Raleigh, N.C. — 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.