ONE SMALL STEP…OR A LEAP

Paul Fogleman,

As legislators prepared to department for an Easter recess, a bill was filed in the North Carolina House of Representatives to give more low-income people health insurance. Representative Donny Lambeth of Forsyth County, a former hospital administrator is the chief sponsor, with bipartisan support from Republican and Democrat co-sponsors. The bill calls for the N.C. Department of Health and Human Services to design a government-sponsored benefit package similar to the coverage of the N.C. 2017 Essential Health and Benefits Benchmark Plan and the Blue Cross and Blue Shield Blue Options Preferred Provider Organization (PPO) Plan. Emphasis would be on preventive care and wellness.

Rep. Lambeth insists this is not an expansion of Medicaid which now provides health care insurance for 1.9 million poor, elderly and disabled citizens. Rather this new program referred to as “Carolina Cares,” would be offered to the working poor between the ages of 19 and 64 and who earn less than 133 percent of the federal poverty level. No state funds would be appropriated for the program. Participants would pay 2 percent of household income. Additionally available federal funds and special assessments levied by the state, including hospital fees, would support Carolina Cares.

As Congress tries to tackle the shambles of an effort to repeal and replace the Affordable Care Act, North Carolina may be developing a national model. But Lambeth acknowledges he is facing a tough challenge with other legislators who are opposed to Medicaid expansion. And there are strings attached: participants must be employed, not entitled to or enrolled in a Medicaid program, and must participate in wellness and treatment programs such as drug abuse.

A step toward a national healthcare concept? Or something else?

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