Lt. Gov. Beverly Perdue says Richard Moore is not working toward universal health care.

The Democratic gubernatorial candidate was responding to the state treasurer's campaign's criticism that her plan to insure lower-income children and parents is too expensive.

In an e-mail to Dome, Perdue spokesman David Kochman said that Moore is "turning his back" on a statement from his campaign kickoff that "every citizen should have access to high quality affordable health care."

Kochman said that Perdue's plan to phase in coverage could be paid for through cost savings. He also said "the only real way" to get universal health coverage for children is to insure their parents. 

"If we don't start getting poor people out of the emergency rooms, we'll never be able to lower health care costs for the middle class—and these are the common-sense steps that will get us there," he wrote.

How many parents would sign up for Lt. Gov. Beverly Perdue's health plan?

In her cost estimates for insuring parents, the Democratic gubernatorial candidate relies on figures from the N.C. Institute of Medicine that estimate 30 percent of eligible parents would sign up.

Her rival, state Treasurer Richard Moore, estimates 100 percent would enroll in her plan.

The difference is one reason why his estimate for her health care plan for uninsured parents is nearly six times as high as Perdue's own numbers.

Adam Searing, a health care advocate for the N.C. Justice Center, says that it's unfair to assume everyone eligible would sign up.

"You will never get 100 percent of people to enroll," he said. "No state has ever done that. Even Massachussetts, which is making health insurance mandatory, isn't getting anywhere near that goal."

Because it includes monthly premiums and copays, Perdue's plan is closer to private insurance than Medicaid, he said. Since it is voluntary, many parents would spend their money elsewhere.

Moore has called for parents to be asked for their children's policy number on their state tax forms, but neither he nor Perdue have called for penalties for parents who do not sign up.

How much would it cost to insure parents from working poor families?

In her proposal for insuring poorer children, Lt. Gov. Beverly Perdue has called for extending coverage to their parents as well, arguing it's the best way to make sure their children get care too.

Her rival for the Democratic gubernatorial nomination, state Treasurer Richard Moore, has said her plan is too expensive, arguing it would cost $700 million to "fully deliver" on the plan.

The Perdue campaign estimates her plan would only cost $120 million.

Both sides are using data from a 2006 study by Mercer Human Resources Consulting for the N.C. Institute of Medicine's Task Force on the Uninsured. But they're adding the numbers up differently.

After the jump, we do the math.

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Richard Moore says Beverly Perdue's plan to insure parents is too expensive.

At a debate last week, he alluded to this argument, saying that he had a plan to provide health insurance for all North Carolina children, but not adults.

"I wish I could stand up here and say I've got it all figured out how to pay for health care for everybody," he said.

By contrast, Perdue has proposed phasing in coverage of adults up to 200 percent of the federal poverty level, arguing it's the only way to cover uninsured children, including those who already qualify for the Medicaid or Health Choice plans.

Moore's campaign elaborated on the argument today. Campaign manager Jay Reiff told Dome Moore agrees the state should increase access to health care, but the focus should be on reducing costs.

"Perdue's plan to dramatically expand Medicaid is a very costly option," he wrote. "It would cost taxpayers more than $700 million for Perdue to fully deliver on this promise. When you add this price tag to Perdue's other promises so far, the total tab is well over $1 billion and counting. It begs the question: How is she going to pay for it all?"

Beverly Perdue would phase in coverage of uninsured parents.

The lieutenant governor, who is running for the Democratic gubernatorial nomination, has called for insuring adults up to 200 percent of the federal poverty level. (That's currently up to $41,300 for a family of four.)

In her proposal, Perdue argues this would help insure children who already qualify for Medicaid or Health Choice insurance but are not signed up.

She proposes phasing in coverage by starting with families up to 150 percent of poverty level, or up to $30,975, with federal matching funds during her first years in office. Then, she would attempt to expand coverage up to 200 percent.

Perdue spokesman David Kochman wrote Dome that this reflects a "Families First" approach to health care. He cited a 2002 report from the national Institute of Medicine that showed having one uninsured member can hurt the health of the rest of the family.

