NC Medicaid: Post-Election: “To Expand or Not to Expand.”

When President Barack Obama and Democrats in Congress authored the 2010 Affordable Care Act, they required that all states expand their Medicaid programs for the poor and disabled. But when the U.S. Supreme Court handed Obama what was hailed as a victory for the health insurance law, the justices dealt the administration one setback. The court ruled that states would have the option of expanding their program but couldn’t be forced to do so.

Pat McCrory has not publicly announced whether he is in favor of Medicaid expansion (Well, actually, at the beginning of his campaign, he stated decidedly that he would not take federal money to expand Medicaid. Toward Election Day, he changed his position to a more grey stance). McCrory stated that he would conduct more research on expanding Mediaid. McCrory was elected to governor. But, technically, Perdue is still governor until January 2013.

In the short term, the state must decide by Nov. 15 whether to apply for federal grant money to plan the law’s implementation. More importantly, states were going to have to decide by Nov. 16 how the state will handle the so-called health exchange – a marketplace where those who do not have employer-provided coverage but are too wealthy to be covered by Medicaid can buy coverage.

Late Friday, the U.S. Department of Health and Human Services extended the deadline for that decision by three months. The deadline is now Feb. 15.

So, now, it will be Gov.-elect Pat McCrory who will make the decision. DHHS took the decision out of Gov. Perdue‘s hands.

A generic government health exchange (where the state works with the federal government) would be a bumpy transition. This state’s Medicaid rules don’t mesh exactly with federal guidelines, meaning there could be confusion over whether someone should be sent to the exchange or apply for Medicaid. Also, the state has a new benefits application system getting ready to go online that could make applying for health coverage through and exchange easier. That system wouldn’t be used if a generic federal approach comes about.

So how will McCrory decide? McCrory said he doesn’t have enough information to make a decision yet.  “There’s total confusion,” McCrory said Thursday of the federal health care law. “Nobody understands the bill or its implementation.”

We have 3 months, folks, to study up. Feb. 3, 2012, is decision day.

About kemanuel

Medicare and Medicaid Regulatory Compliance Litigator

Posted on November 13, 2012, in Medicaid and tagged , , , , , , , , , . Bookmark the permalink. Leave a comment.

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