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Legislative Report District 13: Medicaid expansion among important bills approved by Senate

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By Sen. Judy Lee

Medicaid expansion, K-12 education funding, and DUI bills have all been approved by the Senate, all three very important issues.  I will give a brief review of each of them in this and future columns.

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Medicaid is the program which provides health coverage for low income children to age 19 and their parents. Childless adults have never had health care coverage in North Dakota up to now. Federal health care reform originally required that all states expand their coverage to include childless adults up to 138 percent of the Federal Poverty Level (FPL). That is $15,420/year income for one person, $20,880 for two (mother and child, for example). The Supreme Court ruled in June 2012 that states would have the choice of whether or not to expand Medicaid, but that all other provisions of the Federal Health Care law would stand.  That created a gap between the people who make at least 100 percent of FPL and who can benefit from subsidies on the exchange for purchasing health insurance and those people who make less than 100 percent of FPL, which is $11,172 for one person and $15,132 for a family of two.

The writers of the federal law assumed that everyone under 100 percent of poverty would be covered by mandated Medicaid expansion, so there are no benefits for them in the law.  That means that the poorest people would have to pay full premiums for health insurance while those making slightly more would get to purchase it for two percent of their annual income.  For example, someone making $16,000 would get insurance for $320/year, but someone making $14,000 would have to pay full rates, ~$4000/year, which is totally unaffordable.

In addition to the gap in coverage, employers who have more than 50 full time employees will have fines up to $3000/employee, if they do not provide coverage.  Individuals will have increasing penalties, if they do not purchase coverage.  Hospitals and clinics who currently provide millions of dollars in uncompensated care in N.D. will receive lower Medicare reimbursements and still will be providing the charity care, doing the same or more with less funding.  This is hard on all hospitals, but especially the small, rural ones which serve a higher percentage of patients receiving assistance.

North Dakota taxpayers will be paying the 18 new taxes required by ObamaCare, helping to fund expansion for other states, but would not get any of it coming back to ND.  Expansion is 100 percent federally funded for the first three years, then there is a state share to pay.

Yes, the federal government is out of money.  But no one is saying that we should turn back all of the federal funds  that we currently get not only for the existing Medicaid program, which is half federally funded, but for education, roads and bridges, and other purposes.  We cannot solve the deficit by refusing to provide medical services to people with very low incomes, 75 percent of whom are in working families.  It is the law, whether we like it or not, and the legislature, after a lot of study, decided that N.D. citizens are better off for many reasons, if Medicaid is expanded.

You can contact your District 13 legislators by e-mail:  Senator Judy Lee - jlee@nd.gov; Representative Alon Wieland - awieland@nd.gov; and Representative Kim Koppelman - kkoppelman@nd.gov.  You can also connect with us on Facebook at District13legislators, or NDSenateGOP for regular updates.  The legislative website, www.legis.nd.gov, allows you to watch live the voting in both the Senate and House, and also to follow the progress of bills.  We like to hear from you and want you to be well informed.

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