Politics & Government

Speaker Tim Moore blocks Medicaid expansion, but allows a small step in that direction

House Speaker Tim Moore speaks with reporters in his office on Thursday, March 23, 2017.
House Speaker Tim Moore speaks with reporters in his office on Thursday, March 23, 2017. cdowell@ncinsider.com

A state agency could study the costs and benefits of expanding Medicaid under an amendment added to a House rural healthcare bill Monday night.

The amendment to House Bill 998 from House Democratic Leader Darren Jackson of Wake County avoids using the term "Medicaid expansion" but would order the Department of Health and Human Services to study "whether there are changes to the Medicaid Program that will increase preventative health services, improve health outcomes, and lower the overall costs of care" and include the total cost of any recommended changes. A legislative oversight committee would receive the department's report by Oct. 1.

Jackson stressed that the proposal was "only a study" of "what the costs would be of expanding it," and the amendment wasn't debated further before it was added to HB 998 in a 69-43 vote.

About 25 Republicans joined all Democrats in supporting the amendment.

Jackson's amendment came shortly after House Speaker Tim Moore quashed another Democrat's amendment to expand Medicaid in HB 998.

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Rep. Bobbie Richardson, a Franklin County Democrat, argued that expanding Medicaid would improve health care in rural communities. But Moore ruled the amendment out of order because it would be "appropriating funds out of compliance with our rules," and after Richardson appealed the ruling, the House sided with Moore in a 70-42 vote. The vote was largely along party lines with Rep. Ken Goodman, a Richmond County Democrat, joining all Republicans to block further action on the amendment.

Thirty-three states and the District of Columbia have expanded Medicaid since the Affordable Care Act provided that option, according to the Kaiser Family Foundation.

The expansion has removed millions from the ranks of the uninsured, but North Carolina under Republican control has been among the holdouts. GOP political leaders have been skeptical of whether the federal government would follow through on its promise to cover the bulk of the costs.

The original version of HB 998 was not controversial and included recommendations from a study committee on rural healthcare. It would order DHHS to study potential incentives for expanding medical education in rural areas and possible assistance for rural hospitals seeking to become teaching hospitals, and it calls for restructuring a loan repayment program used by health-care professionals.

Another amendment added Monday night would create reciprocity for dental licenses issued in the four states that border North Carolina. Rep. Bert Jones, a Rockingham County Republican and a dentist himself, said allowing dentists who are licensed in bordering states would improve care by allowing dentists from across the border to open satellite offices in rural communities here.

The amended bill passed unanimously and now goes to the Senate.

Also Monday night, the House approved two other health-care study bills: House Bill 1002, which would study medical education and residency programs, and House Bill 967, which would study potential policy for telemedicine. "We need to study this more before we come up with a comprehensive plan," said Rep. Donny Lambeth, a Forsyth County Republican and sponsor of the bill.

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