Even as the Obamacare rollout grows more muddled, some issues are becoming clearer — including why NC should be glad it isn’t more entangled in this mess.
First, defenders of the Affordable Care Act have been saying that the state-run exchanges are running better, so North Carolina should have run its own exchange.
Um, it depends on what you mean by “better.” According to a new report:
A CBS News analysis shows that in many of the 15 state-based health insurance exchanges more people are enrolling in Medicaid rather than buying private health insurance. And if that trend continues, there’s concern there won’t be enough healthy people buying health insurance for the system to work.
In other words, instead of being signed up for private insurance, more people are being added to Medicaid, which threatens to bankrupt states. In North Carolina, Medicaid has had cost overruns running into hundreds of millions of dollars a year. Yet patient health outcomes have grown worse. In a state-run exchange, that problem would only grow worse.
First, as we have pointed out in the past, and the above report confirms, Medicaid does little or nothing to improve health outcomes for poor people as a group. Why add thousands and thousands of people on to it?
Second, how long will that federal money for Medicaid keep flowing? Washington faces a debt of $17 trillion. Congress could decide tomorrow to slash how much it pays for Medicaid, leaving the states holding the bag.
Expanding Medicaid would burden North Carolina taxpayers with hundreds of millions of dollars in costs, while doing little for people who do need help.
Getting involved in Obamacare will bog down North Carolina in these problems. It’s better to hope that, once Obamacare completely collapses, North Carolina can extricate itself from this mess and make real reforms.