Raleigh, N.C. — The state House on Thursday sent bills to the Senate that would block an expansion of Medicaid under the Affordable Care Act and allow transportation planners to study a controversial highway proposed in Garner.

The House voted 75-42 to give final approval to Senate Bill 4. The Senate needs to agree to a minor change before sending the bill to Gov. Pat McCrory, who has said he plans to sign it.

"We've had what seems to be a concerted attack on the unemployed, uninsured and now even the poor," House Minority Leader Larry Hall said. "Are we letting politics get in the way of helping our citizens?"

Hall, D-Durham, unsuccessfully tried to send the bill back to a committee for further study and refinement.

The Medicaid expansion would cover about 500,000 low-income adults in North Carolina, providing them the insurance coverage required when the Affordable Care Act is fully implemented next year. The federal government would pick up the full cost of the expansion for the first three years and the bulk of the costs for several years after that.

Rep. John Blust, R-Guilford, quoted the poem "The Spider and the Fly," saying that North Carolina's budget could end up getting eaten by what looks like an attractive offer from the government.

"Once again, this body has been cast in just a difficult situation because of the make-up of the health care law and the make-up of our politics today. You're left again (with a choice of) are you going to drink cyanide, or are you going to drink arsenic," Blust said.

"Either you have to take the money and take the very big risk that everything isn't going to be paid for in the future, or you can turn the money down and hear some of the stories (of people suffering without health coverage)," he said.

Rep. Nelson Dollar, R-Wake, said there are too many unanswered questions about how the Affordable Care Act will operate for North Carolina to move forward on it.

The bill also prevents the state from creating an online health exchange to allow people who don't have employer-sponsored health coverage to shop around for their own insurance. Without state support, state residents would have to use a planned federal health exchange.

Advocates said expanding Medicaid would bring a projected $15 billion into the state’s economy, creating an estimated 25,000 jobs in health care and related sectors by 2016.

"The whole idea that we can create jobs through this, to me, is hogwash," said Rep. Justin Burr, R-Stanly, saying it was "irresponsible" to take federal money in an effort to create jobs.

Rep. Beverly Earle, D-Mecklenburg, said lawmakers also should send federal transportation and education money back to Washington, D.C., if they turn their backs on the Medicaid money.

"Better to have health care for three years than to not have it at all," Earle said.

'Red route' back on table

Also Thursday, the House voted 87-29 to approve House Bill 10, which repeals a 2011 law that prohibited the state Department of Transportation from considering the so-called "red route" for N.C. Highway 540.

Wake County leaders have planned for years for an N.C. 540 corridor that would take the highway south of Garner. But federal officials insisted on studying alternatives, including the red route, which would take the highway through the middle of town.

Because of the 2011 law, federal transportation officials cut off planning funds needed to complete N.C. 540, saying the state was no longer in compliance with environmental regulations for the project.

Dollar said the state has already invested too much money in the highway to jeopardize its completion by refusing to follow federal guidelines.

"If for some bizarre reason the red route were to come back as the only possible route, we would not build it," he said.

Rep. Darren Jackson, D-Wake, said the study would be pointless because the U.S. Army Corps of Engineers has already decided that the red route would be less environmentally damaging than the preferred "orange route."

"They’re going to tell us, 'Hey guys, you guys got to build the red route, and that’s going to be a waste of $15 million and four years for the town of Garner," Jackson said.

Rep. Bill Brawley, R-Mecklenburg, said the cost of the study will be $1 million, not $15 million and that federal environmental laws don't dictate the location of highways.

"If it comes back that it is less environmentally damaging to build the red route than the orange route, that does not mean that we have to build the red route," Brawley said.