The state Senate gave final approval Tuesday to a bill that would restructure the way health-care and health insurance for the poor, elderly and disabled is handled in North Carolina.
On a 34-10 vote, the Senate sent the bill back to the House, where its prospects are not entirely clear.
The bill would change the current fee-for-service system to a per-member monthly allotment, meant to encourage patients and medical providers to control costs in the Medicaid program. It calls for a mix of commercial insurers and in-state health-care providers.
It would create a new cabinet-level department of Medicaid, with a secretary appointed by the governor and confirmed by the legislature.
An attempt by Democratic whip Sen. Terry Van Duyn of Asheville to amend House Bill 372 to expand Medicaid coverage was defeated.
“I don’t know how many times we can say ‘no,’” said bill sponsor Sen. Ralph Hise, a Republican from Spruce Pine, speaking of the provision in the federal Affordable Care Act that permits states to expand coverage.