For 10 years, North Carolina state Sen. Phil Berger remained opposed to expanding Medicaid, the public insurance program that provides health coverage to low-income Americans.
Ever since the Affordable Care Act was passed in 2010 and Medicaid expansion was approved in 2014, Sen. Berger watched other states add hundreds of thousands to their Medicaid rolls, certain that one day they’d be caught holding the short end of the stick.
As president pro tempore of the North Carolina Senate, Berger holds the most powerful position in the chamber, and as such stymied any action to expand the benefits program despite overwhelming public support.
Allowing more North Carolinians on the rolls would discourage people from working, Berger had contended, and likely bankrupt the state because the federal government was bound to renege on its pledge to fund 90 percent of the expansion.
With traditional Medicaid, states pick up anywhere from 50 percent to 75 percent of the tab, depending on a state’s per capita income. In North Carolina, it’s 73 percent; Kansas 66 percent. Were North Carolina be made responsible to pay the same percentage for an extra 600,000 low-income applicants, “that could bust our budget in significant ways,” Berger has justified.
Understandable.
But, stubbornly misguided.
As Berger has since learned, no matter who’s president or which party is in control of Congress, the 90 percent federal funding has remained solid.
The bottom is not going to fall out. “It ain’t going to happen,” he said.
So, expanding Medicaid, “makes perfect sense from a budgeting standpoint at this time,” Berger said in a recent NewsHour program.
Voilá. Berger is a believer.
STATE AFTER state has successfully expanded Medicaid, providing their governments and their hospitals, health clinics and citizens better healthcare services and funding streams. Kansas is currently refusing to accept $370 million to $450 million from the federal government in the initial two years after expanding Medicaid, according to State Medicaid Director Sarah Fertig.
Critically, states that took advantage of the additional funding experienced job growth, particularly in the rural health care sector where hospitals and clinics have a higher rate of unpaid bills.
Allen County Regional Hospital, for example, historically has written off more than $1.5 million in annual debt because its clientele are unable to pay their bills, a casualty of inadequate coverage.
What Berger has also come to understand is that those qualifying for such services are not deadbeats, as opponents are wont to characterize.
“The reality is that [these] are people who are actually working full time, such as a single female with one or two children who works a full-time job,” he said.
