The state moved formally Friday to make changes to the Medicaid program with the aim of adding hundreds of thousands of people to the government insurance plan despite opposition from state Republican leaders.
Gov. Roy Cooper announced earlier in the week he would seek to expand Medicaid as allowed under President Barack Obama’s Affordable Care Act. The details of the plan were made public Friday evening.
Proposed changes to the state plan must be posted on the state Department of Health and Human Services website for 10 days before a request goes to the federal government office that oversees Medicaid, the Centers for Medicare & Medicaid Services, or CMS. The state is accepting comments on the proposal.
Republican legislative leaders are already fighting it.
In a letter to CMS, legislative leaders said Cooper was violating the state constitution and three state laws. One of those laws, passed in 2013, prevents Medicaid expansion without legislative approval.
In a statement, Cooper said the 2013 law does not apply to the draft plan.
Expansion is no sure thing, and the statement from Cooper’s office is couched in several conditions.
“If CMS approves a change, if local matching money can be secured, and if state eligibility requirements are changed, then more than a half-million North Carolinians could receive health care beginning in January 2018,” Cooper’s office said.
The hospitals have not agreed to provide the matching money, which Cooper’s office said could be between $100 million and $150 million in the first year. The N.C Hospital Association says the hospitals provide about $1 billion in care each year to residents who cannot pay for it, Cooper’s office said.
Medicaid is the government insurance that covers poor children, some of their parents, the elderly, and the disabled. About 1.8 million people in the state are enrolled in the program, and it costs about $14 billion a year. The federal government picks up about two-thirds of the cost.