NC Senate Republicans vote to block Medicaid expansion, exchanges

jfrank@newsobserver.comFebruary 4, 2013 

— Despite last-minute objections from Gov. Pat McCrory, the Republican-led state Senate pushed through legislation Monday evening that will prevent nearly 650,000 residents from getting health insurance and block the state from establishing a health care exchange.

The GOP supermajority used the 31-17 vote to send a message to the federal government that it wants no part of the health care law signed by President Barack Obama, even as other states led by Republicans are accepting the money.

Republican Sen. Tom Apodaca, the bill’s lead sponsor, said the measure tells Washington, “if you want to do it, do it the way you want to do it and leave us out of the equation.”

Hours before the vote, McCrory’s administration expressed caution about moving too swiftly, given the unknown financial ramifications. The Republican governor is worried that the legislation may threaten money for the current system that tracks the state’s Medicaid patients, according to a letter his administration sent to Senate leaders.

“We believe additional time is necessary to evaluate the serious financial ramifications of Senate Bill 4 to North Carolina taxpayers,” wrote Fred Steen, the governor’s chief lobbyist.

The letter put Democrats in the unusual position of echoing the governor’s words, advocating to delay the first major legislation considered by the Senate, which came on the third day of its term.

Medicaid currently covers only low-income women, disabled and elderly adults and children. But under the Affordable Care Act, the program would expand to cover anyone making 138 percent of the federal poverty level or less. The federal government would pay 100 percent of the cost for the first three years and 90 percent thereafter.

The expansion would cover 648,000 uninsured residents, with at least 500,000 expected to enroll, the state estimates.

Senate Republicans called the money “a bait-and-switch” and the rising costs of Medicaid “a cancer” that eats the state budget.

“Too many people have been seduced by the lure of easy money from the federal government,” said Senate President Pro Tem Phil Berger, an Eden Republican. “They will promise anything and they do – often.”

Senate Democrats, outnumbered but vociferous, expressed concern about the “far-reaching implications” of the bill.

“Can the administration of Medicaid be improved? Absolutely,” said Sen. Floyd McKissick, a Durham Democrat. “But don’t throw the baby out with the bathwater. Look at what you are doing to the people who could benefit from this.”

Raleigh Democratic Sen. Josh Stein chastised Republicans for trying to fight the federal health care law with state legislation.

“We can’t,” he said. “That is the law of the land.”

More than 700,000 North Carolinians are expected to take part in the online health care exchanges, a marketplace to buy health insurance, studies show.

Before former Gov. Bev Perdue, a Democrat, left office, she took the first step toward the creation of a state-federal exchange partnership that would give North Carolina some oversight flexibility.

The state received a $74 million grant from the federal government in January to help establish the exchange. But the legislation would require the state Insurance Department to return the money.

The Senate is expected to give a final approval to the bill Tuesday and send it to the House for consideration.

Frank: 919-829-4698

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