Gov. Roy Cooper’s bi-annual State of the State address outlines his vision for North Carolina over the next 2 years. Unsurprisingly, expanding the state’s Medicaid program was a top priority for Cooper.
While discussing expansion, Cooper highlighted Boone pediatrician Dr. Gregory Adams. This seemed to be an emotional appeal to persuade North Carolinians that children will benefit from Medicaid expansion. The governor’s press release gives this blurb about Adams:
“Dr. Adams, a pediatrician practicing in Watauga County, has been in practice for more than 35 years. Dr. Adams is concerned about patients with chronic conditions being able to get the health care they need and believes our state should expand Medicaid.”
The wording in the biographic blurb is very carefully chosen. Notice that the statement says that Adams is “concerned about patients,” but it does not specify whether it is his own patients that he is worried about.
That’s because low-income children are already covered under the state’s current Medicaid program.
There is no direct benefit to children for expanding Medicaid. But unless someone was very familiar with current Medicaid eligibility rules, he or she would probably not catch Cooper’s subtle deception. And the governor is not the only one using this dirty trick.
Last month, the president of the North Carolina Pediatric Society wrote an opinion piece for the Raleigh News & Observer on her support for expansion. The piece was titled “Why close the gap? Kids’ health depends on it.”
This title is disingenuous and misleading. The article describes how children are better off if their parents and caregivers are in good health. But that argument ignores two significant facts. The first is that, like low-income children, many low-income parents are already covered under the state’s current Medicaid program. Low-income pregnant women are also covered under the current Medicaid program.
Of individuals eligible to be covered under Medicaid expansion, 78 percent are working-age, able-bodied, childless adults.
The article says that Medicaid expansion would help “future parents” remain in better health. But it does not mention that Medicaid coverage for family planning health services is already available for non-pregnant adults of child-bearing age with an income of up to 195 percent of the federal poverty line.
The second fact conveniently ignored in the article is that Medicaid coverage is not equivalent to better health outcomes. A groundbreaking study in Oregon in 2011 found no positive health improvements between new Medicaid enrollees and the uninsured, with the exception of slightly better mental health outcomes.
One reason for the disconnect between Medicaid coverage and health could be the issue of access. A limited number of doctors in the state accept Medicaid patients at all, and even fewer accept new Medicaid patients. It is likely that current Medicaid recipients already have a harder time finding a doctor than someone with private insurance. Expansion will increase Medicaid enrollment by thirty percent in one year and that will only perpetuate the problem of access, for both the expansion population and current Medicaid enrollees.
The irony? Expansion could worsen the strain on access and actually harm the health of low-income children, parents, pregnant women, and “future parents” that currently receive Medicaid if they have a harder time finding a doctor.
Medicaid expansion proponents know that low-income children and their parents garner public sympathy that they need to push their initiative to victory. Cooper and other expansion proponents are using children as political pawns to advance their big-government agenda – and they are not letting the facts get in their way.