Big Biden Deal out of North Carolina yesterday.
Because the federal government is funding 95 percent of the cost of Medicaid expansion, Cooper called on hospitals to put assessments on themselves to generate the other 5 percent because they are “by far the largest beneficiaries” of any expansion.
Cooper said he plans to file by Friday an amendment to North Carolina’s Medicaid plan submitted to federal regulators to allow an expansion.
State lawmakers in 2013 passed legislation blocking any expansion, and the governor told reporters after his speech he believes that law infringes on his executive powers.
“I do believe it invades on the core executive authority of the governor to accept federal funds to look out for the public health of the people, but I would rather not get into a dispute with that. I think it’s important for us to try to be cooperative,” he said. “Someone needs to take action. So, I’m going to take action, and then we’ll try to work it out with them.”
My first thought is that this is a Big Biden Deal. North Carolina is one of the Big-4 non-Expansion states. If Governor Cooper (D-NC) can get expansion, that is a massive improvement in the welfare and well being of the currently uncovered.
My second thought is that this would be a great time to be a North Carolina lawyer specializing in North Carolina constitutional law as the billable hours were already promising a great year with the Lame Duck disputes going before the state courts. Now this will almost inevitably be in court by the weekend. And then we have a great question as to which court can hear North Carolina constitutional questions as those are now in dispute given the Lame Duck.
I think the effort is to create facts on the ground for any repeal and replace by getting North Carolina qualified as an expansion state before any potential cut-off date that comes out of Congress for the status quo.
So good news from last night!
Sister Rail Gun of Warm Humanitarianism
That’s my Gov!
(All together now: Coop! There it is!)
I do admit to being disappointed that the inaugural parade on Saturday had to be canceled.
The Repubs will fight this tooth and nail. I love it. It puts the onus on them and I don’t see how they can spin it. (they will, I just don’t see how it will do them any good)
Thanks for the update Mayhew.
It’s almost as if elections have consequences.
And so begins the efforts to clean up what the Gushing Over Putin party has done to us here in NC.
Go get ’em Coop!
I’m stealing that.
Great to see Governor Cooper doing something about healthcare insurance in N.C. This is a BBD. Another example of elections having consequences.
Great news. Maybe Fighting Roy Cooper can go national in a few years. Smart, principled guy.
The Rethug spin is ” Cooper is trying to raise taxes after only 3 days in office” the response should be if we paid a dollar the federal government pays 19 a great deal for taxpayers
NC is one of those states where smaller rural hospitals had to close due to Medicaid not being expanded.
@Carolina Dave: math is never their strong point.
Doesn’t seem to matter, the expansion is about to be repealed.
@Elizabelle: Math has a very liberal bias. One branch even has a Muslim name!
Nice article and I completely agree with you as Lawyers are very important now a days, they are the one who deals with all the legal issues and gives the best legal advise being in law
Richard, partly off-topic: what is the whole “across state lines” thing, who is pushing it and why? How does it inhabit the basic tension between risk pooling and risk segmentation?
@Frank Wilhoit: State lines in insurance markets are a legacy of massive insurance fraud in the nineteenth century, and states have variably strict regimes for regulating insurers. Make insurance a national market like credit cards, and insurance companies will flee tight regimes like New York for laissez faire bases (and permissive legal venues) like North Dakota. It´s another scam.
WRAL (via Richard Mayhew @ Top):
If that’s necessary to get it done, then, fine, do it.
But since this is an insurance program, wouldn’t it be cheaper for everyone in NC to spread the cost over the whole population by budgeting for it in general revenues (even if it requires a slight increase in sales tax or some other general tax), than by taxing the hospitals – who will just pass off the cost increase in concentrated form to their patients, and at a markup?
I mean, not to put to fine a point on it, but aren’t the largest beneficiaries the citizens & patients of NC, rather than the hospitals?
Sister Rail Gun of Warm Humanitarianism
@JGabriel: Sure, but Art Pope still runs the General Assembly. Cooper is actually flying in the face of a law passed by the GA several years ago forbidding the acceptance of the expansion.
There are probably several things going on here. First, there’s the “get any benefits we can if/while Congress dithers about repeal”, second would be “get us in under the wire in case Congress repeals by grandfathering in existing expansion states for a wind-down”, third would be yet another in-your-face “this is an unconstitutional law and I’m calling you on it” to the GA.
Experts in NC Constitutional Law are going to be going nuts the next few years, because Cooper has made no bones about his opinion of the GA’s legislative efforts.
@Frank Wilhoit: here’s the problem I see with out of state coverage:
-Who oversees the providers to ensure timely delivery of services
-what physicians/specialists/gyn/neuro/etc., will accept you as a patient
– when can you get an appointment
-What’s covered (preventive/perscriptions/durable goods)
How are complaints handled?
Which states laws apply?
Where do you litigate?
Out of state attorneys?
I am hard pressed to think of an easier insurance company from out of state that cares for anything other than grabbing the money, denying proper care, and laughing at the ease of shaking down the rube’s and those who have few options for health insurance.
Mike in NC
The Teabaggers in the NCGA will never go along with helping their constituents. Everything they do is in service to Art Pope and the Koch brothers.
@Frank Wilhoit: will reply on length soon… It is econ 101 thinking
J R in WV
Anyone who can’t see the plain old profit in $1 -> $20 – spending one state dollar to get twenty federal dollars – is really really too dumb to qualify to hole any public office. NC stands to get money from the blue states, in order to provide better citizen services, keep rural local hospitals in business, and prevent very expensive health care to people who become critically ill for lack of ordinary health care.
This whole Health Insurance thing shows the lack of an ability to make logical decisions based upon logical chains of evidence. And we solicit these folks to sit on juries where they are expected to follow complex logical chains of evidence that are complicated, where smart people have invested lots of time and energy into hiding the evidence.
Not going to matter. ACA is toast. The “Republicans in disarray” nonsense that Democrats have been telling themselves is just that – nonsense. Ignore Trump – he’s a tweeting figurehead who will tweet in the wee hours about the “EVULLS OF OBUMMERCARE” to get the rubes riled up, while Pence does the actual work of riding heard on Ryan and McConnell. He’s as dangerous a VP as Cheney and possibly more so, as he’s a theocratic nut job – which means he’s completely immune to logic and has long ago sold his soul to Satan.
ACA is toast. They do not CARE. And they are going to ram it through straight out the gate and count on the electorate being as stupid as it always is – which means counting on 50% of Americans being unable to remember anything that happened more than 2 weeks ago. (See, repeated GOP attempts to shutdown govt over debt ceiling that had absolutely no effect at the ballot box.)
They will get that out of the way quickly so they can focus on their priority, which WILL happen – massive tax cuts for corporations and the wealthy, financed by completely gutting the safety net. Which will ALSO happen.
GOP has been drinking Democrats milkshake since 1994. It took the combined cock-up of creating a global financial meltdown AND a disastrous war in the Middle East to result in Democrats LUCKING into power for a measly 4 years (only 2 of which they had control of WH).
And if for some fluke the economy goes into the complete toilet and Dems somehow get control in 4 years, Dems will handed a red ink budget in a recession, complete inability to raise taxes (because TAXES BAD), and oversee austerity budgeting that will quickly turn on them.
@Sister Rail Gun of Warm Humanitarianism: Danke.