Shouldn't someone holding a major statewide office, and running for higher office, understand the basics of finance and politics?
From the N&O:
State Attorney General Roy Cooper said the state should reconsider its decision to not expand Medicaid, saying Republicans “put politics over policy” to deny the state financial benefits and working poor people health insurance. … Cooper, a Democrat planning a run for governor in 2016, hit many of the pro-expansion talking points: the federal government would pay 100 percent of the cost of expansion in the first three years, expansion would add jobs, and more people would have health insurance. After three years. federal support would drop gradually to 90 percent by 2020.
Memo to the AG: We do not know the future. We cannot control it. We can't control Congress. And the Federal coffers are awash in IOUs. Taking of the federal government on its "promise" to fund Medicaid is like responding to an email that promises you millions, if only you'll supply your birthdate and bank account number.
Here's a North Carolina story that illustrates this reality in miniature. According to the Associated Press:
Jo Ann Freeman says her father told her before he died to hold on to the family's Bertie County farmland because she could always live off of it, and besides, "God's not making any more." So tobacco was still growing there in 2004 when Congress ended the allotment system that gave people the right to farm and sell the golden leaf under a Depression-era price support program. In exchange, more than 400,000 right holders and farm operators nationwide would receive annual payments through 2014 for each pound of flue-cured, burley or other tobacco they were allowed to grow.
Today, people like Freeman might not benefit fully from the last annual payments. U.S. Department of Agriculture officials say the payments are subject to the next round of automatic budget cuts that take effect in mid-January. The department announced Friday that sequestration cuts are poised to result in a 7.2 percent reduction — unless Congress changes its mind.
That is just one of the first foretastes of what is to come. The federal government is, officially, $17 trillion in the red. It is on the hook for tens of trillions of dollars more. More and more, Washington won't be able to meet its obligations. It's broke. It's going to renege on many, many of its promises.
Here's how it plays out with Medicaid: Budget crises will keep coming. Congress will realize that to save billions it merely has to trim its Medicaid payments to the states. When the states howl, Congress will say: The states have to start paying their fair share. Don't you state legislators care about the poor?
Meanwhile, there is solid proof showing that Medicaid fails to help the poor. As a new book puts it: "The medical literature reveals a $450 billion-a-year scandal: that people on Medicaid have far worse health outcomes than those with private insurance, and no better outcomes than those with no insurance at all."
North Carolina must avoid further entanglement in Medicaid until the health program's finances and practices are thoroughly reformed, and until Washington gets its own budget in order.
I'm mindful that might be a very long wait.