NC sheriffs, county commissioners back Medicaid expansion bill as a crime-, poverty-fighting measure

Two major lobbying groups have put their weight behind a Senate proposal to expand Medicaid and overhaul hospital industry regulations, a bill that is languishing in the House.

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General Assembly Entrance
Travis Fain
, WRAL state government reporter

The lobbying groups for sheriffs and county commissioners across North Carolina backed a major state health care bill this week, calling on lawmakers to pass Medicaid expansion along with wide-ranging changes in health industry regulations.

The North Carolina Sheriffs’ Association said in a letter to House and Senate leadership that expanding Medicaid would fight crime by providing professional care to the “significant percentage” of people in county jails suffering from mental illness and substance abuse disorders.

Giving them taxpayer-funded health insurance “would likely reduce the number of individuals who commit those crimes,” Association Vice President and General Counsel Eddie Caldwell said in the letter. “This in turn would enhance public safety, not only for those individuals, but also for future potential victims of crime.”
The North Carolina Association of County Commissioners weighed in as well, saying Medicaid expansion would “reduce rising health care-related economic pressures at the local level, increase the availability of care for patients, and help struggling rural hospitals.”
Both groups specifically backed the House Bill 149, a Senate proposal that combines Medicaid expansion with a rollback in state hospital regulations, as well as new rules for advanced practice nurses that would let them do more things without supervision from a doctor.

The bill cleared the state Senate with bipartisan support and the blessing of the chamber’s Republican leaders, a major milestone given that Republicans in control of the General Assembly have blocked Medicaid expansion for more than a decade. House Republicans, though, have said they don’t plan to take the measure up this legislative session, which they hope to wrap by early July.

The pressure on them to do so is increasing. The associations represent large groups of local officials. Lawmakers also got letters this week from ECU Health, the state’s largest rural health care provider, and UNC Health, one of the largest hospital groups in North Carolina.

Those letters offered more tepid support for the bill, praising the Medicaid expansion that would unlock billions in new federal funding for hospitals by providing insurance to hundreds of thousands of the state’s working poor, but cautioning lawmakers on the proposed rollback in the state’s certificate of need program.

That program limits the expansion of health care services, such as stand-alone surgery or imaging centers, by requiring providers to prove they’re needed. Hospitals generally favor this program as a check on competition, saying it protects against the over-saturation of profitable services offered by groups that don’t also offer money-losing health services, such as emergency rooms.

“Expanded [Medicaid] coverage would significantly improve the health status of our entire region, from our youngest to our oldest residents,” Michael Waldrum, the CEO of ECU Health, said in his letter. “We recognize there is room to improve the bill.”
UNC Health dubbed itself “grateful” for the bill, which Chief External Affairs Officer Andy Willis called “a tremendous starting point for true negotiations that could lead us to a health care legislative vehicle that does more than close the coverage gap.”


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