January 5, 2017

In Roy Cooper’s patently illegal plan to expand Medicaid, nothing is more disingenuous than Cooper’s claim that hospitals, not taxpayers, will pay for it.

Let’s just ignore the fact that state law prohibits any state agency from expanding Medicaid under ObamaCare. With a rubber stamp State Supreme Court behind him, Cooper obviously doesn’t have to worry about obeying the law as he took an oath to do.

Let’s ignore Cooper’s ridiculous claim that $4 billion a year in new entitlement spending is “an investment.” That claim is about as sensible as Nancy Pelosi’s boast that expanding food stamps was the best thing Congress could do to stimulate the economy.

Instead, let’s just look at the Governor’s plan to pay for the $3 billion it will cost the state to expand Medicaid and match federal money.

Cooper says the money will come from “an assessment” on hospital revenue. In plain English, Cooper wants an additional tax on hospitals.

Of course, nobody – not a rocket scientist – can figure out their hospital bill now and why things cost what they cost. Does anyone doubt hospitals will just find a way to pass the tax on to patients?

But let’s dig deeper. North Carolina already has a hospital tax to raise money to pay part of the state’s bill for Medicaid. These kinds of taxes on providers of medical care are used in 49 states to get more federal Medicaid money. The medical providers are often rewarded with higher reimbursement rates so they won’t have to bear the full cost of the tax.

And guess what? Both parties in Washington are getting tired of sending more money to states that raise provider taxes like Roy Cooper proposes to do with his hospital tax. In fact, Joe Biden called provider taxes a “scam.”

The Simpson-Bowles commission said cutting the ability of states to use them would save $44 billion, and President Obama agreed.

Legislation to reduce the amount states can get from the federal government through provider taxes is already moving through Congress. The Healthcare Financial Management Association says, ”The new bill could have serious impacts on efforts in any of the 19 states that have not yet expanded Medicaid to use provider assessments to fund the states’ portions of the cost—a critical approach according to hospital leaders in states where it was used.”

So Roy Cooper’s hospital tax is a mirage. If Cooper wants to give free healthcare to single, childless, able-bodied adults who won’t work, the hospital tax won’t fly. Cooper will have to get the money from someone else. He will have to raise taxes, cut education or reduce Medicaid services to disabled children or some other deserving group.

Roy Cooper isn’t stupid. He knows the hospital tax won’t pay for Medicaid expansion. He just doesn’t have the courage to tell us where the $3 billion he needs is really going to come from.