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Medicaid expansion has been talked about since the governor vetoed the state budget over this issue. I would like to share some of my thoughts on the subject. Medicaid expansion is a complex issue with several pros and cons. It is certainly not worth a major budget stalemate.
Did the Affordable Care Act make health insurance more affordable? No. Health insurance premiums almost tripled for most people. Those with a subsidized plan have such a large deductible that they can’t use it when they need it. Medical bills increased to cover the lower payment rates. Was it a good idea to take funds from Medicare to expand Medicaid? I don’t think so. Medicare is the program that helps senior citizens. Medicare patients have very few ways to increase their income to pay the higher Medicare copays. The working poor, that Medicaid expansion covers, often can increase their income. These are federal programs. As a state legislator, there is nothing that I can do about it.
Should the state of North Carolina take part in the Medicaid expansion program? It is true that there is a pool of federal money available that our medical providers could be receiving. Proponents say that it will create jobs. I don’t believe that. We don’t have medical providers in our community looking for jobs, especially at Medicaid rates. It is hard to get an appointment to see them now.
I don’t believe that it will increase access for patients. They go to the ER now and they will continue to go to the ER. The federal money would help our ERs. I ran an ER and it was paid by less than half the patients and most of those were Medicare. More money for ER visits would help our hospitals. The biggest risk of Medicaid expansion is that Medicaid spending could get out of control again.
Ohio has become the poster child for a state that expanded Medicaid and let it get out of control. When I started in state government, Medicaid spending was out of control and there was no money for education growth. We got Medicaid under control and have made large investments in education and teacher pay since then. Education and Medicaid are the two largest drivers of the state budget.
Rep. Donny Lambeth is a retired hospital administrator from Winston-Salem. He successfully led the effort to get Medicaid back under control. He has a plan now to use the federal money from Medicaid expansion to help our hospitals. The hospitals would provide the matching funds, so the state budget and the taxpayers would not be put at risk. I have learned to trust Rep. Lambeth and I am supportive of his plan, The Working Families Act.
There are many Republicans and conservative Democrats that are still leery of the risk of Medicaid expansion. There are many Democrats that don’t care how much it will cost. I am supportive of the Republican plan to expand Medicaid but I don’t think it is as important as all of the good things in the state budget.
Larry Yarborough is a Republican member of the North Carolina General Assembly representing the state’s 2nd House district, including constituents in Granville and Person counties.