A good article at Carolina Journal discusses the fact that the recently passed Big, Beautiful Bill in Washington will likely cause the invalidation of Medicaid expansion in North Carolina.
Of course, Governor Josh Stein is demagoguing the situation. He and the other socialists will capitalize if the Raleigh Republicans do not save Medicaid expansion at great expense to NC taxpayers.
He said the following: “There’s no question that the federal government is just dumping expenses onto the state, whether it’s health care or whether it’s SNAP benefits…”
This reveals willful ignorance of the Constitution. There is no rightful role for the federal government to pay for health care or SNAP benefits. The Constitution’s clear, original meaning is that these are state and local activities.
This entire discussion highlights the foolhardiness of passing Medicaid expansion in the first place. It was relatively easy for the Raleigh Republicans to do this because the federal government paid for the vast majority of the expenses incurred.
It all depended on massive federal largesse in the form of taxpayer dollars and deficit dollars. Shut off even part of that flow of money, and the whole thing comes crashing down.
Now, what do the Republicans do?
They can raise taxes significantly, thereby alienating their base. Or they can begin allowing benefits to be cut for all or some beneficiaries, and pay the political price.
Think about Winston-Salem’s Donny Lambeth– the hospital systems’ Republican representative in the NC House– who worked intently to pass Medicaid expansion. What does he do now? He shares the responsibility for this mess.
The Raleigh Republicans are in a no-win situation, and it is their own fault.
This certainly puts the GOP on the horn of a dilemma. I don’t have any suggestions. Punt is not an option.
Having dug themselves in this hole, Fred, it will be interesting to see how they claw their way back out. I think we intuitively know how this ends– with a cave.
“New work requirements of at least 80 hours a month, and the 3.5% provider tax cap that would eliminate all or most of the Healthcare Access and Stabilization Program (HASP), a system of state-directed payments to hospitals, will effectively end Medicaid expansion in the state.”
I believe the “provider tax” is the trick by which NC was sold on the Medicaid expansion in a way in which NC did not have to pay their 10%. My recollection is that the proponents declared and put in the bill that if the full Federal payment ceased that the Medicaid expansion in NC would cease. Can someone more knowledgeable confirm this?
You are correct, J. Sobran, that the proponents of Medicaid expansion made a declaration that if the federal largesse ceased, then Medicaid expansion would terminate. But now they have created an expectation on the part of the general public and the media/ left complex. It is very unseemly to give candy to a baby and then take it away.
They will have enormous difficulty taking candy away from the baby.