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Just about every morning a group of MCO promoters (the Carolina Partnership for Reform) drop an email into legislators mailboxes and the other morning they gave legislators a list of 15 states and told them, Look. See. North Carolina spends more on Medicaid per enrollee than states that have MCOs.

It looked logical. And sounded logical. But there was a little sleight of hand going on.

Missouri – one of the states on Carolina Partnership for Reform’s list – has MCOs (Managed Care Organizations) – so its costs should have been lower than NC’s. But they weren’t. They were higher.

How much each state spends per person on Medicaid is determined, in large part, by how many different types of illnesses each state will pay to treat. For instance, NC provides dental care to Medicaid patients and other states don’t – so their costs are lower than ours.

And MCOs can’t change that a bit. They don’t decide what types of illnesses are covered. The legislature does that and our legislators have voted to provide more types of care than most other states.

There’s an honest case to be made for cutting Medicaid spending. But the CPR isn’t making it. It’s just selling MCOs. With a little devilment.


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