Confusion on Medicaid
Chris Fitzsimon Fitzsimon File
Six months ago DHHS Secretary of Health and Human Services Aldona Wos famously blamed the decision not to expand Medicaid under the Affordable Care Act on Insurance Commissioner Wayne Goodwin, who had nothing to do with it.
It was Wos’ boss Governor Pat McCrory and Republicans in the General Assembly who made the decision to turn down federal funding to provide health care coverage for 500,000 low income adults.
Either Wos knew that Goodwin wasn’t responsible but said it anyway because she thought it was politically expedient — which is troubling enough — or she really didn’t understand why Medicaid was not expanded, which is even worse since she is the person in charge of the program.
Wos never apologized to Goodwin and never explained her statement but the incident raised serious questions about her ability to oversee Medicaid, much less “reform” it as McCrory has repeatedly promised to do.
Now, six months later, DHHS and the McCrory Administration are still stumbling on Medicaid, sending confusing signals about their intentions for the program that is so important to so many families across the state.
Last week, Governor McCrory announced his appointments to the Medicaid Reform Advisory Group that will work on “a detailed plan to reform North Carolina’s Medicaid system,” according to a news release from McCrory’s office.
The head of the committee will be former Cone Hospital CEO Dennis Berry, who told the Triad Business Journal that the recent departure of Medicaid Director Carol Steckel “allows” the state to take a new look at reform.
That was an interesting way to put it. Steckel was hired by Wos nine months ago with great fanfare from a top health and human services job in Louisiana and was the former Medicaid director in Alabama.
McCrory stood with Steckel and Wos in April to announce the creation of the “Partnership for a Healthy North Carolina,” a plan to turn over the operations of Medicaid to a handful of for-profit out of state managed care companies, a scheme that has caused a host of serious problems in other states that have tried it.
Steckel was clearly brought to North Carolina to privatize Medicaid and she joined Wos on a speaking tour earlier in the year to promote it. It wasn’t her decision. It was McCrory’s, who sold the privatization as the greatest thing since sliced bread to fixed what he continues to call a “broken” Medicaid system.
Steckel left after eight months on the job to work for a managed care company that had some interest in making some money off North Carolina’s privatization efforts. No one ever explained her abrupt departure, but reportedly she had a falling out with Wos.
Her departure hasn’t “allowed” or resulted in anything other than another attempt to reframe and rebrand the proposal to turn over more of the Medicaid system to for-profit companies, maybe on a regional level this time, instead of statewide.
And DHHS is putting plenty of taxpayer resources behind the publicity effort. Sarah Ovaska with NC Policy Watch recently reported that an internal memo at the department lists 24 positions in the expanded marketing and communications division, three of them specifically assigned to the Partnership for a Healthy North Carolina.
McCrory’s appointments to the new advisory board that will be working with the department to flesh out the privatization plan are also telling. They are all hospital officials.
There are no doctors or other providers, no consumer advocates, not even anyone from Community Care of North Carolina, the state’s homegrown managed care nonprofit that has won awards for its efficiency and patient care.
McCrory meanwhile continues to blame Medicaid for his struggles to give teachers a raise, which doesn’t make much sense since the tax cut for the wealthy he signed will cost $438 million next year, $650 million a year when fully implemented.
The truth is that despite the desperate attempt to convince us otherwise, Medicaid in North Carolina is not broken. It needs to be expanded and improved, not chopped up and privatized.
Providing health care for people who need it ought to be point, not making profits for private companies.
We don’t need a big new marketing team to rebrand an ill-advised effort. We need someone in charge of the department that oversees Medicaid who we can be confident actually understands it and we need the governor to town down the bluster and starting putting people ahead of ideology.
Chris Fitzsimon writes for NC Policy Watch.
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