Bill would block Affordable Care Act changes in NC

Posted January 30, 2013

— Senate Republicans opened their session Wednesday with an effort to opt out of provisions of the federal Affordable Care Act set to take effect next year.

Senate Bill 4 would exempt North Carolina from establishing a state-run health insurance exchange or an exchange jointly operated by the state and federal government. The exchanges provide people without employer-sponsored health plans with a marketplace to purchase their own coverage.

Sen. Tom Apodaca, R-Henderson, sponsored the bill.

"We think it’s time to opt out immediately - to make our feelings known in the legislature," he said, adding that he doesn't believe a state-federal partnership would give the state more control over any exchange. 

"We’ve heard that argument, but it’s hard to get any details at all from the Feds on exactly how it’s supposed to be," Apodaca said. "They’re still trying to formulate that and move forward. And we feel like, you know what? If they’re gonna do it, let them implement it, let them take care of it."

 The bill directs the state Department of Insurance to return a $73.9 million grant the U.S. Department of Health and Human Services awarded to North Carolina two weeks ago to build a state exchange. Former Gov. Beverly Perdue's administration applied for the grant last fall, with plans to create a jointly operated exchange that the state would gradually assume control of and tweak to fit its needs.

The legislation also would prevent North Carolina from expanding its Medicaid program. The U.S. Supreme Court, in upholding the legality of the Affordable Care Act last summer, exempted states from the federal mandate to expand Medicaid eligibility.

Lawmakers said they have tried to rein in Medicaid costs in recent years – last year, the General Assembly had to fill a $500 million shortfall. While the federal government would cover almost all costs for Medicaid expansion for the first few years, the state's share after that could add hundreds of millions to the budget.

"We feel like anytime you deal with the Feds and they’re talking about expanding a program, you’re gonna get a bill for it," Apodaca said.  

“Senate Republicans are committed to ensuring every North Carolinian receives the highest quality health care and outcomes,” Senate President Pro Tem Phil Berger said in a statement. “Saddling our citizens with the enormous costs of a new federal bureaucracy and entitlements is simply not the way to achieve this goal.”

Gov. Pat McCrory has said his administration is still studying the impact of the health exchange and Medicaid expansion, and he hasn't made a decision on either.

"The governor is continuing to work with HHS Secretary (Aldona) Wos to analyze all options and long-term implications to decide what's in the best interest of North Carolina,” spokeswoman Crystal Feldman said Wednesday.

Apodaca said lawmakers will move ahead with their own proposal, regardless of the governor. 

"We think it’s time to stop now. And we think it’s more of a legislative issue than it is an executive branch issue," he said. 


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  • goldenosprey Jan 31, 2013

    "I am one of the so called elderly (senior)that some of you are crying for and about, but I am sure my ability to survive this tightening of the belt is much better than a lot that have never done a thing to take care of themselves!" Heavenly

    SO I'm already footing the majority of your health care bill thru medicare. You're welcome. Now, why are you worried some poor uninsured families may actually have affordable access to healthcare?

    Why is it a victory to cede state control of a program in NC to DC? At the expense of jobs I was led to believe were so important.

    Republican hypocrisy knows no bounds.

  • NYtoNC81 Jan 31, 2013

    affirmativediversity: Thank you...YES...so far I am quite happy with them.

    Me: Why? They haven't done anything yet. This is just the unreasonableness that partisan politics has created. There should be no reason to bash or praise at all yet. All that's happened so far is talking. Literally.

  • Krimson Jan 31, 2013

    Affirmative Diversity - that's weird, I distinctly remember the Bill passing 60-39, with all dem, 2 ind, and 1 rep voting for, and 39 rep abstaining... But you know, you go ahead and live in your alternate reality, you have that right...

  • lessismore Jan 31, 2013

    wildervb.... you say this money would be paid by the federal government.... and where does the federal gov't get money from??? Some people believe the federal gov't is independent from taxpayers...that money just appears from no where and the fed's have a hugh money tree behind the White House and states should take all they can, because it's free.

  • humm61 Jan 30, 2013

    I am sure those legislators will trot off to their churches this Sunday, piously "amen"ing everything hot-aired preacher in their good Southern Baptist way...an dutterly forget anything Jesus had to say about helping the poor. These are selfish hypocrites and will soon be remebered for what they are - racists and haters.

  • wayneboyd Jan 30, 2013

    Ncfarmhand..."Where is your plan to make it easier for high risk patients to find affordable healthcare.
    Sir open the gate to your chicken pen and stop handfeeding your chickens and watch how quickly they adapt to fending for themselves. The government makes it too easy to sit back and feed off the taxpayers.

  • Nancy Jan 30, 2013

    The cost overruns of this healthcare plan keep going up and no end in sight. I think it's wise for the state not to do the feds job on this. The 'share' the feds will pick up just means we pick it up in taxes on the federal level instead of both federal and state.

  • dontstopnow Jan 30, 2013

    I love our new folks runing the state! About time to get the money hogs out of office and put the brakes on all the giveaway programs in NC. The reckless spending had to stop at some point. Did you folks think that gravy train had no caboose?

    . And BTW, I am one of the so called elderly (senior)that some of you are crying for and about, but I am sure my ability to survive this tightening of the belt is much better than a lot that have never done a thing to take care of themselves!

  • wildervb Jan 30, 2013

    If the State doesn't operate an health insurance exchange then the Feds will by default. So basically the State opted to give up some State control and hand it over to the federal government.
    As for the Medicaid expansion, this would have been 90% paid by the federal government. That money would pay doctors, nurses etc... to provide coverage. Turning that down will cost jobs.

  • affirmativediversity Jan 30, 2013

    More disappointment from this legislature. Those who voted them in, I hope you are happy. Just wait to see how much they stick it to the poor and elderly. Their interest are the wealthy which is less than 10% of N. C. They are not done yet. per free2bme


    Thank you...YES...so far I am quite happy with them.