By Peg O’Connell
Care4Carolina Executive Director Erica Palmer Smith was recently a guest on the radio talk show, Mountain Morningson WJUL 97.7 The Lake and was challenged by one of the hosts on the permanency of the 90% federal Medicaid match for states that close their health insurance coverage gap. The host would simply not accept the fact that this enhanced match is permanent. So, in case there are any other Doubting Thomases out there, I thought now would be a good time to address this issue.
Section 1905 of the Social Security Act: https://www.ssa.gov/OP_Home/ssact/title19/1905.htm, is part of the Affordable Care Act that was passed in in 2010. This is the provision that increased the federal match for states that expand their Medicaid programs to cover people up to 138% of the poverty level. These are the folks that are currently in the coverage gap in North Carolina. In relevant part it says, “Federal medical assistance percentage for a State that is one of the 50 States or the District of Columbia, with respect to amounts expended by such State for medical assistance for newly eligible individuals described in subclause (VIII) of section 1902(a)(10)(A)(i), shall be equal to…(E) 90 percent for calendar quarters in 2020 and each year after.” If you don’t believe me, you can click on the link above and see the actually statute.
There is no expiration date on this 90% match, no reauthorization required, no hidden trap doors. It would take an Act of Congress in order for the match to be enhanced or reduced. Now, I don’t mean to throw stones, but our federal policymakers have tried to monkey with the Affordable Care Act in the past and found themselves on the receiving end of a firestorm. It is not likely they will try again soon. The ACA is the law of the land and will be for the foreseeable future. It has withstood legislative challenges and constitutional challenges and is still going strong.
The 90% match is here to stay and it is time to stop using it as an excuse for failing to find a North Carolina solution to close the coverage gap. Six hundred thousand North Carolinians need out help. Let’s get this done for them.