For those of you who live in North Carolina, scroll down to read the second article on how our Democrat Governor is planning to veto a bill that does not include Medicaid expansion.   Nancy


State Medicaid Tax Trap

The bill for expansion hits business in Rhode Island.

May 3, 2019

Medicaid expansion under ObamaCare was sold as a free federal lunch for the states, but the bill is now coming due. Witness Gov. Gina Raimondo’s plan to tax businesses that employ low-income workers to fund Rhode Island’s booming Medicaid case load. Look for this soon in a state near you.

Ms. Raimondo has proposed a 10% payroll tax on businesses with more than 300 workers for each employee who enrolls in Medicaid. ObamaCare requires businesses with more than 50 full-time workers to offer health insurance and duns employers $3,750 for each employee who purchases a plan on the exchanges with a federal subsidy.

But many low-income private employees sign up for Medicaid because they pay nothing. By contrast, the average family earning below 200% of the poverty line with employer coverage will pay about 14% of income on premiums and out-of-pocket costs, according to the Peterson-Kaiser Health System Tracker. More workers also qualify now because ObamaCare’s expansion increased Medicaid eligibility to 138% of the poverty line.

Medicaid enrollment in Rhode Island has increased 63% since 2014. In 2013 the state projected about 40,610 low-income childless adults would become eligible, yet 119,754 have since signed up. While the feds have picked up most of the tab, state Medicaid spending has also increased by more than 25% since 2013.

Last year 6,428 more people enrolled in Medicaid than Rhode Island estimated and spending tracked nearly $20 million above budget projections—about as much as Ms. Raimondo’s new employer tax would raise. “The biggest part of our budget is Medicaid, over $1 billion a year,” Ms. Raimondo said recently. “The reality is this is a growing cost and you are getting the benefit of an employee with health insurance. To pay a small piece of our cost, I think, is reasonable.”

Another reality is her Medicaid tax would discourage businesses from hiring low-income workers and prompt many to shift jobs to other states or automate work where possible. Employers won’t know whether their workers enroll in Medicaid until they get the state’s tax bill, and some can’t afford to provide even low- or no-cost plans.

Ms. Raimondo deserves some sympathy since ObamaCare strapped the state in a straitjacket. In 2008 the Bush Administration issued Rhode Island a global waiver that capped federal payments while providing flexibility to shift patients to managed care, among other reforms. The waiver helped the state reduce per-patient costs, but its reforms have mostly been negated by ObamaCare.

As the state explained in its application last year for a waiver extension: “The ACA’s eligibility changes and maintenance of effort requirements brought considerable fiscal uncertainty to the State, and limited its ability to exercise the Demonstration’s existing authorities and flexibilities to institute additional program changes.”

The disappointment is that Ms. Raimondo hasn’t sought flexibility from the Trump Administration to impose cost-sharing and work requirements as other states have done. In 2011 Ms. Raimondo championed public pension reforms that were among the boldest in the country. Yet as her party has moved left since she became Governor, so has she.

Ms. Raimondo has mandated that employers provide paid sick leave, pushed free community college, and proposed extending the state 7% sales tax to services and digital downloads. At the same time the state’s rate of private job growth (0.39%) has trailed Massachusetts (2.1%), New Hampshire (2.7%) and even Connecticut (0.63%). No doubt Connecticut Gov. Ned Lamont will welcome a competitor for worst business climate in New England.

Cooper to Veto State Budget Without Medicaid Expansion?

RALEIGH – Democrats have been beating the Medicaid Expansion drum for years. Governor Roy Cooper and Democrats in the General Assembly made it clear last year that Medicaid Expansion was their top priority. They’ve filed bills to expand, made expansion a key thrust in the recent ‘teacher’ protest, and even pulled some Republicans into proving they ‘care’ by making proposalsto create entirely new government healthcare entitlement programs aimed at the same population Medicaid expansion would affect.

Now it looks like Governor Cooper is preparing to veto the biennial state budget if it does not include Medicaid expansion.

The N.C House, after a bevy of appropriations committee deliberations this week, is expected to soon pass a budget bill over to the senate. That bill does not include expansion, which is reassuring considering Republican majorities wouldn’t exactly be sticking to the values their voters subscribe to if they were openly holding hands with Democrats and expanding Big Government entitlement programs.

The governor’s going to veto it,” Wake County Rep. Darren Jackson, the top Democrat in the House, said at the start of Thursday’s hours-long debate over the budget. […]

Jackson proposed sending the budget back to a health care committee to be rewritten to include Medicaid expansion. He said that well over half of the members of the House support some sort of expansion, including both Republicans and Democrats.

And while they might not all agree on the exact details, he said, they ought to at least try finding a compromise that a majority could support. Jackson said the budget only needs 61 votes to pass the House, and he knows of “over 70 members” who support expansion.

“Lets put Medicaid expansion of some sort — what makes sense, what can get 61 votes on this floor — in this budget,” he said.[…]”

We would like to know who those 70 members of the N.C. House that support Medicaid expansion are. We’d like to know because it is important that voters across the Old North State know which Republicans actually believe in the limited government, liberty principles they espouse on the campaign trail, and which ones are more than willing to fold to pressure from the Left and give in to the hubris that often comes with holding office.

There are still lots of problems with healthcare, in this state and around the country. Many of those problems were exacerbated by Obamacare. The appropriate way to address these issues IS NOT WITH MORE GOVERNMENT HEALTHCARE, BUT WITH LESS GOVERNMENT INTRUSION.

If Republicans give in to Medicaid expansion, either in this budget, or in a separate piece of legislation, they will be hammering a big nail in the coffin of the Republican majorities on Jones Street.

Grassroots Republicans are sick and tired of the selling out, the tentative stances, the lack of bold policy driven by truly Republican principles.  Republicans on Jones Street should be loudly and proudly rejecting any mention of Medicaid expansion; snuffing out attempts by  ‘Republican’ members to placate the Left and score compassion points by expanding government involvement in healthcare; and, offering real solutions to alleviate healthcare price inflation and accessibility bottlenecks.

There is PLENTY that can be done on the latter point, starting with a a repeal of the antiquated, ineffective, and disruptive Certificate of Need laws. These are the kind of pushes Republican voters expect them to make; you know, free market and freedom kind of things. Instead we have a Governor threatening to veto a budget that doesn’t include expansion of an entitlement program, and a gaggle of Republicans trying to best each other in proposing laws with a ‘Republican’ label that merely expand government all the same.

Conservatives expect Cooper and the Democrats to keep up the pressure to grow government, and smear people that get in the way. That’s just a fact of life when it comes to the Left. However, it’d be a lot easier to combat it all if we didn’t have so many on our side actually sympathizing with the Left’s goals and finding creative ways to carry their water for them.

As the budget progresses through the state legislature, we’ll keep you apprised of its broad strokes. We will also do our best to keep the pressure on Republicans to govern according principles, instead of the all too common drift toward Bigger Government with an ‘R’ beside it.




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