North Carolina’s most powerful Republican lawmaker on Wednesday fully backed the expansion of Medicaid, raising the stakes of a persistent issue in state politics for a decade that could result in the insurance of hundreds thousands of low-income adults.
Senate Leader Phil Berger was a longtime opponent of accepting federal funds through the Affordable Care Act of 2010 to cover people who earn too much money to qualify for traditional Medicaid, but too few to be eligible for subsidized private schemes. Republican opposition made North Carolina one of twelve states that did not accept the game.
Berger revealed last fall that he was willing to consider expanding Medicaid as part of budget negotiations. Earlier this week, Senate Republicans revealed they were seriously considering a package of healthcare access and insurance changes, including expansion, which was disclosed on Wednesday and heard by a committee. senatorial. A committee vote was expected on Thursday.
“If there is one person in the state of North Carolina who has spoken out against Medicaid expansion more than I have, I would like to meet that person,” Berger said at a press conference, but now, “I think (the expansion) is the right thing for us.
Even if the measure is approved by the Senate, the chances of full passage appear well before the end of this year’s fiscal adjustment session around July 1. expansion and access to health care did not make recommendations.
Berger said the Senate bill contains several provisions the review committee likely would have recommended anyway, and that passing the measure will give the House “something else to chew on.” It is possible that lawmakers will meet again later in the year.
Any final action would be up to Democratic Gov. Roy Cooper, a staunch supporter of expansion who is “encouraged to see progress in getting more people covered by health care in North Carolina,” spokesman Jordan wrote. Monaghan in an email.
In his most public and comprehensive explanation to date, Berger described how he changed his mind after market-based attempts to reform insurance and health care failed.
“Why now? Why is that?” Berger asked. “First, we need coverage in North Carolina for the working poor. Second, there is no fiscal risk to the state budget in the future with this proposal.” And the Medicaid program has been overhauled in recent years so it can handle additional consumers without creating fiscal problems. for the state, he added.
The expansion proposal would probably cover 500,000 or 600,000 people. While about 2.7 million North Carolina residents are now enrolled in Medicaid, some current consumers the state has been required to keep on the rolls during the pandemic would ultimately be covered by the expansion.
Berger said he’s pretty confident Congress won’t cut the federal government’s 90% share of spending on expansion enrollees, and the bill nullifies the program if that were to happen. The state would pay its share through hospital assessments and get an additional $1.5 billion over two years to treat traditional Medicaid patients — an extra sweetener for North Carolina.
“We are unlikely to ever get a better deal than what is on offer to us now,” said Sen. Joyce Krawiec, a Republican from Forsyth County, also a former expansion opponent who helps guide the measure.
The bill directs that a work requirement for expansion beneficiaries be developed and presented to federal Medicaid regulators for approval, but its rejection would not nullify the expansion. Such mandates in other states have been overturned by the courts or blocked by President Joe Biden’s administration.
The long-term prospects for the final passage of the Senate package may have more to do with its non-expansion elements. They include significant easements to state certificates of need laws, which regulate health care facility expansion and equipment purchases, and allowing advanced-level nurses to work independently of physicians.
The nursing license changes were requested by the profession’s lobbying association. Some senators and the North Carolina Medical Society raised concerns about those provisions at Wednesday’s committee meeting, citing patient safety.
Rep. Donny Lambeth, a Forsyth County Republican who, along with Krawiec, leads the study committee and supports the expansion, said in a text message Wednesday that it was important that “we pass a bill of clean expansion – not one that combines a number of other controversial health policy issues.”
But supporters of the Senate bill have said the measure must be comprehensive to ensure enough medical professionals and facilities are available to serve Medicaid patients.
Still, longtime proponents of the expansion were thrilled with the prospects that their ultimate goal might soon be achieved.
“I will say that I am very optimistic,” said Erica Palmer Smith, executive director of Care4Carolina, after the press conference.