Ever heard of the butterfly effect? The idea is that small changes in initial conditions can mean larger changes elsewhere in a system. A butterfly's wing beat in Raleigh, through complex cause and effect, can make waves in Austin or Alaska. The same can be said of our health care system — if we can find the wing beat.
Created by the U.S. Congress in 1997 as a supplement to traditional Medicaid (§ XXI of the Social Security Act), SCHIP was initially conceived of as a health insurance program for children in low income families. The program is jointly funded by the federal government and the states. Each state is operationally responsible for the program and may set its own eligibility rules at or above federal minimums. North Carolina created its SCHIP program – NC Health Choice – in 1998 (S.L. 1998-1es).
The Civitas Institute has been involved in conducting surveys in North Carolina for more than two years. Every month the voters are asked to pick the issue or program that needs the most attention from state government. During the past two years lower healthcare costs has always been in the top three and usually the top choice.
A slim-majority of 51 percent of North Carolina voters support the $35 billion expansion of the State Children’s Health Insurance Program (SCHIP) that passed Congress and was vetoed by President Bush. The October DecisionMaker Poll conducted by the Civitas Institute indicates, however, that voters do not support the expansion of the program that the legislation established. As approved by Congress, SCHIP would be expanded to cover families of four who earn up to 400 percent over the poverty rate or approximately $82,000 a year. The Civitas study found that 26 percent of North Carolina voters agree with the expansion to include families of four who make between $62,000 and $82,000 a year, while 62 percent oppose the expansion.
I'm not afraid to admit it: I'm middle class. I never knew I needed help paying for my child's health insurance, but apparently I do. Other readers like me may also qualify soon for an expansion of children's Medicaid. Since I may not have to insure my little one, should I get an iPod? A new car? That's right: Congress' expansion of SCHIP means that families at 300 percent of the poverty level could get government-run health care. A family of four in North Carolina making over $60,000 a year would be eligible.
Newsflash: Health insurance is expensive. OK, so that’s not news to anyone. But what may be news to you is why insurance premiums are so high. A common explanation is that health insurance and drug companies are greedy. This narrative is used to justify more intervention in healthcare markets by both state and federal governments. Some familiar voices are even calling for a socialized system like Cuba’s.
The Department of Health & Human Services (DHHS) budget was $4.6 billion for FY2008 and $5.1 billion for FY2009. The DHHS budget thus increased by some $400 million over the previous fiscal year Health & Human Services budget of $4.2 billion. The DHHS budget also created 198 new positions. After years of wrangling over who is responsible for paying for state and federal unfunded mandates, the state agreed to take over the county share of Medicaid payments.
This article was originailly published in the Fayetteville Observer, August 2007 We are often treated to editorials about "desperately needed" programs like children’s Medicaid. This year’s state budget expanded the program to 300 percent of poverty via a program called N.C. Kids’ Care. But do working families in North Carolina really need these programs? Contrary […]
A variety of Medicaid “swap” plans have become major sticking points in this year’s budget negotiations between the North Carolina House and Senate. These plans put real Medicaid reform further into the future and either raise taxes on North Carolina citizens, or set the stage for future tax increases.
Senator Dan Clodfelter (D-Mecklenburg) has recently developed a proposal to shift all nonfederal Medicaid costs in North Carolina to the state government. Unfortunately, this plan fails to address the comprehensive reform needed for a Medicaid system that has grown out of control.
The good news in both the Senate and House budgets is that the expansion of NC Health Choice is again limited to 6 percent a year. The bad news is that legislators want to create a new program – NC Kids’ Care – that would expand taxpayer-subsidized insurance for kids from families earning up to either 225 percent or 300 percent of the federal poverty level (FPL). Currently, 225 percent of FPL for a family of four is $46,463; while 300 percent is $61,950.
A coverage mandate is a legal requirement that dictates that all health insurance policies sold in North Carolina cover certain services, providers, and groups of people. Mandates are the result of laws passed by the General Assembly as a means of regulating the insurance market. Insurance buyers pay for coverage mandates through higher insurance premiums. While some mandates do not affect the price of insurance by very much, others are more costly. North Carolina has 46 mandates, which together have increased the price of health insurance an estimated 41 percent.
A coverage mandate is a legal requirement that dictates that all health insurance policies sold in North Carolina cover certain services, providers, and groups of people. Mandates are the result of laws passed by the General Assembly as a means of regulating the insurance market. Insurance buyers pay for coverage mandates through higher insurance premiums. While some mandates do not affect the price of insurance by very much, others are more costly. North Carolina has 46 mandates, which together have increased the price of health insurance an estimated 29 percent.
House Bill 265, sponsored by Representatives Verla Insko (D-Orange), Hugh Holliman (D-Davidson), Bob England (D-Rutherford) and Alice Underhill (D-Craven), would create a state-sponsored high-risk pool (HRP) for people with serious health conditions that make it difficult to purchase health insurance on the open market. In order to be eligible for the pool a person must not only have a health condition that is difficult to insure, but also be unable to purchase a plan that is below 175 percent of the prevailing market cost. While 34 other states have high-risk pools, the legislation currently being considered differs from many of these plans and could prove very costly to North Carolina taxpayers, as well as the people who enroll in the HRP.