North Carolina would reap more than $500 million a month in federal funds if lawmakers agree to expand Medicaid in the coming months, according to the state Department of Health and Human Services.
Most of that money would come from increased insurance coverage as the state adds hundreds of thousands of people to its Medicaid rolls and the federal government picks up at least 90% of the cost.
The extra money would come to hospitals through a federal stabilization program tied to the expansion, and the state itself would save about $15 million a month in excess costs if the expansion went through, according to a one-page analysis the department provided. WRAL News.
But Medicaid has not been expanded. Negotiations between chambers in the state legislature stalled before the session adjourned this month.
And on Tuesday, the state Senate’s Republican leader pointed the finger at the hospitals, saying their continued opposition to a regulatory rollback that GOP senators want to bundle with the expansion is blocking a deal.
Hospital support is key to passage in the North Carolina House of Representatives, which will have to vote on the expansion to send a bill to Gov. Roy Cooper, who has made expansion a top priority all along his on duty.
Hospitals, however, say they have been seeking expansion for years. North Carolina is one of a dozen states that hasn’t expanded, and Senate President Pro Tem Phil Berger and other members of the Senate Republican majority are a big reason why Medicaid hasn’t been expanded here.
“We are disappointed that the expansion has not been resolved and urge state lawmakers to do so sooner rather than later,” North Carolina Health Care Association spokeswoman Cynthia Charles said Tuesday. The association lobbies for hospitals across the state.
Berger and other Senate Republicans are pushing for industry changes that hospitals and doctors oppose. For hospitals it’s a return to the so-called certificate of need rules that govern competition in the industry. Hospital executives say they need the rules to keep surgery centers and other independent providers from cherry-picking the profitable parts of their business, leaving hospitals to fund emergency rooms without all the revenue lines that subsidize them. those.
Berger, R-Rockingham, argues that if the state is going to provide health insurance to hundreds of thousands more people, North Carolina needs supply-side changes to avoid provider shortages. He combined the restoration of the certificate of need and legislation giving more authority to nurses — something many doctors oppose — with the expansion in House Bill 149, which GOP senators released in late May.
Since then Berger said the Senate has offered “concrete proposals for compromises that would be acceptable and there is absolutely no movement.”
“There is a window to do something,” Berger said Tuesday. “But frankly, as long as hospitals remain as intransigent as they are, I don’t see us making any progress.”
The House Republican majority backed its own expansion plan in June, but it does not include the reforms senators are pushing for. Even if it passed, the House proposal would require another vote in December to actually expand Medicaid coverage.
Both chambers have said the other’s bill is a non-starter.
House Speaker Tim Moore, R-Cleveland, said Tuesday that there is “some room for some of those things [the Senate proposed],” but lawmakers should be careful interfering with health industry regulations.
“When hospitals come to us and say something is stable or not stable, we have to listen to that very carefully,” Moore said. “[On certificate-of-need reform]I’d like to see hospitals on board with that before it’s something we go through.”
Advocates held a vigil Tuesday outside the General Assembly, imploring lawmakers to act and highlighting the stories of people who have died in recent years without health insurance. Rebecca Cerese, a policy attorney at the North Carolina Justice Center, held up pictures of people whose cancer wasn’t caught until it was too late to treat.
They delayed care, she said, because they didn’t have insurance. Routine screenings may have saved their lives, she said
“These are real human lives,” Cerese said with tears in her eyes. “Health care cannot wait.”
Despite the apparent lack of movement over the past month, Berger maintained some optimism that an extension deal will be negotiated, although negotiations could spill over into next year.
“I don’t think you can look at where we are now compared to where we were in April of this year and not feel like we’ve made progress,” Berger said. “I think there has been good progress. I think we will get there. … I think we’re moving in the right direction.”