Benign-Sounding Policies Often Have Negative Consequences

North Carolina is a battleground state in this election. After a responsible State Treasurer and a responsible State Legislature brought us into fiscal solvency, we are in danger of forgetting where we have been and what it took to get where we are. Because of an influx of people fleeing high tax states with bad weather (guilty as charged), it is possible that North Carolina will become a purple state instead of a red state. Many of those people coming into the state are attempting to implement the very expensive state policies that they fled. That would mean that the hard-fought income tax decreases passed by the legislators would be undone and spending would increase drastically as it had under previous Democrat legislatures. One of these items currently being mentioned in the gubernatorial campaign is Medicaid Expansion. Governor Cooper supports it and Dan Forest does not.

On September 22, 2020, The John Locke Foundation posted an article explaining what Medicaid Expansion would mean to North Carolina.

The article reports:

Expanding Medicaid in North Carolina is a misguided and costly plan for our state, and would not be free to state taxpayers, as Gov. Roy Cooper claims. New economic analysis released by the John Locke Foundation reveals that expansion would leave the state with a funding gap estimated between $119.3 million and $171.3 million in the first year alone.

The expansion funding gap would continue every year and could increase based on enrollment in the program and cost of the enrollees in the future. Multiple North Carolina expansion scenarios are detailed by JLF Health Care Policy Analyst Jordan Roberts in the report, Big Government, Big Price Tag: Medicaid Expansion = Funding Gap For State Government.

…Nearly 2.4 million people are currently enrolled in North Carolina’s program. Gov. Cooper and state Democrats have fiercely advocated for overloading Medicaid with 500,000 to 600,000 additional people. Nearly eight of 10 of the proposed expansion population are able-bodied, working-age adults with no children, according to the Kaiser Family Foundation.

Gov. Cooper claims that adding this massive new group would not require any state money and that the state’s portion of costs would be paid for via taxes on hospitals and providers.

“The governor’s statement is wrong,” said Roberts. “Our modeling is rigorous and uses varying enrollment numbers and expenditure data from respected sources. The most likely modeled scenarios result in the need for state appropriations. That means taxpayers.”

Beyond the fiscal implications for the state, Roberts worries about the fate of those currently enrolled. “If massive numbers of new people are added, it will be harder to access care. Many current Medicaid patients have multiple health issues; they’re our most vulnerable. The worst thing we could do is to push their needs aside.”

We need to provide a way for all Americans to get the healthcare they need. However, we need to do it carefully–providing what is needed to the people who need it. The welfare state has grown so large that there is no concept of individual responsibility included in allocating resources. There is also no incentive for the overgrown bureaucracy to decrease the number of people getting assistance. It is time to encourage all Americans to take responsibility for their own economic welfare. That may mean providing a path out of government dependence rather than bringing them deeper into it.

The Cost Of Immigration

America is a country that was built by immigrants. People came here from Europe and other places to celebrate freedom, escape religious persecution, or simply to begin again. The Catholics fled the potato famine, the Jews fled the pogroms, and others came to buy land to farm and support a family.

Well, not all of today’s immigrants have the same sort of ambition. National Review reported today that 42 percent of new Medicaid recipients are immigrants.

The article reports:

Federal law bans the admission of immigrants who are likely to be significant beneficiaries of welfare, technically a “public charge,” but that definition doesn’t consider in-kind welfare programs like Medicaid: U.S. Citizenship and Immigration Services defines being a public charge as “the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government expense.” The USCIS union president has recently complained that President Obama is not enforcing public-charge laws.

Illegal immigrants are ineligible for Medicaid currently and are technically ineligible for the Medicaid expansion or any other direct Obamacare benefits, but fraud in the program is rarely investigated and recipient-level eligiblity is rarely investigated.

The article also reminds us that Medicaid has been expanded so that people with incomes up to 138 percent of the federal poverty line are eligible. This greatly increased the cost of the program.

I am not opposed to immigration, but I question the wisdom of an immigration policy that allows people to come here and be a burden on the federal government. Our federal deficit is out of control, why are we passing laws that make it worse?