Obamacare–in NC and nationwide

Dr. Joe GuarinoThe fall of 2013 is shaping up to be a defining moment for Obamacare.  It is during the fall of every year that insurers decide how much they will increase insurance premiums.  Because much of Obamacare becomes effective during 2014, the next round of premium increases could prove to be quite revealing.

Forbes has reported that insurance carriers in California are advising brokers to expect that premiums might triple in the fall.  Yes, triple– a 300 percent increase.

I doubt that will happen nationwide, or with uniformity.  But we are already beginning to see some real world consequences of Obamacare.

Medical device manufacturers in the US are laying off employees.  At least some employers are already planning to reduce the number of full-time employees and increase the number of part-time employees to evade the employer mandate. The cost of college health plans is increasing.  In academia, there is apparently a heightened movement toward adjunct faculty positions instead of full-time, permanent positions.  The IRS has already estimated that the cost of the lowest-tier family health plan under Obamacare will be $20,000 annually.

Some have maintained that Obamacare is a trojan horse for a single-payer health care system because it will cause the implosion of private insurance markets.  That project appears to be on schedule.

There are a couple of encouraging notes, however.  For instance, it has been reported that Obama is having difficulty getting qualified people to serve on his health care rationing board (the “IPAB”).

And the individual states are turning out to be a major focus of resistance to Obamacare.

In North Carolina, legislation was filed this week that would apply the brakes with respect to establishing an Obamacare exchange in our state; and with respect to expanding Medicaid under Obamacare.  While this legislation could have been written more strongly, it is still a very positive step.  I hope that Governor McCrory and Speaker Tillis ultimately show the backbone needed to prevent permanently any kind of state-based exchange and Medicaid expansion.

Yes, they will be under withering pressure from the state’s mainstream media.  The RaleighNews and Observer and the Associated Press, for instance, can be relied upon to advocate the Democratic point of view with their reporting.

And the Greensboro News and Record will do so also.  (Warren Buffett apparently bought the paper last week because he recognized– correctly– that Greensboro and Guilford County are hotbeds of socialism.)

The state’s MSM recently reported that numerous liberal institutional players have been lining up behind expansion of Medicaid under Obamacare.  First, these were reported to include the state AARP, the regional YWCA, Duke University Health System, various community health centers and health associations. 

And now, the Associated Press is reporting that the North Carolina Institute of Medicine is also advocating for the state’s expansion of Medicaid.  That is nothing new.  This is a group heavily influenced by current and former Democratic health bureaucrats; and other liberal Democratic partisans and functionaries.  They employ the commonly utilized progressive strategy of asserting that more public spending will somehow save us money, or make us more money. 

It seems that all we need to do to balance our budget and boost the state economy is to spend more public monies, according to this formulation.

Nonetheless, the institutional players carry some weight; and my concern is that the media/left complex will ultimately prevail in North Carolina if Governor McCrory relents.  We would then be part of an atypical southern state that acquiesces with– and facilitates— Obama’s intention to socialize the health care system.

Enacting the Obamacare exchange would have one very serious effect on the state’s employers.  Under the Affordable Care Act, having a state-based exchange would make North Carolina employers subject to the employer mandate.  Conversely, if there is no exchange, then there would be no enforceable employer mandate in the state of North Carolina.  That is a big deal.

Nationwide, the hospital industry and the pharmaceutical industry compromised themselves shamelessly by angling to become the beneficiaries of Obamacare.  They failed to recognize that their problems have been caused by too much government– not insufficient amounts.  These two industries carry great weight with the North Carolina Chamber of Commerce, which astonishingly endorsed the concept of a state-based exchange.  And some physicians’ organizations have also been weak on the matter of acquiescing with Obamacare.

Governor McCrory, Phil Berger and Thom Tillis will be tried severely by the state’s media/left complex as they navigate the Obamacare issue.  But they need to remain steadfast; and in fact, I would like to see them strengthen the legislation that has already been filed.

Dr. Joe Guarino is a Guardian columnist.

7 Responses to Obamacare–in NC and nationwide

  1. Fred Gregory says:

    The chickens are coming home to roost

  2. Lee Haywood says:

    Excellent column. I’m keeping my fingers crossed that they will do the right thing in Raleigh.

  3. Joe Guarino says:


    Politico is reporting that a survey of health insurers will reveal a TRIPLING of insurance premiums for young, healthy men. That corroborates what Forbes reported regarding California:


  4. Joe Guarino says:

    According to an e-mail news release from Senator Berger’s office, the NC Senate “tentatively passed” tonight legislation to rule out any Obamacare state-based exchange and the Medicaid expansion.

  5. William H. Edwards says:


  6. Joe Guarino says:

    Now, McCrory is urging the House to slow down the process; and he is claiming his issue is funding for eligibility verifications. Meanwhile, John Kasich caved on the Medicaid expansion in Ohio.

    I hope McCrory is not contemplating a similar “cave” in North Carolina. This is a huge issue, and if his knees buckle, it will arouse the enmity of conservatives around the state permanently. He will drive away what would otherwise be his base.

    McCrory needs to decide who he wants to be. This is not a complicated issue, and it has been “out there” since the day he was elected. Nobody needs any more time.

  7. William H. Edwards says:

    Lee, thanks for your comment.

    Even better than crossed fingers would be a personal contact with the Governor’s office, preferably by phone, but otherwise via personal letter or e-mail, just to briefly share your thoughts on the matter. With sufficient public response, our elected officials are more prone to be influenced by concerns of the many…just a thought.

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