Duke and UNC students join to effect change to Medicaid

A team of UNC and Duke University graduate students released a proposal last week to reform North Carolina’s Medicaid program in hopes of gaining the attention of state policymakers.

The proposal was part of a class at Duke’s Sanford School of Public Policy composed of Duke and UNC graduate students.

“You could say it was a bipartisan effort between Duke and UNC,” said Laura Mortimer, a graduate student at Duke and a member of the Duke-UNC Medicaid Reform Team.

The class was coordinated after last year’s state budget required the N.C. Department of Health and Human Services to propose state Medicaid reforms.

Gov. Pat McCrory’s goals include streamlining the program’s efficiency and uniting physical and mental health care.

“With that in mind, we let those goals guide our work and we incorporated them into our project,” Mortimer said.

Don Taylor, a Duke professor who taught the course, said he saw this as an opportunity for students to apply their research.

“This was a unique opportunity because this was happening in our state,” Taylor said.

“There’s health policy and there’s also the politics.”

Taylor wanted his students to recognize the political climate of the state after the N.C. General Assembly voted last year not to expand Medicaid. The team created three proposals to expand health coverage in the state.

The first would expand Medicaid using the Affordable Care Act’s requirements as a model.

The second would create a “private option,” where people newly eligible for Medicaid would enroll in private insurance in the state’s health care marketplace.

The third, which the students feel is the most ideal plan, is a hybrid of the first two options that would enroll people below 100 percent of the poverty level in Medicaid and enroll people between 100 and 138 percent of the federal poverty level in private insurance.

Mortimer said the group’s support for a private option was inspired by recent action in Arkansas, where the legislature passed funding for its own version of a private option. The bill was delivered to the governor Tuesday.

“We also know the political culture is a bit much more like North Carolina than some other states,” Mortimer said.

Kate Luck, spokeswoman for the Arkansas Department of Human Services, said the program was proposed by Republicans and was considered an alternative to traditional Medicaid expansion.

“We knew that there was a slim possibility of that happening,” Luck said. “It’s something that the Republicans can get on board with.”

Luck said she thinks the proposal could serve as a model for other states to expand Medicaid coverage.

As the commission prepares to reveal its proposals for Medicaid reform, the students say they hope to show their proposals to administration officials.

Last week, the N.C. Medicaid Reform Advisory Group discussed aspects of the reform, including coordinating with organizations that would be responsible for quality of care.

Mortimer said she is supportive of these organizations, but the students’ proposed plan would take more steps in expanding coverage.

“The advisory group has gotten off to a good start but there’s a lot more robust reforms needed to fulfill Gov. McCrory’s goals.”

state@dailytarheel.com