North Carolina Medicaid expansion measure back before House

Published 9:11 am Sunday, February 12, 2023

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By Gary D. Robertson, Associated Press

The North Carolina House will hear and likely vote on a Medicaid expansion measure in the coming week, a key legislator said.

The bill’s introduction last week, along with comments Thursday from Senate leader Phil Berger, reaffirms that a deal on expansion and perhaps other health care access reforms hasn’t yet been reached between the two chambers. But it also means that accepting expansion remains a priority for Republicans during this year’s chief General Assembly work session.

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The House measure scheduled for debate in the chamber’s health committee on Tuesday would direct the state starting in 2024 to cover several hundred thousand people who would qualify for expansion under the 2010 federal health care law.

Floor votes could come later Tuesday and Wednesday, said Rep. Donny Lambeth, a Forsyth County Republican and chief bill sponsor.

Both the House and Senate passed competing expansion bills last year, but they couldn’t agree on whether additional health care access changes sought by the Senate should be included.

The House bill lacks many of those additional provisions sought by the Senate, including ways to scale back and streamlining “certificate of need” laws that require health regulators to sign off on expansion plans by medical providers. Another provision the Senate wants would give some specialty nurses independence to practice without a physician’s supervision.

“It’s not the bill that we need in North Carolina expanding Medicaid,” Berger told reporters on Thursday.

In a recent interview with The Associated Press, Lambeth said that he was also assembling a separate certificate of need reform bill and was working with another House Republican on how to increase the supply of health workers.

Lambeth acknowledged that partitioning these health care proposals in separate bills contrasts with the more comprehensive bill the Senate passed last year. But some House Republicans only support some of the provisions, he said.

North Carolina is one of a dozen states that hasn’t accepted Medicaid coverage for healthy adults who make too much money to receive conventional Medicaid coverage but not enough to access highly-subsidized private insurance.

The federal government pays 90% of the costs to cover expansion enrollees. The state also could get an extra $1.5 billion over two years through a financial sweetener in a COVID-19 federal relief package.

The House bill also would direct the state to participate in a program that would result in higher reimbursements for hospital systems when they treat Medicaid patients. And it lays out efforts to help Medicaid recipients access workforce development initiatives as they seek to return to employment or establish new careers.

Berger pointed out that the House measure contains a provision that would void the act if it became law should no state budget law get enacted this calendar year. He suggested such a condition could further complicate negotiations with the House on a package of health care changes.