Medicaid privatization risky for poor, disabled

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Gov. Pat McCrory rolled out an ambitious but dubious plan to privatize North Carolina’s Medicaid system.

Under the plan outlined Wednesday by McCrory and N.C. Health and Human Services Secretary Aldona Wos, the state would bid out the delivery of Medicaid services to a handful of managed-care providers. Each would be paid a monthly set amount for each Medicaid patient the private firms have enrolled in networks of medical providers they would have set up.

The primary stated purpose of the plan is to transfer the financial risks and cost overruns of the Medicaid system from the state and its taxpayers to the for-profit companies that would receive the bids to administer the services.

But the surest way for these managed care corporations to ensure profitability would be to limit access to health care and cut critical medical services to the state’s poor, elderly and disabled people.

These services currently are provided by the nonprofit group Community Care of North Carolina series of Medicaid managed care networks, which saved the state nearly $1 billion between mid-2006 and mid-2010. U.S. Sen. Richard Burr, R-N.C., was in Winston-Salem on the same day as McCrory’s press conference to help present Community Care of North Carolina with an efficiency award from the Healthcare Leadership Council, a national group of health care chief executive officers.

Community Care of North Carolina has become a national model for its delivery of Medicaid services. McCrory’s own Medicaid Director Carol Steckel testified in February to the N.C. General Assembly that her former state of Alabama is looking at North Carolina’s Medicaid system as a model for saving money and improving care, results largely due to Community Care of North Carolina. If privatization is adopted, Community Care of North Carolina would have to submit a bid to continue to administer Medicaid services along with other for-profit companies interested in contracting with the state.