Raleigh, N.C. — Three Democratic members of the North Carolina congressional delegation have asked state House leaders to defeat a bill passed Tuesday in the state Senate that would prohibit the expansion of Medicaid to cover adults under the Affordable Care Act.

Congressmen David Price, G.K. Butterfield and Mel Watt sent a letter Thursday to House Speaker Thom Tillis and House Minority Leader Larry Hall, saying they try not to stick their noses in the General Assembly's business but worry that Senate Bill 4 poses "a grave threat to our state's economy and quality of life."

In addition to blocking Medicaid expansion, the bill would preclude the state from establishing an online health insurance exchange, which would give people who don't have employer-sponsored health coverage a way to shop around for their own insurance.

Only 30 percent of low-income adults are now covered by Medicaid because of strict eligibility rules, the congressmen said in the letter, so many families have to rely on hospital emergency rooms for medical care. That creates a "hidden tax" on people with private insurance, as the cost of care increases.

"One need not support the other major reforms included in the Affordable Care Act to agree that expanding Medicaid to able-bodied, low-income adults is a 'win-win' for both the State of North Carolina and its residents," the letter states.

Under the law, the federal government will cover all costs of the expansion for three years and 90 percent after that, and the North Carolina Institute of Medicine estimates that the state could save $65 million over eight years by taking advantage of the federal funding.

"While we are cognizant of the fiscal challenges North Carolina's Medicaid program has faced in recent years, expansion will strengthen the fiscal integrity of the program, not weaken it," the letter states.

Also, a Department of Health and Human Services report projected a $1.4 billion boost to the North Carolina economy from Medicaid expansion, as drug makers, medical device manufacturers and others expand to serve a larger patient base, the congressmen said.

"Why would we block this infusion into the North Carolina economy when unemployment remains so high and our economic recovery remains so fragile?" they asked in the letter.

Gov. Pat McCrory also has expressed reservations about the bill, saying it could cost the state grant money it could use to upgrade the information technology system used to process Medicaid claims.