RALEIGH, NC – The North Carolina General Assembly began Tuesday, what could become a last-ditch effort to expand Medicaid to hundreds of thousands of low-income adults in the state with one measure. The House quickly passed two committees with bipartisan support.
The bill, expected to be debated in the House of Representatives on Wednesday, would direct the state to accept Medicaid coverage for people aged 18-64 who earn too much to qualify. get regular Medicaid but not enough to get the highly subsidized health insurance that the Affordable Care Act of 2010 provides. North Carolina is among 11 states that have not yet approved the Medicaid expansion.
Related: North Carolina is more likely to expand Medicaid, says Adam Searing of Georgetown University
“We are fighting to pass this measure to help people in North Carolina have a better standard of living (and) better health care,” said Rep. Donny Lambeth, a Forsyth County Republican. and was a major sponsor of the bill, told the House Health Committee. “Let’s really make a difference in North Carolina.”
The question of expanding Medicaid has been discussed in the state for more than a decade, with Republicans in charge of the General Assembly often blocking the idea and Democrats led by Governor Roy Cooper leadership asked them to enact it. But GOP heavyweights, especially Senate leader Phil Berger, have recently come up with the idea.
Last year, both chambers overwhelmingly passed measures to expand competition without ever reaching a compromise. Senate Republicans insist any package contains provisions designed to ease the “certificate of need” law that requires health regulators to sign off on expansion plans. medical service providers. The Senate also wants to allow certain specialty nurses to practice independently without a doctor’s supervision.
Tuesday’s House bill had nothing to do with it, as Lambeth had said House GOP leaders wanted a sensible expansion measure that many Republicans in the room could support. But Lambeth said he hopes the additional provisions will be reviewed by the Senate, with the goal of hammering out a final agreement.
“My guess is that we’re going to put together a comprehensive bill that covers more than just expansion at some point,” Lambeth told reporters after the health committee approved the measure later. Less than 15 minutes of discussion on a voice vote containing a “no.” The bill was then passed by the finance committee without any public objection.
The measure would direct the state starting next January to include eligible applicants to expand — potentially up to 600,000 people — under the 2010 federal health care law through a program that name NC Health Works.
The federal government covers 90% of the costs for Medicaid recipients during the expansion. The measure would again pay for the 10% state share through assessments paid for by hospitals, which in turn would benefit from being reimbursed when they cover patients with Medicaid.
Not a Modern Healthcare subscriber? Sign up today.
The state could also receive an additional $1.5 billion over two years through financial assistance in the federal COVID-19 relief package if it accepts the expansion. Wayne Sasser of Stanly County, who chairs the health committee, said about half of that money could be spent by lawmakers for mental health services.
The measure contains a provision sought by the Senate and state hospitals that would result in higher reimbursements — potentially $3 billion annually — to hospital systems as they regulate treating Medicaid patients.
The House Bill also does not include a job requirement for applicants. But it directs the state to ramp up workforce development initiatives as enrollees seek to return to work or establish new careers.
All but six House Republicans present voted for the House expansion bill last year, which would not actually enact the expansion. Instead, it will direct a vote six months later on a package proposed by health officials in Cooper’s administration.
While Lambeth still expects a strong bipartisan vote to pass the current bill on Wednesday, he acknowledged many Republican colleagues remain apprehensive about the expansion. He said Republicans in the House of Representatives in caucus on Monday discussed the expansion for more than three hours.
North Carolina Medicaid enrollment is 2.9 million. The state’s Department of Health and Human Services says up to 300,000 current beneficiaries could lose their full health care coverage when the federal government ends a ban on removing people from the Medicaid list during the period. pandemic and require states to conduct annual eligibility verifications.
Early enrollees could lose coverage under this change starting July 1, but DHHS said many of those removed will be eligible through the Medicaid expansion. Lambeth said passing the Medicaid expansion in 2023 could help prevent the laborious re-application process for some people who would qualify.
Dozens of healthcare lobbyists and advocates for the poor arrived at the legislative complex Tuesday to support the expansion, with some leaving Valentine’s Day-themed messages at the office. members’ rooms. But their voices are not needed in committees as the bill speeds up.
