More than half the health insurance policies sold on North Carolina’s exchange were to people who were 45 and older. One out of four North Carolina policies were purchased by young adults from 18 to 34.
Enrolling young and healthy people is important because they generally pay more into the system than they take out, helping offset the health care costs of older adults. Independent experts say young adults should make up about 40 percent of enrollments to help keep premiums down.
Even if we adjust for inflation, the spending increase in HHS for North Carolina has been growing by huge amounts over the last 35 years. Why do you ask is it growing so much? The quick and easy answer is Medicaid. Most of the state’s welfare programs are administered through HHS, thus resulting in higher expenditures for the agency, the largest of these being Medicaid. As the largest expenditure in the state’s total budget, we will see how much larger it gets before some legislative action is taken to reform HHS.
Arizona’s governor, Jan Brewer, has vetoed a bill aimed at preventing repeats in the Grand Canyon state of the case in New Mexico where a photographer was fined for declining to do the photography at a gay wedding. This has elicited a great deal of controversy. In this Freeman piece, Brian Lasorsa argues that the attacks made against the bill are not persuasive.
This should be easy. Under the common law of contracts, anyone has the right to decline an offer. The reason for declining is irrelevant. The disappointed offeror is entitled to seek to contract with someone else, but not to sue the offeree who declined. If there is any objection to the AZ bill, it’s that it was too narrow, protecting only those who have religious objections to entering into contracts. The grounds for declining should be irrelevant. There is no aggression in saying “no.” But there is aggression in having the government punish someone because you’re spiteful that he did not want to enter into a contract with you.
Medicaid expansion supporters usually claim that because North Carolina did not expand Medicaid, North Carolina’s federal taxes are funding another state’s Medicaid expansion.
True. But even before Obamacare’s optional Medicaid expansion, North Carolinians who pay federal taxes were already funding other state Medicaid programs. And federal taxpayers in other states were funding North Carolina’s program. That’s how Medicaid works – it is a jointly funded program by the state and federal government.
Avik Roy, author of “How Medicaid Fails the Poor”, further explains Medicaid’s federal match rate:
The fact that Medicaid is jointly funded by the states and the federal government has had a consequential role in its evolution. The share that states pay, relative to Washington, is determined by a formula called the Federal Medical Assistance Percentage (FMAP).Title XIX of the Social Security Act, which now contains the Medicaid program, specifies that the federal government will contribute no less than 50 percent of a state’s Medicaid costs.
“That means that for every dollar a state spends on its Medicaid program, the federal government will kick in an additional $1.50. It’s not everyday that a state politician gets to spend one dollar of his constituent’s money and gain credit for spending $2.50 in return. But that’s how Medicaid works. As a result, irresponsible officials in many states have ratcheted up their Medicaid spending, knowing that taxpayers in other states will be forced to foot a good chunk of the bill”.
Obamacare is bad policy. North Carolina state leaders rejected Medicaid expansion for sound reasons. Instead of adding more individuals onto a poorly run medical assistance program, the state is now focusing on reform and NOT adding to the federal deficit.
Only one North Carolina think tank made the cut to be listed on the UNC Faculty Assembly’s resource page alongside government offices and links to local, state, and federal representatives. And it’s not the Pope Center–the only public policy group in NC that focuses exclusively on higher education issues.
Instead the Faculty Assembly chose to list NC Policy Watch, the “progressive, nonprofit and non-partisan public policy” project of the NC Justice Center that regularly calls for increased funding for the UNC system.
Joseph Bast, Lindsey M. Burke, Andrew J. Coulson, Robert Enlow, Kara Kerwin, and Herbert J. Walberg published a must-read joint letter on school choice and accountability. Their letter, “Choosing to Learn: Increasing compliance to the state reduces accountability to parents,” appears on the National Review Online website.
Here is a sample passage:
Americans face a choice between two paths that will guide education in this nation for generations: self-government and central planning. Which we choose will depend in large measure on how well we understand accountability.
To some, accountability means government-imposed standards and testing, like the Common Core State Standards, which advocates believe will ensure that every child receives at least a minimally acceptable education. Although well-intentioned, their faith is misplaced and their prescription is inimical to the most promising development in American education: parental choice.
True accountability comes not from top-down regulations but from parents financially empowered to exit schools that fail to meet their child’s needs. Parental choice, coupled with freedom for educators, creates the incentives and opportunities that spur quality. The compelled conformity fostered by centralized standards and tests stifles the very diversity that gives consumer choice its value.
The concluding paragraph brings the message home.
Instead of imposing ineffective bureaucratic “accountability” on schools, our education system should ensure choice to all students so that every school is held truly and directly accountable to families. Policymakers then can dispense with rigid testing mandates, and all schools, public and private, will be free to serve their most important clients: families.
Kudos to Bast et al. for affirming the need to empower parents and use their choices as the basis for educational accountability.
• The 2nd Congressional District Democratic primary is getting interesting, as Democratic consultant Brad Crone (who’s not working for a candidate in this race) questions Clay Aiken’s commitment and relevant experience. Meantime, former Commerce Secretary Keith Crisco releases his latest campaign ad, focusing on economic development. Link here.
• Two Republican U.S. Senate hopefuls — House Speaker Thom Tillis, R-Mecklenburg, and Dr. Greg Brannon — have been lining up endorsements from elected officials. The Rev. Mark Harris has joined the party, securing the support of state Sens. Warren Daniels, Buck Newton, and Dan Soucek.
• The Democratic Public Policy Polling firm is spinning its latest survey of the U.S. Senate field as bad news for Tillis, whose lead over Brannon and Harris has evaporated (PDF), and noting that the race to defeat incumbent Democrat Kay Hagan “looks like a toss up.” Not so fast? Hagan is within 2 percentage points of all eight contenders, defeating three, tying three, and losing to Ted Alexander (by 2 points) and Jim Snyder (by 1 point). More than 70 percent of those surveyed have “no opinion” of seven of those candidates who are tied statistically with the incumbent, and 46 percent have “no opinion” of Tillis.
• Rockingham County District Attorney Phil Berger Jr. is running for the 6th Congressional District seat held by the retiring Rep. Howard Coble, and he’s chosen his preferred successor as DA — Assistant District Attorney Melanie Bridge, who’s worked in the office since 2005 and is running for the top job.
Last week, the NC Department of Public Instruction released “Highlights of the North Carolina Public School Budget 2014,” a collection of useful bits of information on state and federal education appropriations and expenditures.
I added the lines to the following figure from page 3 of Highlights 2014:
The black line represents Democratic control of the NC General Assembly. (I wanted to use blue, but it was difficult to see the line because of the blue bars.) The red line represents Republican control of the legislature.
Debates about the causes and effects (and the sufficiency or insufficiency) of budget changes are legitimate. Debates about whether the budget increased or decreased are not.