Is NC Medicaid expansion coming? Lawmakers are ‘optimistic,’ but stuck on a compromise
A Medicaid expansion deal between the Republican-majority state House and Senate is still stalled out.
Democratic Gov. Roy Cooper signed the state budget into law in July, shortly after the end of the General Assembly’s session. Both Cooper and the Republican leadership said that a deal on Medicaid expansion — long an issue tied to state budget negotiations — could be imminent.
But nearly two months after lawmakers left town, there hasn’t been a deal. The standoff this year isn’t between political parties — both Democrats and Republicans now want it. It’s between Republican leaders in the House and Senate whose ideas differ on the bill’s finer details.
On Tuesday, Senate leader Phil Berger and House Speaker Tim Moore separately told reporters where they stand, indicating a compromise could be delayed until December or next year.
“I’m reasonably optimistic that something will happen in December,” Moore said. “Do I think something will happen sooner? That I don’t think so. Is it possible? It’s certainly possible.”
Berger was similarly sanguine.
“You know, the bills are very easy to put together once we can get a deal,” he said. “So I don’t think it will take very long.”
But neither Moore nor Berger indicated any palpable progress had been made toward ameliorating their real rift: amendments to the state’s “certificate of need” law.
North Carolina’s certificate of need law endows the Department of Health and Human Services with authority to prohibit “health care providers from acquiring, replacing, or adding to their facilities and equipment, except in specified circumstances ...,” according to the organization’s website.
Major hospitals and the House argue that certificates of need foster a healthy system in which medical facilities can moderate costs and limit unnecessary services.
Senate Republicans say CONs impede fair competition and promote monopolistic systems.
Moore and Berger each suggested the other is intransigent.
“We have been willing to compromise on the bill we sent over to the House,” Berger said. “Unfortunately, the willingness to compromise on CON does not exist (in the House). We will continue to wait until we get something.”
Moore said the CON kerfuffle distracts from what’s more important: expanding Medicaid.
“I mean, let’s think about this. It’s not the expansion piece that’s in controversy, right?” he said. “It’s CON and the scope of practice provisions. So it depends, if folks are really serious about wanting to fix expansion, we can take care of expansion, and deal with all that other stuff at a later date.”
Berger did not explain what CON amendments his chamber has recently proposed except that they would involve a partial repeal of the current law.
For more North Carolina government and politics news, listen to the Under the Dome politics podcast from The News & Observer and the NC Insider. You can find it at https://campsite.bio/underthedome or wherever you get your podcasts.
This story was originally published August 23, 2022 at 5:23 PM.
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