Medicaid expansion will likely be a significant issue in NC this year. Indeed, Gov. McCrory continues to indicate he is willing to expand if NC is first able to make “reforms” to the program.
Many arguments have been made for and against Medicaid expansion in the Tar Heel State. One argument for expansion gaining momentum of late is that expanding Medicaid will create jobs due to the money “drawn down” from the federal government and spent in the state. Multiple studies have been released recently purporting to show how NC will gain thousands of jobs courtesy of Medicaid expansion.
These studies, however, suffer from a fatal flaw in their assumptions. In this article, previously printed by the N&O, I explain why the job creation claims are misguided. Here’s a sample:
The fatal flaw in this methodology, however, is that in order to “draw down” federal Medicaid dollars, actual medical services need to be provided to Medicaid patients. It is only when doctors actually treat Medicaid patients that the federal government pays those providers for the services.
For instance, the NCIOM study assumes that more than 500,000 North Carolinians will not only enroll in Medicaid under expansion, but each would receive on average roughly $4,300 in medical services each year. As these services are rendered, the doctors and hospitals are paid by the federal Medicaid program, which injects the money into the state’s economy and spurs the job creation, according to the studies.
But here’s where the studies’ jobs claims fall apart: North Carolina already suffers from a shortage of doctors.
Such extreme supply constraints tells us that if North Carolina were to expand Medicaid, the newly enrolled would have great difficulty actually seeing a doctor. Coverage will not equal access……With no services provided, no federal dollars are “drawn down” to Medicaid providers. The whole premise behind the studies purporting to show job creation is unsupportable.
On a related note, this HHS report from December examined Medicaid enrollee access to medical providers. The report’s findings confirm the concerns I outlined regarding lack of access:
- Half of the primary care and specialty providers contacted in the study could not offer appointments to Medicaid enrollees
- among those providers who could offer appointments, more than a quarter had wait times of more than a month and 10 percent had wait times longer than 2 months
Medicaid coverage does not equal access to medical care. To read my whole article, click here.