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McCrory talks Medicaid, infrastructure with Obama

Gov. Pat McCrory and four other governors sat down Tuesday with President Barack Obama at the White House to discuss how the federal government could best work with states during the president's final two years in office.

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By
Matthew Burns
and
Michelle Marsh
WASHINGTON — Gov. Pat McCrory and four other governors sat down Tuesday with President Barack Obama at the White House to discuss how the federal government could best work with states during the president's final two years in office.

The 45-minute closed-door meeting, which included members of Obama's cabinet, covered subjects from immigration reform to energy exploration to education, but McCrory said his focus was on Medicaid and transportation infrastructure.

"I presented a very strong argument for more flexibility if we even consider Medicaid expansion, so we can have a North Carolina plan instead of a Washington plan, and especially a plan that would encourage more people to get a job or get training before we expand another government program," McCrory said after the meeting.

Lawmakers and the governor's office have been grappling for much of the past two years with Medicaid, the state's health insurance program for the poor and disabled. McCrory has pushed for a reform effort that would allow state hospitals and medical providers to create accountable care organizations, or ACOs, to manage patient care. That approach won adherents in the state House, but most state senators seem to favor an approach that would involve large managed care companies and insurers.

Even if McCrory gets what he wants from state lawmakers, those plans would have to be approved by federal regulators. He says the federal oversight is a hindrance in not only reforming North Carolina's Medicaid system but taking on any expansion as allowed under the Affordable Care Act.

Obama debated McCrory's position but the governor said he also left the door open for consideration.

"My main message to these governors is going to be let's figure out how to work together," Obama told reporters before the meeting. "That's the same message I'm going to have for Congress."

Colorado Gov. John Hickenlooper, chairman of the National Governors Association, said all of the issues presented during the meeting led to constructive conversations that focused on providing states more flexibility.

"Flexible federalism is sometimes a cliche, but it's a real meaningful policy issue when you're trying to navigate through the bureaucracies of state government and the federal government," Hickenlooper said.

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