McCrory punts on Medicaid expansion

Gov. Pat McCrory is showing, again, who’s in charge in Raleigh. And it’s not Pat McCrory.

After repeatedly floating trial balloons about expanding Medicaid in North Carolina, McCrory now says he will kick that can down the road until summer at the earliest, and probably until 2016. McCrory told the Associated Press this week that he won’t make a recommendation about Medicaid expansion until after the U.S. Supreme Court rules in an Obamacare case, probably this summer.

“I will not make any recommendation as to whether or not we extend insurance for the uninsured until the court case because there are so many ramifications of the court case,” McCrory told the AP.

McCrory has indicated several times that he might be open to Medicaid expansion, a political lightning rod because it is part of the Affordable Care Act. Now it appears that McCrory has gotten the message from legislative leaders: Medicaid expansion is going nowhere. So McCrory has chosen not to fight for the uninsured, not to use his bully pulpit on the issue.

Twenty-eight states and the District of Columbia have expanded Medicaid eligibility under the ACA, including 10 led by Republican governors. Many or all of those GOP governors reversed their opposition under pressure from voters and hospitals who wanted the billions of dollars that would come to their states. Seven more states are considering expansion.

The Supreme Court will hear oral arguments next month in a case challenging some federal tax credits for coverage obtained through federal, not state, online exchanges. That case has not stopped a majority of U.S. states from moving forward.

Some 300,000 to 500,000 uninsured North Carolinians would qualify for federally funded coverage under the ACA. The federal government would pay 100 percent of the cost in the early years, and 90 percent thereafter. By not accepting the federal money, North Carolinians don’t save those tax dollars; they send them to other states.

It would have been a tough fight to get any kind of expansion through the N.C. legislature. But McCrory won’t even try. That’s a political calculation that could go either way in McCrory’s re-election bid next year.

-- Taylor Batten