More Information

• Dole, Hagan on final vote drives
  
• Voters Guide: Our region's races
  
• The candidates' stances on health care

  Children

  Perdue would increase coverage of low-income children by expanding N.C. Health Choice, a federal-state matching program also known as S-CHIP. That plan insures nearly 130,000 children in families that earn up to twice the federal poverty level, or about $42,000 per year.

  Perdue also backs N.C. Kids Care, enacted by the General Assembly in 2007, which would expand coverage for children in families with incomes up to 300 percent of the poverty level, or about $63,000. That would provide nearly universal coverage to children in the state, according to the N.C. Institute of Medicine. (Kids Care is on hold since the matching share from the federal government was not approved.) Perdue would also allow any family to buy insurance through that program, on a sliding scale or for the full premium, to cover children who are uninsured or uninsurable because of existing illness.

  McCrory doesn't mention Health Choice in proposals for health reform outlined on his Web site. Instead, McCrory favors reinstating the child health-care tax credit that began in 1999 but was repealed by the legislature in 2001 when they were seeking cost savings during a budget crisis.

  Low-income parents

  Perdue cites studies that say the only way to achieve universal coverage for children is to make insurance more affordable for their parents. To do that, she would expand Medicaid to cover low-income adults who earn up to 150 percent of the federal poverty level, or about $32,000 per year. Parents would have to prove their children also have coverage. Currently, only low-income pregnant women and new mothers qualify for Medicaid.

  Medicaid expenses are shared – one third paid by the state and two thirds by the federal government.

  McCrory doesn't speak specifically about parents, but he talks about giving people “choice” instead of forcing them into particular insurance programs. He suggests making insurance more affordable through tax credits and elimination of some state-mandated benefits that contribute to higher premiums. (See below)

  He would also reduce costs in the Medicaid program by putting more emphasis on prevention and permitting Medicaid recipients to opt out of the program in favor of less expensive, leaner private policies without so many mandated benefits.

  Mandates

  McCrory wants to eliminate some insurance benefits that are mandated by state law so insurance companies can offer a bare-bones, low-cost benefit plan. He says that would enable more people to buy private insurance.

  N.C. laws and regulations mandate that insurance plans must cover more than 40 benefits, including screening for breast and colorectal cancer and a minimum 48-hour hospital stay for mother and newborn after a vaginal birth. McCrory has not specified which mandates he would eliminate, but aides suggested some policy holders might choose to buy less expensive plans without mandates to cover pastoral counseling or chiropractic care.

  Perdue opposes the elimination of mandates. She says such a reduction would not significantly lower the cost of insurance, and “stripped down” plans would leave more people “under-insured.”

  Tax credits

  McCrory favors giving tax credits to small businesses that provide health insurance to their employees. He has not specified the size of the credits he would support.

  The General Assembly approved a $250-per-employee credit in 2006. Nationally, the average annual premium for a family in an employer-sponsored plan was more than $12,000 in 2007, according to the Kaiser Family Foundation.

  McCrory also favors permitting small businesses to pool their employees and their risk of illness to make insurance more affordable.

  Perdue also favors tax credits to help employees of small businesses buy employer-sponsored insurance or individual plans. She hasn't specified the size of the credit she supports.

  Libertarian Mike Munger

  Instead of expanding government programs to cover the uninsured, Munger emphasizes cost-cutting to make basic medical care more affordable. “My main concern is not to make sure that everybody has insurance paid for by the state. It's that everybody has affordable high-quality health care. If we had a system where people could pay for their own health care, that would be better.”

  He would renegotiate Medicaid rates so North Carolina doesn't reimburse doctors as much as 30 percent more than Virginia and South Carolina for treating Medicaid patients.

  Munger would like to increase the number of primary care doctors as well as physician assistants and nurse practitioners who can provide primary care at lower cost. He would also expand the authority of PAs and nurse practitioners.

  He supports insurance for unexpected major medical problems, but thinks primary care should be more affordable so consumers can pay for it themselves. “I have auto insurance, but it doesn't pay for oil changes.”

  He supports current programs that provide health insurance for children.

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