Following the first meeting of the McCrory administration's Medicaid Reform Advisory Group last week, one thing became clear. Medicaid in North Carolina is not "broken," despite the governor's frequent statements to the contrary. Indeed, the Medicaid program is in good enough shape that the "reform" group had trouble figuring out what it was supposed to reform.
McCrory hammered Medicaid from the moment he took office in January, alleging runaway costs and excessive administrative overhead. Neither charge was accurate, but as we're now all well aware about our governor, facts are not central to his narratives.
I don't know if he makes things up, or if he just hears what he wants to hear for purposes of Republican soundbites. Either way, 2013 will go down as the year of McCrory's falsehoods, when citizens realized they'd elected a governor who didn't care whether what he said was true or not.
On subjects big and small, if McCrory was talking, mendacity followed. He said he waded into the Moral Monday protests "all the time" to engage his critics. No, he didn't. He denied ducking petitioners at his Capitol office so he could throw a baseball. Yes, he did.
The trouble with little lies is that they lead to big lies, like the one McCrory told about not cutting unemployment benefits—yes, he did sign a Republican bill to cut them—and the one in which he blamed the elimination of extended unemployment benefits in the state on President Obama.
The latter fabrication mystified McCrory's chroniclers: Why would he say something so patently false? Last Monday, we were given a clue.
The Rev. William Barber, president of the state NAACP, was leading a protest outside Art Pope's office in Raleigh. Pope is the state budget director and multimillionaire string-puller for conservative causes [see related story]. Pope confronted Barber, and as they batted some issues around, Pope blurted out the same crock of bull as McCrory: Extended unemployment benefits were terminated for this state alone, Pope told Barber, because "the federal government declined to grandfather North Carolina's unemployment reforms."
What Pope said, and McCrory before him, has as much relation to reality as blaming Mike Krzyzewski for UNC's loss to Belmont. (Why won't Coach K help the Tar Heels shoot free throws?)
The suspicion: McCrory has no thoughts until Pope's people hand him his talking points.
Here's reality: Congress enacted extended unemployment benefits due to the lousy economy. To qualify, the states were required to maintain their basic benefit levels for as long as the extended-benefits were in place—something which North Carolina, and only North Carolina, refused to do.
I turn now to the economic damage these lies, and the policies they misrepresent, are doing to North Carolina. The cuts to unemployment took effect July 1, slashing the amount and duration of aid to North Carolinians who lose their jobs. The fact that these cuts disqualified the long-term unemployed in our state from collecting extended benefits means that, for the last six months of 2013, the North Carolina economy will forgo $600 million in federal aid we should've had.
If Congress renews the extended-benefits program for all or part of 2014 (it's an issue currently) and we remain ineligible, the toll on North Carolina will only grow.
For sheer stupidity, however, even that pales in comparison to the way McCrory and the Republicans have mangled Medicaid. On Jan. 31, McCrory held a press conference to declare Medicaid "broken." State Auditor Beth Wood joined him and must share in the blame. The two claimed, based on Wood's audit, that North Carolina's administrative costs were 38 percent higher than in nine comparable states. They claimed Medicaid spending was over budget.
Wood, a Democrat, was seeking the limelight as a nonpartisan watchdog. Unfortunately, her audit was wrong about administrative costs, which in other states were blended with managed-care accounts but in North Carolina were reported separately—a fact known within McCrory's Department of Health and Human Services.
When independent analysts such as the N.C. Justice Center's Adam Searing and Rose Hoban of N.C. Health News howled, the General Assembly's Fiscal Research Division took a closer look and determined, in a recent report, that far from being excessive, our administrative costs are relatively low.
As for Medicaid spending, as McCrory's advisory group heard Thursday, our costs are in line with other states. In the past two years, they've increased just 2.7 percent and 2.2 percent, according to Rick Brennan, chief financial officer for the program. From 2007–10, according to the Kaiser Family Foundation, our rate of increase was the lowest in the nation. [See this also.]
How, then, could McCrory and Wood say spending was out of control? It's because Republicans in the Legislature budgeted too little for what is, after all, a federal and state entitlement program.
But realize this: For every dollar North Carolina puts into Medicaid, the federal government puts in four. (Overall, Brennan said, the state's share is 21 percent.)
McCrory used the fiction that Medicaid was broken to justify refusing to accept the Medicaid expansion under Obamacare—which would extend coverage to some 377,000 low-income North Carolinians who are currently uninsured.
Medicaid expansion would be 100 percent federally funded for the first three years, 90 percent thereafter. North Carolina is rejecting $2.6 billion a year in free federal money, according to the Commonwealth Fund, some of which would replace indigent-care aid we're also not going to get. As a result, hospitals are laying off workers. Some 25,000 health care jobs that would've been created—won't be.
Here's the kicker. The state Department of Commerce reported last week that the unemployment rate dropped in the past year from 9 percent to 7.5. Why? It's because many of those out of work either retired or gave up looking. From last October to this, including the first 10 months of McCrory's watch, jobs in our state declined by 13,000. They were growing before McCrory took office.
This article appeared in print with the headline "McCrory: He can't handle the truth."