GOP lawmakers propose new way to expand Medicaid

Posted April 11

— After years of vehement Republican opposition to expanding Medicaid in North Carolina, a group of GOP House members on Tuesday rolled out a plan to provide health coverage to an estimated 300,000 of the state's working poor.

Under House Bill 662, the state Department of Health and Human Services would create a program similar to Medicaid, dubbed Carolina Cares, for people ages 19 to 64 who earn too much to qualify for Medicaid but are still below 133 percent of the federal poverty level. Participants would have to pay 2 percent of their annual income as an insurance premium, as well as routine co-pays, and they would have to undergo routine health screenings, such as physicals and mammograms, to remain eligible.

"I don't really view it as an expansion (of Medicaid) as most of the states that have expanded have approached it," said sponsor Rep. Donny Lambeth, R-Forsyth. "This has no new costs, no new liabilities, for North Carolina."

Lambeth, a former president of Wake Forest Baptist Medical Center, said Carolina Cares would be funded by participant payments, federal funds and special assessments on hospitals and health care providers.

"This product is unlike any other state in the nation," he said. "It establishes a new health care paradigm in North Carolina rooted in consumerism and personal responsibility."

Democratic Gov. Roy Cooper has been pushing for a Medicaid expansion for months, saying it would improve the overall health of North Carolina and bring millions of federal dollars to the state, which would help struggling rural hospitals. Republican lawmakers went to court in January to block any unilateral expansion attempt, citing laws passed in recent years that require legislative approval.

Cooper's office didn't respond Tuesday to a request for comment.

Rep. Verla Insko, D-Orange, called the proposal "a step in the right direction" but said she is concerned about some of the restrictions in it.

"There are probably places in the state where people don't have jobs and can't get jobs because they're not qualified for any job that's available and no one will hire them," Insko said.

Meanwhile, House Speaker Tim Moore said he's leery about anything that smacks of Medicaid expansion.

"At the end of the day, I want to see people on private insurance that have jobs and not expand any type of entitlement that's out there," Moore said, adding that he is willing to consider the measure.

Lambeth said he has been working on the Carolina Cares concept on and off for a few years, but he said North Carolina's overall Medicaid reform program needed to be in place first. He said he also held off to see what actions would be taken regarding the Affordable Care Act before rolling it out.

An analysis of the program shows it could save North Carolina $45 million annually because providers wouldn't have to shift the cost of caring for uninsured patients to those with health coverage, he said.

"We need this program. We need this for our citizens, we need it for our hospitals and we need it for our state's future," said sponsor Rep. Greg Murphy, R-Pitt, a practicing physician, who said access to health care in eastern North Carolina is extremely limited and would receive a boost from Carolina Cares.


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  • Bobby Lee Jimmy Billy Apr 12, 6:57 a.m.
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    Carolina Finally Cares after years of refusing Medicaid Expansion 6 years ago. Wonder why...

  • Teddy Fowler Apr 11, 3:53 p.m.
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    Maybe they will be still getting the federal money for Medicaid expansion... and the 2% will offset any additional monies that the State would normally be required to pay

  • Kathryn Adams Apr 11, 3:25 p.m.
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    Good point. I wonder if they're counting on the requirement for annual checks-ups to save the state money. Having medical conditions like diabetes and heart problems brought under control BEFORE someone has to be rushed to the ER has the potential to save a lot of money. I'd like to see a rundown of how much is spent in this state on emergency treatments for manageable conditions.

  • Mike Watson Apr 11, 2:39 p.m.
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    I'll need to see the actual data to see if this is a workable idea, but its doubtful that it will pay for itself like they are trying to say. 2% of an indigent's yearly salary isn't much. For a family of 4 133% of Federal poverty level is a salary of only 33,00 (approx), thats about $660 per year for the family in medical payments (not including co-pays).