North Carolina Medicaid expansion moves forward in legislature

With North Carolina’s two legislative chambers at odds over details of a comprehensive plan for health care, the House on Wednesday voted to approve the linchpin of any deal with the Senate to expand Medicaid to low-income adults. Gave.

With strong bipartisan support, the chamber voted 96-23 to approve more Medicaid coverage made available under the Affordable Care Act of 2010. This could potentially cover 600,000 people who typically make too much to qualify for traditional Medicaid but too little to benefit from subsidized private health insurance. The bill will face another House vote on Thursday before going to the Senate.

North Carolina is one of 11 states that have not adopted Medicaid expansion.

“I’m asking you to support Medicaid expansion because it’s a smart and necessary investment in our state,” Rep. Donny Lambeth, a Forsyth County Republican and the bill’s lead sponsor, said during the debate. “Think about the people you represent who would really benefit from this,” he told aides.

Republican Senate Leader want to expand Medicaid, but with changes such as loosening “certificate of need” laws to offer medical equipment or adding hospital beds, and empowering advanced-practice nurses to treat patients without a doctor’s supervision. House Republicans said they are open to considering individual changes to boost the supply of medical services and providers.

House and Senate Competing bills passed in 2022But could not compromise. Lambeth has expressed optimism that some work can be done this year, and that early voting could start a conversation.

All Democrats joined two-thirds of Republicans present Wednesday in backing the House measure. Democratic Gov. Roy Cooper, who will be asked to sign off on any final deal, strongly supports expanding Medicaid.

For years the Republicans in charge of the legislature argued that expanding Medicaid was Risky for the state’s fiscal picture and broaden the influence of the federal government in people’s lives. But GOP leaders have recently echoed the view, saying that the state’s current Medicaid program is good, there were no signs that Congress would stop covering 90% of expansion spending, and that the working poor should have access to medical insurance. Needed.

The House measure would allow extension applicants ages 18-64 to obtain coverage starting next January. The state would pay its 10% share — several hundred million dollars annually — using revenue from assessments paid by hospitals, which in turn benefit from getting reimbursed because they cover patients with Medicaid.

The state could get an additional $1.5 billion over two years through the fiscal sweetener in the COVID-19 federal relief package. House Republicans aim to use a good bit of the bonus for mental health services and other needs.

The House bill also includes a provision sought by the Senate and state hospitals that would give an additional $3 billion annually. hospital system that treats Medicaid patients,

An amendment approved during 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 receive coverage.

North Carolina has 2.9 million people on Medicaid. Up to 300,000 could lose coverage when COVID-19-era protections expire. Many may qualify again if the state expands Medicaid.

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