In June, policy analysts at the RAND Corporation determined that the 14 states that turned down Medicaid expansion under the Affordable Care Act—Obamacare—were making a giant mistake. The 14, Rand said, would lose $8.4 billion a year in federal funds while denying 3.6 million of their residents—the working poor—a chance to obtain affordable health insurance.
Not only that, these states—or, more precisely, their taxpayers—would be saddled with $1 billion in extra costs, RAND said, as hospitals bill them for taking care of the uninsured.
RAND, a global policy think tank, published its conclusions in Health Affairs, a leading policy journal. Its findings tracked a state-by-state analysis by the Kaiser Family Foundation, a respected health care organization. Kaiser estimated that if North Carolina accepted Medicaid expansion, we would create 37,000 new health care jobs.
Gov. Pat McCrory, however, had his own team of experts on health care, so why would he listen to Kaiser or RAND? And McCrory's experts told him to turn down Medicaid expansion because—well, because.
They did mouth the words, "Medicaid is broken" again and again.
But c'mon: Obama? Socialism? Kenya? Must Stop Obama is all the policy analysis most Republicans require these days. So McCrory was sold, and billions went down the drain.
And who were McCrory's trusted experts? For starters, there was Dr. Aldona Wos, secretary of the N.C. Department of Health and Human Services. And Wos' top policy aide, 24-year-old Matt McKillip, a Georgetown University graduate fresh off his gig with the McCrory gubernatorial campaign.
Yes, that Matt McKillip, who drew attention last week when it was revealed that Wos was paying him $87,500 a year as chief policy officer at DHHS even though he has zero background in health care. Wos gave him a promotion and a 35 percent pay bump after McCrory, on March 8, ordered all state agencies to freeze salaries.
Apparently that freeze didn't apply to McKillip—or Ricky Diaz, another 24-year-old from McCrory's campaign. Diaz is pulling in $85,000 as communications director at DHHS following a 37 percent pay hike from Wos.
In fact, after the N.C. Justice Center disclosed the two raises, WRAL dug further and discovered that Wos has handed out $1.7 million in pay hikes to 280 staffers, many with "no career or educational experience for the jobs they hold."
Now, I know what you're saying. Make it stop. How many times must we be told that the McCrory gang did another inexplicably dumb thing? Two weeks ago, the governor was telling us that the state couldn't afford pay raises for teachers because—yes—"Medicaid is broken." The real reason, of course, is the hefty tax cut the Republicans handed to wealthy individuals and corporations.
But don't confuse McCrory with the facts.
And when it came out that McCrory's administration is larded with overpaid political staffers, the governor, instead of keeping his mouth shut, told a TV interviewer that the salaries are justified. He noted that Diaz, for example, was promoted from a "lower-level" staff job where he was paid just—wait for it—$62,000.
So low-level aides to McCrory make twice the $31,000 paid to a starting teacher—or for that matter a sixth-year teacher, given that teachers have had no raises for five years.
As outrageous as that is, there's a deeper issue: Obamacare is upon us, with its promise of health care transformation and insurance coverage for almost everyone. But at the McCrory health care shop, nobody is there to receive it—or explain it.
Take Wos. Yes, she's a physician, so she must know something. But what? She was ambassador to Estonia in the George W. Bush years, a reward for her gushing loyalty and political fundraising. Since being selected by McCrory, for similar services, she's been a serial embarrassment.
First, Wos appointed Diana Lightfoot, a pro-life crony from the Triad, as head of childhood development programs. Lightfoot was gone in a day when her nasty tweets were unearthed, along with the fact that she disliked childhood development programs.
Next, Wos pointedly blamed Insurance Commissioner Wayne Goodwin, a Democrat and an innocent party, for the Republicans' rejection of Medicaid expansion.
Then, Dr. Laura Gerald, the highly regarded state health director, resigned from DHHS, citing deep policy differences with Wos "that are making it increasingly impossible to continue."
Meanwhile, stories of Wos memos about dress codes and how to write memos—with threats that violators may be terminated— were floating around DHHS.
This would all be comical if the rollout of Obamacare, which begins Oct. 1, wasn't so important—and complicated. North Carolinians, including many who are uninsured and others who need more affordable plans, will be able to shop for insurance on an exchange—a market—established for the state by the federal government. Many will qualify for subsidies.
They will, that is, if they know about the exchange in the first place. North Carolina could've taken charge of our exchange, or developed one in partnership with Washington, but the McCrory policy team would have none of that. Nor would the Republican General Assembly, which barred the state from cooperating in any way with Obamacare.
So instead of accepting federal funds to develop the exchange, recruit more insurers and publicize the options and subsidies, the McCrory administration is stonewalling. They're acting as if Obamacare will go away like Diana Lightfoot if they pretend it doesn't exist.
Wos was supposed to discuss national health care at the Wake County Republican Women's Club last week. But when she got there, Wos said she was not able to speak on the topic, according to a report in The News & Observer, and recounted her life story instead.
I emailed Diaz asking why Wos couldn't talk about health care. He didn't respond. For $85,000 a year, he could at least say "no comment."
This article appeared in print with the headline "Who cares about health care?"