By Rose Hoban
Secretary of Health and Human Services Aldona Wos told an audience in Reidsville today that the decision not to expand the state’s Medicaid program came from state Insurance Commissioner Wayne Goodwin.
Her comments came during a community forum held at Annie Penn Hospital during a question-and-answer period with the audience of 70 to 80 hospital personnel, community members and medical professionals.
Steve Luking, a local family practitioner in Reidsville, rose to express his mistrust of the Medicaid reform plan, Partnership for a Healthy North Carolina, that Wos has been traveling the state to present to community groups.
Luking talked at length about the numerous Medicaid and uninsured patients in his practice who he felt he could not care for adequately under the current system. He then expressed his frustration with the state’s decision not to expand Medicaid, as permitted under the president’s Affordable Care Act.
“There will be people in this county who will die because of the decision that your boss made and that your silence, Dr. Wos, agreed with,” said Luking, who estimated that some 7,000 residents of Rockingham County would have received coverage under the expansion.
“Now I’m just supposed to trust you that the 67 percent of kids in my practice on Medicaid are going to get good care by this [Partnership for a Healthy North Carolina]?” Luking asked.
“In reference to your roundabout way of commenting about Medicaid expansion … in North Carolina, based on our constitution, the issue of Medicaid expansion or not, actually, was the commissioner of insurance’s,” Wos said. “Just so that you all know that and are aware of that.”
Wos left quickly after the forum wrapped up.
No to Medicaid expansion
The comment was met with incredulity at the Department of Insurance. According to Marni Schribman, a spokeswoman for the department, Goodwin had been directing his department to prepare for expansion of the Medicaid program for months.
But that process was derailed this winter when both houses of the General Assembly passed legislation to reject the Medicaid expansion. In the Senate, the bill was filed on the first day of the session. The House followed soon after.
During hearings on the legislation, Department of Insurance officials urged expansion.
During the Senate debate, Gov. Pat McCrory sent a letter to senators asking them to slow down the process, but legislators ignored the governor and passed the bill out of both houses by the end of February.
McCrory, who has repeatedly called North Carolina’s Medicaid system “broken,” signed the bill into law on March 6.
“Before considering Medicaid expansion, we must reform the current system to make sure people currently enrolled receive the services they need and more taxpayer dollars are not put at risk,” McCrory said in a prepared statement when he signed the bill into law.
According to Schribman, the Department of Insurance was also prepping to establish health insurance exchanges in partnership with the federal Department of Health and Human Services. With the rejection of the expansion and the exchanges, the department was compelled to decline a $72 million federal grant to help build them. Instead, the General Assembly had to appropriate dollars to cover part of the costs of creating a computer system that will be used to determine Medicaid eligibility.
“Whether or not to expand Medicaid was never within our authority,” Schribman said.
On Saturday afternoon, Insurance Commissioner Goodwin called on DHHS Secretary Wos to apologize for her remarks.
“I am offended and truly disappointed that Secretary Wos decided to incorrectly accuse me of being the cause for the state’s rejection of Medicaid expansion,” Goodwin said in a prepared statement sent to media. “That decision was not within my constitutional authority. I trust that the Secretary will swiftly issue a correction and apologize for her statement.”
According to the News & Observer, DHHS spokesman Ricky Diaz said Wos’ comments were taken out of context.
“The Secretary was talking broadly about the Insurance Commissioner’s oversight authority over the health care insurance industry in North Carolina,” Diaz said, as reported on the N&O‘s Under the Dome blog.
In the interest of full transparency and allowing readers to decide, we are posting a recorded excerpt from the hearing below (approx 3 mins.). The exchange starts in the middle of Dr. Luking’s comments and runs through Secretary Wos’ response until just after her comments quoted above.