Medicaid, the federal healthcare law, and the legislature
Authors of the federal Affordable Care Acted wanted states to expand their Medicaid programs. But it's unclear if North Carolina will and that could create a gap between those covered by the health insurance program for the poor and those able to buy insurance on new health care exchanges.Posted — Updated
But when the U.S. Supreme Court handed Obama what was hailed as a victory for the health insurance law, the justices dealt the administration one setback. The court ruled that states would have the option of expanding their program but couldn't be forced to do so.
Adam Searing, a health policy expert based in North Carolina, says this could leave some families betwixt and between, since they won't be able to afford coverage even with subsidies available to those in the new health exchanges.
"They will not be provided any help when people above them in the income scale will be," Searing said.
But legislative Republicans may be unwilling to expand Medicaid. Although the federal government will initially bear the cost of expansion, states will eventually have to pick up part of the tab.
"There's a potential downside risk there in the range of several hundred million dollars," said Rep. Nelson Dollar, R-Wake, who has been a key player in health and budget policy at the General Assembly. Future versions of the U.S. Congress could push much of the cost for the expanded Medicaid coverage down to the states.
"I think we're going to have to hash that out," Dollar said.
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