A Quagmire
The Senate Bull Mooses have locked horns with the Opossum Drop Caucus over in the State House;—for years the Bull Mooses have hollered Medicaid spending was out of control and soaring but that turned out not to be so – that the Bull Mooses were simply spinning a yarn to accommodate their friends the MCOs (Managed Care Organizations) who wanted to run Medicaid.
Caught red-handed the Bull Mooses pirouetted adroitly, changing directions, then declared it was future not past Medicaid spending that was soaring. But that landed them in another fix.
When someone goes onto the Obamacare Exchange to sign up for health insurance, if they qualify for Medicaid the Exchange sends a message straight to North Carolina and tells their local Social Services Department to sign them up. New people have been signing up in droves and it turns out legislators – like the Bull Mooses – made it all possible. By making all those people eligible for Medicaid.
The good news for the Bull Mooses was all they had to do to cut spending was remove some of the people from the rolls. But, it turned out, no politician – even a Bull Moose – was anxious to tackle that porcupine.
The other problem – which the Caucus in the House figured out – is no one’s in charge of Medicaid: Washington runs part, the state runs part, and the state’s part is divided three ways between the House, the Senate and the Governor.
The Governor can’t cut the new spending because he can’t cut who’s on Medicaid – only the legislature can do that. But only if Washington goes along. It’s a quagmire.
The Opossum Drop Caucus came up with a logical answer: They put the Governor in charge – they gave him $3.7 billion and told him, That’s it. That’s all you get. You can’t spend one dollar more. Then they also gave the Governor the power to make cuts if needed.
But the Bull Mooses didn’t want the Governor in charge. They wanted MCOs. But, it turns out, that won’t work either. Because Washington won’t let MCOs decide how many people receive Medicaid – when enrollment goes up MCOs simply pass the new costs along to the state. And so, in the end, we’re right back where we started: No one’s in charge.
A Quagmire
The Senate Bull Mooses have locked horns with the Opossum Drop Caucus over in the State House;—for years the Bull Mooses have hollered Medicaid spending was out of control and soaring but that turned out not to be so – that the Bull Mooses were simply spinning a yarn to accommodate their friends the MCOs (Managed Care Organizations) who wanted to run Medicaid.
Caught red-handed the Bull Mooses pirouetted adroitly, changing directions, then declared it was future not past Medicaid spending that was soaring. But that landed them in another fix.
When someone goes onto the Obamacare Exchange to sign up for health insurance, if they qualify for Medicaid the Exchange sends a message straight to North Carolina and tells their local Social Services Department to sign them up. New people have been signing up in droves and it turns out legislators – like the Bull Mooses – made it all possible. By making all those people eligible for Medicaid.
The good news for the Bull Mooses was all they had to do to cut spending was remove some of the people from the rolls. But, it turned out, no politician – even a Bull Moose – was anxious to tackle that porcupine.
The other problem – which the Caucus in the House figured out – is no one’s in charge of Medicaid: Washington runs part, the state runs part, and the state’s part is divided three ways between the House, the Senate and the Governor.
The Governor can’t cut the new spending because he can’t cut who’s on Medicaid – only the legislature can do that. But only if Washington goes along. It’s a quagmire.
The Opossum Drop Caucus came up with a logical answer: They put the Governor in charge – they gave him $3.7 billion and told him, That’s it. That’s all you get. You can’t spend one dollar more. Then they also gave the Governor the power to make cuts if needed.
But the Bull Mooses didn’t want the Governor in charge. They wanted MCOs. But, it turns out, that won’t work either. Because Washington won’t let MCOs decide how many people receive Medicaid – when enrollment goes up MCOs simply pass the new costs along to the state. And so, in the end, we’re right back where we started: No one’s in charge.