Medicaid bill headed to McCrory

jfrank@newsobserver.comFebruary 26, 2013 

— Gov. Pat McCrory is poised to sign legislation that rejects major parts of the federal health care law after Republican lawmakers gave final approval to the measure Tuesday.

The Republican governor supports the effort to block a state-sponsored insurance exchange and the expansion of Medicaid coverage to 500,000 low-income residents. McCrory campaigned against President Barack Obama’s health care law and now says the state’s health care program is too troubled to consider adding more recipients.

But the move comes as another prominent Republican governor and a close ally of McCrory’s – New Jersey’s Chris Christie – announced Tuesday that he would expand the Medicaid program in his state, calling it “the smart thing to do for our fiscal and public health.”

Christie’s rationale echoed Republican Govs. John Kasich of Ohio and Rick Scott of Florida, two strong opponents of the federal law who recently chose to expand Medicaid in their states, and the arguments from North Carolina Democratic lawmakers.

The U.S. Supreme Court case on the Affordable Care Act gave states the option to expand the Medicaid program, and the law allowed states to decide whether to create their own health insurance marketplaces or leave it to the federal government. North Carolina Republican lawmakers initially wanted a state-run exchange but reversed course this year, saying they didn’t want anything to do with what they term “Obamacare.”

The federal law allows Medicaid coverage to extend in 2014 to anyone under 138 percent of the federal poverty level, or about 500,000 people including many uninsured. In North Carolina, 1.5 million people are uninsured, more than the national average.

The bigger program would cost the state about $900,000, with most of the cost covering currently eligible people who aren’t enrolled. But economic studies estimate expansion would add 23,000 jobs and infuse $1 billion into the state’s economy.

Republican lawmakers approved a tweak to the legislation after brief debates that rehashed earlier arguments. A new provision directs the state to return about $64 million in unspent money from a federal grant accepted for the exchange and expansion. The state will still need to spend about $5 million to link its current Medicaid computer system to the federal exchanges that begin enrolling people in October.

In the House debate, Republicans argued the state shouldn’t accept federal money with so many strings attached while Democrats countered that North Carolina’s tax money will go to other states who implement the expansion.

“Let’s stop pretending this is about policy; this is about politics,” said Rep. Jean Farmer-Butterfield, a Wilson Democrat. “What you are doing today is wrong. It is wrong because expanding Medicaid to 500,000 newly eligible people would save nearly 3,000 lives every year.”

Republican Rep. John Blust of Greensboro later countered Democrats’ suggestions, saying that expansion “will not help the poor. It’s just going to increase the day when this whole health care system collapses.”

The legislation won House approval 74-40, largely along party lines. Moments later, the Senate did the same by a 31-16 vote.

Frank: 919-829-4698

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