RALEIGH, N.C. (WNCN) — Most Democrats and now more Republicans in the General Assembly support the expansion of Medicaid in the state.
But as a bill that would expand those rolls passed the Senate this week and now goes to the House, there’s a question of just how many more people that would wind up covering.
THE CLAIM: Jordan Roberts, the director of government affairs for the conservative John Locke Foundation, told lawmakers recently that he projected the final figure could be “upwards of 3.3 million people.”
“That’s 1 out of every 3 in the state,” he said. “We don’t think that’s a sustainable program.”
THE FACTS: Roberts’ statement contains two items worth checking — that raw number, and the claim about sustainability.
Two other experts say the 3.3 million figure is an overestimate.
“That’s really bad math,” said Hyun Namkoong of the left-leaning North Carolina Justice Center.
“One-third sounds a bit high, but 1 in 4 to 1 in 5 is not,” said Donald Taylor, a professor in Duke University’s Sanford School of Public Policy and an expert on health policy.
The state Department of Health and Human Services counts 2.7 million North Carolinians presently on Medicaid.
When asked where the 3.3 million came from, Roberts said he added the NCDHHS number to a projection of another 600,000 from the Urban Institute.
On that calculation, Namkoong called foul.
“We can't just add a straight 600,000 to the current number of Medicaid enrollees because of the public health emergency that we are in,” she said.
The reason for that, Namkoong said, is because the state has yet to perform its redetermination — the process by which it checks to make sure people who presently on Medicaid will continue to be eligible for it.
“We do have a higher number of folks who are on Medicaid right now, but it’s because we haven't done the redetermination,” she said. “And a lot of those folks would actually be transferred to Medicaid expansion if we decided to expand.”
Roberts responded by saying he stands by his numbers.
“We have no idea when the public health emergency will end or when eligibility redetermination will happen so in my estimation this will be the current situation for some time,” he said.
That brings us to the second item — sustainability.
According to federal data — which are dated Jan. 1 and differ from the ones provided by NCDHHS — 18 percent of North Carolina’s population is covered by Medicaid, a rate that ranks 41st nationally.
But let’s assume for a moment that Roberts’ 3.3 million is indeed accurate. In a state with nearly 10.6 million people, that would increase the rate to 31.3 percent.
But that wouldn’t even be the highest rate in the nation: Five states would rank even higher, led by New Mexico at nearly 39 percent.
“By expanding Medicaid, we are creating a much more sustainable source of funding for our state budget because the federal government is contributing 90 percent of the cost.,” Namkoong said.