Medicaid expansion will benefit about 600,000 working adults

(The Center Square) – North Carolina will ease its certificate of need laws as part of a compromise in the General Assembly to expand Medicaid in North Carolina, legislative leaders announced Thursday.

The move will expand the government health insurance to about 600,000 working North Carolina adults who earn more than the Medicaid income threshold but cannot afford health care.

North Carolina is among 11 states that have not expanded Medicaid under the Affordable Care Act. Republicans had long resisted the move over cost, though legislative leaders reversed course last session and have begun to move this session. Expansion has been a top priority for Gov. Roy Cooper since he took office in 2017.

Speaker Tim Moore, R-Cleveland, described the deal as “a huge announcement … for North Carolina” during a press conference with Senate Leader Phil Berger, R-Rockingham, and others in Raleigh on Thursday.

“What a huge policy direction this is, that will provide help for so many in this state, but it’s going to do it in a way that’s fiscally responsible,” he said.

Berger said that while details will be forthcoming, lawmakers will “move with all deliberate speed” to take action.

The expansion will be funded 90% by the federal government, with the other 10% coming from assessments on hospitals. Those hospitals would receive higher reimbursements to treat Medicaid patients that could total as much as $3 billion annually, Berger said.

In addition, North Carolina could receive $1.5 billion over two years as part of a federal incentive, once approved.

Moore and Berger said the deal will include a partial repeal of the state’s certificate of need laws, which mandate government approval for various health care services and equipment. Expansion, however, will not include reforms for trained nurses to take on more duties without a doctor’s supervision.

Both of those provisions were included in legislation to expand Medicaid that cleared the Senate last session, but languished in the House. Legislative leaders said they expect to enact the expansion legislation after the state budget, likely this summer, and to start enrolling people in January.

“I’m very comfortable with it,” Berger said. “It’s a good agreement for the state.”

As previously reported by The Center Square, the change could have multiple impacts.

Cooper responded to the news in a prepared statement that described the deal as “a monumental step that will save lives,” but called on lawmakers to move faster.

“Since we all agree this is the right thing to do, we should make it effective now to make sure we leverage the money that will save our rural hospitals and invest in mental health,” he wrote. “I look forward to reviewing the details of the bill.”

The North Carolina Department of Health and Human Services also applauded the deal.

“Medicaid expansion will be transformative for access to health care in rural areas, for better mental health and for veterans, working adults and their families,” a release read. “For these people, today’s agreement is life-changing.”

The agreement was praised by Democrat legislative leaders Rep. Robert Reives of Chatham County, and Sen. Dan Blue of Wake County, as well.

“This is long overdue, but we still have work to do so that we ensure this deal allows us to fully access federal funds,” Reives wrote in a prepared statement. “I look forward to seeing the legislation and working quickly to make Medicaid expansion a reality for North Carolina.”

The move comes as an April 1 deadline looms that could result in as many as 375,000 North Carolinians losing Medicaid coverage. That’s when the federal government ends a continuous coverage requirement from the pandemic that prevented states from removing those who do not quality.