Did NC Democrats just blow it on Medicaid expansion?
Posted March 13, 2019 6:33 p.m. EDT
Updated March 14, 2019 11:44 a.m. EDT
Raleigh, N.C. — The Senate gave bipartisan approval Wednesday to legislation that would let small businesses band together to buy cheaper health insurance, but only after Democrats tried and failed to tack a multibillion-dollar Medicaid expansion into the language.
Because of a little-used parliamentary rule, some suggested the gambit doomed expansion, probably the Democrats' top legislative priority, for this entire legislative session.
Senate Bill 86 is a Republican attempt to rein in health care costs for small businesses, but it attracted support from the left this year as protections were built in to keep policies offered through these alliances largely in line with the Affordable Care Act.
The bill cleared a key vote Wednesday afternoon with more than half of Senate Democrats voting yes, and the bill will likely pass in another Senate vote Thursday and head to the House for more debate.
Update: The bill cleared the Senate Thursday, 38-8.
But Republicans tabled a series of Democratic amendments to the bill during Wednesday's floor debate, including one to expand Medicaid.
That proposal, also the subject of several Democratic bills and part of Gov. Roy Cooper's budget proposal, would bring down billions in federal funding to expand health coverage to hundreds of thousands of low-income working adults in North Carolina.
There's a rule, deep in the Senate rule book but quite explicit, that says any proposal from any amendment that's tabled on the Senate floor can't come back before the body that session.
"I don't know if they realized that, but at least as far as the Senate rules are concerned, Medicaid expansion would not be eligible for consideration in the Senate for the remainder of this session," Senate President Pro Tem Phil Berger said after Wednesday's floor session.
Lt. Gov. Dan Forest, who as president of the Senate could be called on to interpret the rule, said he'd likely defer to Berger if the issue comes up.
"(They) could have effectively just killed Medicaid expansion in that one little endeavor there," Forest said.
Democrats weren't buying it. The rule, and any other on the Senate floor, can be suspended by three-fifths of the body.
That's 30 votes, meaning nine Republicans would need to side with the chamber's 21 Democrats.
But the bottom line for Democrats: Medicaid expansion isn't coming to the floor without backing from Senate leadership, making all this talk about rules irrelevant.
"If the majority doesn't want to consider Medicaid ... it doesn't matter if you've got this amendment," Senate Minority Leader Dan Blue said. "This rule is not going to keep us from debating the issues that are important to North Carolinians."
Medicaid expansion may well come down to a state budget debate this year. Republicans hold majorities in both chambers but lost their super-majorities last year, giving Cooper's veto new sticking power. He could hold off final approval of the budget over Medicaid expansion.
"Nothing has changed," said Blue, D-Wake. "If it's going to take Medicaid expansion to pass a budget, it will take Medicaid expansion. ... If they want to expand Medicaid and this rule is in the way, you suspend the rule."
Whether it matters at the bottom line or not, Republicans seemed to be enjoying the idea Wednesday that Democrats may have hoisted themselves with their own petard.
Asked what would happen in the end, Forest smiled.
"Strange things," he said, "happen every day."