NC Medicaid expansion attracts Senate GOP attention | National/International
RALEIGH, North Carolina (AP) — North Carolina Senate Republicans are seriously considering legislation that would expand Medicaid coverage to hundreds of thousands more low-income adults. Such legislation would mark a key step in an extraordinary turnaround by GOP members in the chamber opposed to expansion for a decade.
A bill that has yet to be officially tabled would also include several other health and insurance coverage reforms, according to a summary of the bill obtained by The Associated Press. Many of those proposals, including the expansion, have been discussed in a House-Senate Health Care Review Committee that has met multiple times since February.
“Senate Republicans continue to discuss how to address rising health care costs and increase access in the state,” Lauren Horsch, spokeswoman for Senate Leader Phil. Shepherd. Horsch confirmed the authenticity of the summary but could not say. if and when the legislation would be tabled at the General Assembly’s annual business session, which began last week and will likely end around July 1.
The centerpiece of the measure would be the expansion of Medicaid, which Republicans were cold or outright opposed to for several years after the 2010 federal Affordable Care Act allowed coverage for people earning too much money for coverage. traditional Medicaid. North Carolina is one of twelve states that did not expand Medicaid.
But Berger said last fall that he was now open to expansion, in part because he was now confident that the 90% share of federal government spending on expansion enrollees would not be forthcoming soon. eliminated. More Republicans are also intrigued by the idea, as the Federal COVID-19 Relief Act of 2021 would give North Carolina $1.5 billion over two years to treat traditional Medicaid patients if it agrees to the expansion.
Horsch said Berger saw the omnibus proposal outlined in the summary but declined to say whether he supported it.
The bill’s summary says the proposed expansion, called “NC Health Works,” would cover adults with incomes up to 138% of federal poverty guidelines, likely covering at least 600,000 people. Currently, approximately 2.7 million North Carolina residents are enrolled in Medicaid. Some current enrollees who remained on the rosters during the pandemic would ultimately be covered by the expansion.
The summary says the state’s 10% share of expansion spending would be paid for through a reassessment of hospitals. The expansion would end if Congress increased the state’s share. The program would also include a work requirement for expansion recipients — a mandate that in other states has been struck down by federal courts and blocked elsewhere by President Joe Biden’s administration.
It’s unclear whether the lack of a work mandate would be a deal breaker for House Republicans, who had pushed an expansion bill in 2019 containing such a requirement.
House Speaker Tim Moore said last year that at the time he did not see support within the House Republican Caucus for the expansion.
Speaking to reporters last week, Moore said he “would be surprised” if a Medicaid expansion deal could be reached with the Senate before the end of the business session. A House co-chair of the health care review committee said he doesn’t expect any action on the group’s recommendations until the fall, so a Senate proposal would certainly try to expedite the process.
Any bill would need to pass both houses before heading to Democratic Gov. Roy Cooper, who has repeatedly called for expansion since taking office in early 2017. His budget adjustment proposal released earlier this month contains it again.
“I believe we’re getting closer than ever to a deal,” Cooper said May 11. “I appreciate that Republican leaders take this seriously.” A 2019 budget standoff between the governor and GOP leaders centered on the expansion.
According to the summary, first reported by Axios, the bill would also streamline and restrict “certificate of need” laws that require health regulators to approve expansion plans for hospitals and other providers. medical before proceeding.
The measure would also allow nurse practitioners, certified nurse midwives and nurses in other advanced specialties to practice without formal medical supervision. The legislation would also require state health insurers to cover telehealth services, and in-network health facilities would have to alert consumers when out-of-network providers need to provide care.
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