New Polling: The Medicaid Deal and Certificate of Need

Republicans in the State House and State Senate reached a deal to expand Medicaid in North Carolina and make modest reforms to the state’s Certificate of Need (CON) laws. CON laws grant monopolies to specific hospitals and health care businesses for providing health services.

We recently completed a survey of North Carolina voters that fortunately included questions about Medicaid expansion and CON.

We’ve asked voters their opinions on expanding Medicaid in North Carolina for over a dozen years and, in the last five or six years, we’ve consistently seen expanding the taxpayer-funded program gain popularity with voters of all political persuasions.

As you may know, Medicaid is a taxpayer-funded program that provides healthcare coverage to low-income people. Do you support or oppose expanding the state's Medicaid program to cover more people in North Carolina?

Free market reformers in the legislature have had a long-standing goal of eliminating North Carolina’s antiquated, anti-competitive CON laws.  Study after study after study show CON laws serve only to drive up health care costs while limiting access to critical medical care in many North Carolina communities. In the agreement to expand Medicaid, free market reformers made some progress scaling back the state’s CON laws, but much work remains to be done. 

Our poll showed broad support for CON reform among voters.  Only 23% of voters said CON laws make sense while 56% of voters say the laws do not make sense. Majorities from every party affiliation and all parts of the state agreed the laws don’t make sense.

As you may know, North Carolina has Certificate of Needs laws that require hospitals and other health care providers to obtain permission from the state in order to open or expand many new health care and medical services. Which of the following comes closer to your own opinion, even if neither is exactly right:

23% - Certificate of Need laws make sense because they allow state government to control and determine the availability of health care services in each community.

 ...or...

 56% - Certificate of Need laws do not make sense because they add an unneeded layer of bureaucracy that prevents or delays doctors from opening health care facilities in communities that need them.

Unfortunately, proponents of the SAVE Act, which would expand access to healthcare in many underserved rural areas of the state by doing away with archaic rules limiting the medical services nurses can provide, will be disappointed the proposal was not included in the final agreement.

You can see the crosstabs of the survey here.