North Carolinians can expect to spend between 3 percent and 8 percent more on Medicaid if either of the health care bills before Congress becomes law, according to a report released by the state Department of Health and Human Services.
The House version of the bill calls for extending Medicaid to people with incomes up to 150 percent of the federal poverty level. The Senate version cuts off eligibility at 133 percent of the poverty level. The program now covers people living at 100 percent or less of the poverty level.
If the House has its way, the state of North Carolina would inherit an estimated $1.8 billion in additional Medicaid costs over the course of seven years, 2013-19. The Senate version of the bill would saddle the state with a $740 million obligation over the same period of time.
North Carolina House Minority Leader Paul Stam, R-Wake, obtained a copy of the report. He hoped the cost estimates for Medicaid expansion would give state lawmakers “one more reason to oppose the health care bill.”
The Medicaid mandate is not Stam’s biggest beef with the bill. He sees the mandate forcing all individuals to buy health insurance as the most dangerous aspect of the legislation.
Although he believes there are several more pressing reasons for opposing the bill, Stam hopes a provision shifting costs to the states would convince Gov. Bev Perdue and Democrats in the General Assembly to reconsider the “consequences of their support.”
If the final health care bill expands Medicaid to people living at 150 percent of the poverty level, North Carolina would have to spend close to $400 million more per year on the program. That would represent a 2 percent increase in the state budget.
While the federal government can run a deficit indefinitely, most state constitutions require balanced budgets. That would leave North Carolina lawmakers with two choices to come up with the extra cash — tax more or cut or cut services that aren’t mandated by the federal government.
Some say the health care bill would actually reduce the federal deficit. Stam said that’s possible, but the only way the federal government could implement a new multibillion-dollar program and save money is by passing the additional cost to the states.
Taxpayers will receive the bill in the end, he said, either in higher federal taxes or tax increases from the states.
Sara Burrows is an associate editor of Carolina Journal.