'Not on the same page': No deal yet on NC Medicaid expansion

"We're not on the same page," House Speaker Tim Moore, R-Cleveland, told to reporters Tuesday. "I'm reasonably optimistic that something will happen in December."

Hundreds of thousands of uninsured North Carolinians have been waiting for a decade for the state to expand Medicaid. North Carolina is one of only a dozen states that haven't done so already. Gov. Roy Cooper, a Democrat, has been pushing legislators to do it since his first campaign in 2015. But for years, the idea seemed to be dead in the water.

Earlier this summer, it appeared legislators had finally changed their minds. The House and Senate passed legislation to expand the Medicaid program, but their respective proposals were very different.

Legislative leaders pledged to work on a compromise during the summer.

They haven't made much progress, it seems. Moore and Senate Leader Phil Berger each said Tuesday they're not currently involved in any talks.

"No, I’m not negotiating with anyone," Moore said. "Our negotiation was the bill we passed."

Added Senate Leader Phil Berger, R-Rockingham: "They know where I am, and they know what my position is. So I'm not having any active back and forth with them."

At issue is the Senate's insistence that any expansion bill include additional changes to other health care policies, including so-called certificate-of-need rules that allow the state to regulate the number of healthcare facilities that can be built in any given area.

The goal of those rules is in part to reduce costs passed on to consumers for facilities that aren't actually necessary. But Berger said they limit competition, driving up costs and reducing the quality of care.

"I believe what we see, particularly in North Carolina, is a monopoly that hospitals have," Berger said.

Medicaid expansion would mean $500 million a month for NC, state health department says

Hospitals say certificate-of-need rules protect them from losing revenue to other providers for services like outpatient surgeries. They're opposed to the changes the Senate has proposed. Berger blamed the hospitals for the lack of progress toward a deal.

Moore, on the other hand, put the blame on the Senate. He said the House has consistently taken the position that the Medicaid expansion bill should not include other policy items.

"There are other issues that the Senate brought into the mix that don’t necessarily have to be a part of it," Moore said. "If folks are really serious about wanting to fix expansion, we can take care of expansion and deal with all that other stuff at a later date."

Moore said he's open to discussing certificate-of-need reform in a separate bill. But he's concerned that the Senate's proposed changes could hurt the bottom line at rural hospitals, reducing health care access in those communities. "As long as we can protect those things, I think there's a pathway," he said.

High hopes and dashed plans: GOP policy flops prompt calls for further action

Meanwhile, about two dozen activists rallied outside the legislative building, calling on lawmakers to reach a deal.

"The health of North Carolinians should not be a political game in a showdown between the North Carolina Senate and the North Carolina House," said Dreama Caldwell with the rural advocacy group Down Home North Carolina. "Because it's a game where there are no winners, and the people of North Carolina are losing, and they can’t wait any longer."

Leslie Boyd stood behind Caldwell. In 2008, her son Matt died at just 33. She said he was denied care because he could not get insurance due to a birth defect that was considered a pre-existing condition.

"He died of colon cancer, which should have been diagnosed," Boyd told WRAL News. "He went to the emergency room three times and left each time with a misdiagnosis and a bill. By the time they did anything, it was too late to save his life."

Gesturing toward the legislative building, she said: "It’s time that these people who have all the healthcare they need realize that others need it too."