As session ticks away, dim prospects for Medicaid expansion

29 June 2022

Top General Assembly leaders said there was no movement Wednesday toward a last-minute deal to expand Medicaid in North Carolina and bring government health insurance to hundreds of thousands of people in the state.

Both the House and Senate have passed expansion plans, but neither side has been willing to back the other’s deal, and the heads of the two chambers’ Republican majorities said Wednesday evening that they haven’t discussed a compromise.

“We passed our bill,” Speaker of the House Tim Moore said. “We haven’t heard anything back.”

Senate President Pro Tempore Phil Berger said his chamber wouldn’t take up the House bill. “I don’t know that there’s a pathway for us to reach an agreement,” he said.

The Senate plan pairs expansion with a number of regulatory rollbacks in the healthcare industry, including an easing of the state’s certificate-of-need laws, which limit hospital expansions. The hospital industry has fought this change for years and is backing the House’s Medicaid plan, which deals only with expansion.

The House bill doesn’t actually expand Medicaid, though. It creates a joint House-Senate committee to review details of an expansion plan, which Gov. Roy Cooper’s administration would hash out with the federal government. That plan would go before the committee in December, which could forward it to the full legislature for final passage.

“The House passed a study,” Berger said Wednesday. “I don’t know that anybody can look at that and say the House has taken any substantive action in connection with expanding Medicaid.”

Time is running out. The Senate plans to adjourn this legislative session Friday, and Berger has said repeatedly that he doesn’t expect to come back into session again this year to vote on Medicaid. The House has discussed adjourning Saturday, but Moore said Wednesday that there are “decent odds” the chamber will wrap its business Friday.

North Carolina is one of a dozen states that has not expanded Medicaid. Doing so would unlock billions of dollars in federal funding, with the U.S. government paying 90% of expansion costs and kicking another $1.5 billion down to the state in an enticement that Congress passed last year to appeal to holdout states.

Moore, R-Cleveland, said that he and Berger, R-Rockingham, will likely discuss Medicaid again before the session wraps.

“We’ll see what happens,” Moore said.

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