@NCCapitol

@NCCapitol

Preventing Medicaid expansion passes key House vote

Posted February 13, 2013

— The state House gave tentative approval Wednesday to legislation blocking the expansion of Medicaid and the development of an online health insurance exchange under the federal Affordable Care Act.

The House voted 75-39 for Senate Bill 4, and a final vote is expected Thursday. After earlier expressing reservations about the bill, Gov. Pat McCrory said Tuesday that the state Medicaid system is too troubled to expand, so he plans to sign the bill into law.

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.

"When you get this free money, there's a hook," said Rep. Justin Burr, R-Stanly, predicting federal regulations would eventually cost North Carolina.

"This is one of the problems I have with 'Obamacare' or the Affordable Care Act," said Rep. Nelson Dollar, R-Wake. "There's just a lot of promises that down the road there are no answers for."

Rep. Jeff Collins, R-Franklin, compared the government's offer to pay for expanding Medicaid to "playing with Monopoly money," saying continued spending and borrowing will only aggravate the nation's debt crisis.

"It's coming from your children and grandchildren, if you have any, and it's coming from mine. That's where this money is coming from," Collins said.

Democrats chided Republicans, who last week approved a bill to slash jobless benefits as part of an overhaul of the state unemployment system, for again knocking a safety net out from underneath the poor.

"No one put you in office to say you don’t like something,“ said Marcus Brandon, D-Guilford, who accused Republicans of using demagoguery against the Affordable Care Act. “That’s not governing."

Rep. Deborah Ross, D-Wake, said "fear and loathing" was driving the bill.

"It's fear of something you can't control, and I understand that. But even more than that, it's loathing of the fact that we have the Affordable Care Act in the first place, and that is the saddest thing," Ross said.

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.

"You haven’t created a job in the two years that you’ve been here," an irate Rep. Mickey Michaux, D-Durham, told the GOP majority. "You’ve got 23,000 jobs on the line right here."

Republicans easily defeated three attempts to amend the bill, including a proposal to accept the federal Medicaid expansion funding for the next three years.

"You can't unring that bell," Burr said, noting it would be difficult to withdraw coverage for people once they were on the Medicaid rolls.

Under the bill, North Carolina also would not participate in creating a health exchange, which allows people who don't have employer-sponsored health coverage shop around for their own insurance. Without state support, state residents would have to use a planned federal health exchange.

"This is their idea," Burr said of the federal government. "They should manage it instead of putting it on the state."

The only changes made to the original Senate bill ensure that the state can continue to draw down federal funding for the NC FAST system, a computer system that will channel people to Medicaid and other benefit programs. That amendment means the Senate must agree with the change before the bill is sent to McCrory.

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  • Crumps Br0ther Feb 15, 2013

    They care nothing about more jobs for NC. They just hate President Obama and anything he proposes. Now all they whine about is spending but when they had a chance to do something about it, they did nothing. Spending is just a scape goat to push through what they want- making sure their rich friends and contributors are happy.
    free2bme

    time to stop being a victim and depending on government and be a viking and depend on yourself. But it is much easier to blame other people isnt it?

  • junkmail5 Feb 14, 2013

    Under the Affordable Health Care Act, a family of four earning $88,000 or less qualifies for medicaid- Morrigan

    Where'd you get that from?

    http://www.commonwealthfund.org/Blog/How-the-Affordable-Care-Act-of-2010.aspx

    ". In 2014, the ACA expands Medicaid eligibility for all legal residents to 133 percent of the federal poverty level (about $14,404 for a single adult or $29,327 for a family of four). "

    $29,327 is less than $88,000 isn't it?

    A lot less in fact.

    $88,000 is the cut off to get ANY help at all (some tax credits).. not to get medicaid.

  • Terkel Feb 14, 2013

    "Under the Affordable Health Care Act, a family of four earning $88,000 or less qualifies for medicaid."

    Some managers at DHHS in the Medicaid Division qualify for Medicaid.

  • Terkel Feb 14, 2013

    oleguy, you convinced me. I need an eye exam and glasses. I asked the Dr here in town if there was a cash discount and was told no. I'd heard often of cash discounts and was surprised: they have no form to file, no waiting for the money, and then they never get the full amount they "bill" anyway! They wouldn't even hear of accepting that amount from me. I guess when you live in a dying town with few services and the nearest option is an hour away, you do what you want. And I guess I'll drive an hour.

  • free2bme Feb 14, 2013

    They care nothing about more jobs for NC. They just hate President Obama and anything he proposes. Now all they whine about is spending but when they had a chance to do something about it, they did nothing. Spending is just a scape goat to push through what they want- making sure their rich friends and contributors are happy.

  • Terkel Feb 14, 2013

    "FairPlay - forgive me, but would you please cite a source for that "auditor was said to have found hundreds of millions of waste and incorrect bookeeping", so we can all feel good about believing it - Gork"

    Psst. Gork, there's ANOTHER story about DHHS fraud, this time with overtime payments to salaried, and VERY well-paid, people including the program manager. No link. Look it up yourself.

  • free2bme Feb 14, 2013

    The NC Legislature cares about nobody but their rich friends. They do not care about the low income families that would have benefited from this expansion. The solution is for NCarolinians go to the polls in record numbers in 2014 and 2016 and show them how disappointed and hurt we are by their actions.

  • aetius476 Feb 14, 2013

    "Almost all investments are in things other than currency so whilst high inflation has its bad sides its not exactly Armageddon." - Grand Union

    It is a heavy tax on the poor and those on fixed incomes. Inflation is a VERY regressive tax. something I thought you did not approve of.

    "And one good side is that it would make our National debt shrink in real terms." - Grand Union

    Well, if interest rates track inflation up, our debt service will be very painful indeed. Plus everything government buys will have gone up in price as well. All your precious "infrastructure projects" will cost much more.

  • rocket Feb 14, 2013

    "TAKE IT FROM THE POOR AND GIVE IT TO YOUR RICH FRIENDS."

    Government "takes" through taxation. The poor pay very little in taxes. You are confusing "taking" with giving less.

  • lasm Feb 14, 2013

    eddybal: "Here is a chance to get health care coverage for half a million uninsured North Carolinians, with very little money to pay, and the governor claims he is not ready for it."

    Did you not read or know "Without state support, state residents would have to use a planned federal health exchange". Same kind of coverage minus NC getting stuck with the bill later on. As quoted in the article: "This is their idea," Burr said of the federal government. "They should manage it instead of putting it on the state." He should have "their MESS".....

    "23,000jobs"??? That's not creating jobs because they would be gov't jobs-paid by taxpayers (taxes-which BO wants to increase AGAIN). We finally have people in our NC gov't that have some financial sense. We don't need anymore "tax & spend" or letting the federal gov't tell us how to run our state.

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