With two North Carolina legislative chambers disagreeing over the details of a comprehensive plan for access to health care, the House gave provisional approval Wednesday to a peg of any deal. Senate by voting to expand Medicaid to more low-income adults.
With strong bipartisan support, the board voted 96-23 to accept more Medicaid coverage available under the 2010 Affordable Care Act. It could cover 600,000 people. potentially earning too much to qualify for Regular Medicaid but too little to benefit from subsidized private health insurance. The bill still faces another House vote on Thursday before reaching the Senate.
North Carolina is among 11 states that have not yet approved the Medicaid expansion.
“I ask you to support expanding Medicaid because it is a smart and necessary investment in our state,” said Rep. Donny Lambeth, Forsyth County Republican and lead sponsor of bill, said during the debate. “Think about the people you represent who will really benefit from this,” he told colleagues.
Republican Senate leaders also want to expand Medicaid, but with changes such as relaxing the “certificate of need” law to provide medical equipment or add hospital beds and empower nurses Advanced practice of treating patients without physician supervision. House Republicans said they were willing to consider the changes separately, as well as other changes to promote the delivery of health services and providers.
The House and Senate passed competing bills in 2022, but were unable to reach a compromise. Lambeth has expressed optimism that some things can be achieved this year and early voting could start negotiations.
All Democrats joined two-thirds of Republicans present Wednesday to support the House measure. Democratic Governor Roy Cooper, who would be required to sign any final compromise, strongly supports Medicaid expansion.
Republicans in charge of the legislature for years have argued that expanding Medicaid is risky to the state’s fiscal picture and would expand the federal government’s influence over people’s lives. . But GOP leaders recently floated the idea, saying the state’s current Medicaid program is reasonable, with no indication that Congress will stop covering 90% of open costs. wide and the working poor need health insurance.
The House measure would allow extended enrollees aged 18-64 to receive coverage starting next January. The state will pay out 10% of its shares—several hundred million dollars annually—using the revenue from assessments paid for by hospitals, thereby benefiting from reimbursement as they cover for patients with Medicaid.
The state could also receive an additional $1.5 billion over two years through financial assistance in the federal COVID-19 relief package. House Republicans want to use a good portion of the bounty for mental health services and other needs.
The House bill also includes a provision sought by the Senate and state hospitals that would bring an additional $3 billion annually to hospital systems that treat Medicaid patients.
An amendment approved in Wednesday’s floor debate would direct state health officials to try to negotiate with federal regulators to require some Medicaid enrollees to work if they want to continue to receive coverage.
North Carolina has 2.9 million Medicaid beneficiaries. Up to 300,000 could lose coverage when COVID-19 era protections end. More people could qualify again if the state expands Medicaid.
