House and Senate vote to send Medicaid bill to McCrory's desk

Posted February 26, 2013

— North Carolina will reject two central tenets of the federal Affordable Care Act under a bill the House and Senate approved Tuesday.

The House vote was 74-40. The Senate vote was 31-16. Gov. Pat McCrory has said he supports the measure.

The governor and Republican leaders in the House and Senate have remained firm in support of the measure, despite some other GOP administrations around the country embracing Medicaid expansion. New Jersey Gov. Chris Christie is the latest Republican leader to back an expanded Medicaid system in his state.

Changes made during the House-Senate conference committee were "mainly technical," according to those who worked out the compromise. The changes were largely aimed at ensuring the state could continue to draw down federal funding for the NC FAST system, a computer network designed to channel those in need of public aid to the right services. However, advocates point out that North Carolina will be sending back one grant in the hopes of getting another. 

Under current law, only those making 100 percent of the federal poverty level are eligible for the health insurance program. Medicaid expansion would have raised the eligibility limit to those making 133 percent of poverty, or about $15,000 for an individual. All of the expansion costs would be carried by the federal government during the initial three years of expansion. The state would then pay 10 percent of the cost after that. 

Republicans said they worried that, in subsequent years, the federal government would shift more of that burden to the state.

"The notion that you can solve the federal budget problem... is entirely misguided," Sen. Josh Stein, D-Wake, said during the Senate debate.

But GOP leaders said it wasn't the federal budget they were worried about. Sen. Harry Brown, R-Onslow, said Medicaid threw the budget out of balance last year and was on track to run a $300 million deficit this year.

"We had to go to every other agency in state government to pay for Medicaid," Brown said. "I think we’re just being prudent by taking a step back and seeing how this plays out at the federal level. We can always get back in the game."

In the House, Democrats argued that the state is giving up both the chance to cover more people with health insurance as well as the fringe benefits that would come with the funding.

"We are turning down 23,000 new jobs," said Rep. Joe Sam Queen, D-Haywood. 

Debate Tuesday in the House was testy at times.

"Let's stop pretending this is about policy," said Rep. Jean Farmer-Butterfield, D-Wilson. "This is about politics."

That prompted Rep. John Blust, R-Guilford, to push back against the idea that Republicans were acting out of "ill will" or simply to fight a bill championed by a Democratic president.

"It's getting a little tedious to hear this constant cacophony that we're doing things not for good motives but for politics," Blust said, prompting several of his colleagues to stand up to challenge him. 

"Is there something we can see that's a concrete plan for the 500,000 people who will not have health insurance?" Rep. Marcus Brandon, D-Guilford, asked Blust.

"No," Blust replied, earning a sharp, "thank you," from Brandon.

Blust went on to say the 500,000 conflated those who are uninsured now with those who would dump their private health coverage in favor publicly funded insurance.

"They (those numbers) are designed to sell something that people wouldn't buy if they could calmly reflect on the facts," Blust said.

Rep. Verla Insko, D-Orange, cited studies from the North Carolina Institute of Medicine to argue that the 500,000 figure was in fact accurate.


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  • anonymous99977 Feb 28, 2013

    It is my hope that North Carolinians make sure Gov. Pat McCrory is a one term governor. He is going to run this state to the ground. His policies are wrong for North Carolina and the Middle class. Not embracing Medicaid expansion is a fatal decision for the state's economy. What do you think of Bev Perdue now? HUGE MISTAKE.

  • lopo Feb 28, 2013

    As much as I am against medicaid stopping it will only hurt hospitals and EMS. These people do not care, they will continue to use EMS as a taxi and ER's as their free private doctors but now the govt won't pay anything and these people will never pay a red cent and the hospitals and EMS will suffer.

  • tigo7 Feb 28, 2013

    I think expanding Medicaid is a bad idea no matter the cookie the feds offer to take it. After 3 years the matching funds go away and then more of the matching feds funds go away and NC is on the line for all of it. Also consider a health care business cannot afford more than 40% of their practices to be from medicaid or one will be out of business. The rest has to come from private and self-pay patients because reimbursement rates are minimal and a business want have enough money to pay salaries, rent ,lights,insurance etc. I think people think of medicaid as paying like perhaps their own private health care insurance but it does not. For example a therapist said reimbursement is about 18 dollars an hour with lots of regulations that eat up more of one's time. One can imagine the beurocracy required to handle the endless regulations /paperwork involved which is also costly for state governments interms of employees salaries and retirement.

  • NcNativeRaleigh Feb 27, 2013

    With Obama-Care possibly "we the people" can get some relief... "monies", thru penalties (tariffs)as reimbursement for the uninsured and take control of inflated medical cost which lead to higher insurance premiums to offset the medical expenditures they, the uninsured create while staying true to our belief of helping those less fortunate. That is fair and that is conservatism that all can and should support...except welfare Republicans. They would rather act like spoiled brats stomping their feet. No doubt the entitlement mentality of corporate welfare has been lead by blind mice marching to the tune of today's GOP which promises with just one more tax cut, they will give you a better paying job...and off the cliff the blind mice go.

  • jeffdewitt Feb 27, 2013

    Excellent news, we need to be doing things to improve health care access and cost, and ObamaCare does exactly the opposite. This new law puts North Carolina squarely on the side of the good guys in fighting the worst piece of legislation since the New Deal.

  • junkmail5 Feb 27, 2013

    "Please show me proof that their study is wrong." PC, still fighting about the report funded by DHHS

    Show me proof it's accurate. You brought it up.

    that's now how adults have discussions.

    He presented a report. With research, data, and conclusions.

    If you wish to state it's not correct you need to provide evidence of it.

    Stamping your feet and going "nu uh!" is not a rational rebuttal of his source.

  • goldenosprey Feb 27, 2013

    "oldaltar- I totally agree. Chris Christi showed that he cares about his constituents more than a particular political party. In my opinion that is a true public servant. I would love a Chris Christi in NC.- F2bM

    If repubs don't realize that CC and his sort are the only hope of salvation for their party, they will find themselves irrevocably marginalized. Otherwise, he could be the Reagan of the next decade. Even fraudster Rick Scott took the money, Pat. Maybe he was still smarting from the loss of other fed money 2 years ago.

  • Terkel Feb 27, 2013

    "If you make $15K a year you cannot afford health insurance."

    Tell it it your hero. He said we have to spend our money as he orders us to, and you re-elected him.

    "It's not like Roses and Maxway are going to insure the poor."

    That's right. The way 0 wrote this, the middle class is going to insure the poor. Again, complain to him.

  • Terkel Feb 27, 2013

    "Please show me proof that their study is wrong." PC, still fighting about the report funded by DHHS

    Show me proof it's accurate. You brought it up.

  • No Party Affiliate Feb 27, 2013

    "oldaltar- I totally agree. Chris Christi showed that he cares about his constituents more than a particular political party. In my opinion that is a true public servant. I would love a Chris Christi in NC."

    Gotta admit, I do like Chris Christi and thought everyone did as well except his own party. His own party does not like him and calls him a traiter. What does that say about his party?
    Christi has made his party mad so I guess he is doing something right.