"The research clearly indicates that the only way we will reach the now widely-shared goal of getting more poor children enrolled in public coverage is by extending coverage to their parents," he wrote.

Beverly Perdue thinks insuring parents would help insure kids.

As previously noted, two-thirds of North Carolina's uninsured kids already qualify for either Medicaid or Health Choice plans.

The lieutenant governor, who is running for the Democratic nomination for governor, says that providing state health insurance to parents would be the biggest step toward extending coverage to children.

In her proposal, she proposes insuring families up to 200 percent of the federal poverty level with health insurance. (Currently, only children are covered in North Carolina.)

In addition, she proposes reaching out to uninsured families when they apply for a birth certificate and when they present their pre-kindergarten health assessment to enter school.

She also endorsed the recommendations of the Task Force for a Healthier North Carolina.

Richard Moore has four proposals to get more uninsured children on existing programs.

As previously noted, two-thirds of North Carolina's uninsured kids already qualify for either Medicaid or Health Choice plans.

The state treasurer, who is running for the Democratic nomination for governor, says the most important part of his proposal is committing state resources to match federal money already available for the programs.

To enroll more kids, he proposes stepping up outreach programs and offering a financial incentive to schools, hospitals, county health departments and other groups for each previously uninsured child they enroll.

He also would require parents to provide a policy number for their child's health insurance on their state income tax return.

Finally, Moore proposes making an interactive form available online for enrollment and re-enrollment.

How can the state get uninsured kids into existing programs?

As noted on Dome last month, two-thirds of North Carolina's uninsured already qualify for either Medicaid or Health Choice plans for low-income children.

A July report from the Task Force for a Healthier North Carolina has more than a dozen recommendations to enroll those children. The task force, a partnership between the N.C. Health and Wellness Trust Fund and UNC-Chapel Hill, was co-chaired by state Sen. Bill Purcell, Rep. Verla Insko and Trust Fund Commissioner Carole Bruce.

In a position paper on health care, Lt. Gov. Beverly Perdue's gubernatorial campaign said the state "needs to implement" the report's recommendations.

They include targeting families on reduced-lunch and food-stamp programs, enrolling children who show up in emergency rooms, allowing parents to apply for benefits online, providing preprinted renewal forms, and reimbursing counties for each child enrolled.

The report also recommends tracking health insurance eligibility through existing computer databases for the state's social workers.

The gubernatorial debate Tuesday was about education.

But both state Treasurer Richard Moore and Lt. Gov. Beverly Perdue took the opportunity to plug their plans for health care as well — a sign of the issue's importance in the Democratic primary.

In response to a question about helping lower income students in school, Moore said that helping children get universal health coverage would help their education.

"We've got a plan," he said. "That's one thing we can take off the plate, take off the schools' plate, the school nurses' plate."

But he said that the state could not afford universal health care for adults at this time.

In a rebuttal, Perdue said that she would provide coverage for all children as well, but she also wants to help lower income adults get health care.

"I would suggest for working poor North Carolina families, the parents too need that health care coverage because the kids don't get it otherwise," she said.

Two-thirds of North Carolina's uninsured children already qualify for state health plans.

According to figures compiled by Action for Children N.C., a child health advocacy group, 177,000 uninsured children in the state come from families earning below 200 percent of the federal poverty level, or less than $41,300 for a family of four.

That means they already should be covered by either Medicaid or Health Choice, two health care plans for low-income children paid for with state and federal dollars.

The state already promotes both programs at hospitals, schools and state agencies, but many parents fail to sign up. Others don't qualify. Children who immigrated illegally cannot receive benefits, while those who immigrated legally still must wait five years to sign up.

Adam Searing, project director for the N.C. Justice Center's Health Access Coalition, said the state can't afford to cover all those children anyway, unless Congress provides more money for the State Children's Health Insurance Program, which funds Health Choice.

"All those kids could sign up, but we don't have the money available," he said.