Raleigh News & Observer: McCrory misses chance on Medicaid

March 8, 2013 

North Carolina Gov. Pat McCrory has expressed his admiration for the man he’s called “Boss,” New Jersey Gov. Chris Christie. There are good reasons for the admiration, not the least of which are Christie’s candor (he releases his tax returns to the public as soon as he files them), his statesmanship (he thanked President Obama and praised him in the aftermath of Hurricane Sandy) and the fact that Republican Christie is governor of a Democratic state yet he’s got a nearly 3-out-of-4 popularity rating.

And here’s one more reason to admire Christie: Despite hard-line Republican opposition to the expansion of Medicaid, made possible by the Affordable Care Act, Christie decided for the good of his state and for poor people in need of health care to accept a federal deal that makes more people eligible for help. It’s help the federal government, by the way, will pay for.

In North Carolina, 500,000 people might have been helped, but Republican lawmakers, suspicious of anything to do with the federal government – they also declined to join in running a health insurance exchange that will help people find affordable insurance – rejected Medicaid expansion. McCrory signed off on that position and on Wednesday he literally signed the measure about Medicaid and the health exchanges into law in the State Capitol.

So he’s not such a Chris Christie fan after all?

Just giving up?

In going along, the governor surrendered leadership on a key issue to the General Assembly, where Republicans are in charge and in the process of scuttling spending that helps many citizens in need. Now the rejection of the Medicaid extension joins the rejection of an unemployment benefits extension. Both forms of assistance would have been paid by the federal government.

McCrory missed an opportunity to demonstrate his political independence and, more importantly, to do the right thing. That’s what Christie did, and it’s what Florida Gov. Rick Scott, a vocal opponent of Obamacare, did in the name of helping residents of their states.

The governor’s argument for rejecting the Medicaid expansion was that the state Department of Health and Human Services’ division that oversees Medicaid payments “is broken” and that it would be unwise to bring more people into the system until its administrative lapses are corrected. He also shares the skepticism of many Republicans in the legislature who think the federal government can’t afford to pay for more Medicaid coverage. They think the feds will renege on their offer to cover the expense of the first three years of expansion entirely and then cover 90 percent afterward.

But these reasons ring hollow and serve more as political cover for the rejection than as a justification for it. The governor’s newly hired Medicaid director, Carol Steckel, says the administrative issues with DHHS can be fixed in a few months. And projections that the federal government won’t come through on its promised payments have no factual basis.

So what’s the real reason? The usual one: If it comes from President Obama, we don’t want it, and we don’t much care what common sense has to do with it.

The good news for McCrory and North Carolina is that this rejection is a mistake he can take back. The offer of federal support for expanding Medicaid will remain on the table. Next year, wiser and perhaps more confident about leading, McCrory will have another chance to persuade his fellow Republicans to say yes to a good deal for the state’s needy, the state’s hospitals and the state’s economy.

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