taken as a result of the affordable care act, we look forward to working with the North Carolina legislature to find the solution that best works for the state to expanding access to quality care.”
The directors of local clinics for people who have no insurance had similarly measured responses.
Krista Woolly, executive director of the Community Care Clinic of Rowan County on Mocksville Avenue, said she and others in the free clinic community aren’t surprised by the news, given that nearby states are taking similar positions.
And Woolly said that while her “heart is in” expanding health care coverage, she’s not sure it would even work right now.
“I would love to see us out of business where everybody has access to health care, but we’re so far away from that,” she said. “This Affordable Healthcare law was a good stab, but it has so many loopholes.”
With North Carolina facing a shortage of primary care physicians — and Rowan’s doctor-to-patient ratio far worse than the state average — people newly covered by Medicaid could simply flood emergency rooms seeking the primary care clinics like hers now provide, Woolly said.
“It’s all a great idea on paper, but until we have physicians and medical professionals who can treat these folks, it’s all for naught,” she said.
Jean Allen, executive director of the Good Shepherd’s Clinic on Fulton Street, said she’d rather not comment directly on such a politically charged issue since her faith-based agency runs on “donations and good will” from many sources.
“We’re grateful that in a bad economy, people still donate their resources and their time and service to help those that are even more less-fortunate, and until we can make positive changes in this country’s indebtedness, it’s not going to get better,” she said.
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.