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WNC legislators take first voters to expand Medicaid for 600,000 North Carolinians

State Rep. Donny Lambeth (R-Winston-Salem), a retired hospital administrator, filed House Bill 76 “Access to Healthcare” last week, which would expand the state’s Medicaid program to close the coverage gap for an estimated 600,000 North Carolinians. 

The legislation has wide bipartisan support, flying through the North Carolina House with a 96-23, even after adding amendments for a work requirement – if one were to be adopted by Congress – $50 million to help counties with their expenses for verifying Medicaid roles and $14 million in tuition reimbursement for nursing students who agree to work in underserved rural areas. 

The bill would mean health insurance coverage for people ages 18-64 who make too much to qualify for conventional Medicaid but not enough to receive the heavily subsidized health insurance that the 2010 Affordable Care Act provides. North Carolina is among 11 states that haven’t adopted the expansion. 

“This bill would extend coverage to hundreds of thousands of hard-working North Carolinians for which healthcare is still too costly for them to afford,” House Speaker Tim Moore said in a statement released after the vote. This legislation also addresses the pressing mental health and behavioral health concerns in our state, using federal dollars already allocated for this purpose.”

WNC House representatives Rep. Mike Clampitt, Rep. Karl Gillespie, and Rep, Mark Pless were among the 96 other members of the House to vote for the legislation. 

“We have a unique opportunity to expand coverage with federal funds already on the table,” said Moore. “The stakes are high and the cost to the state is minimal. Finally, hundreds of thousands of North Carolinians who have been getting by without healthcare coverage will have the peace of mind that an injury or illness will not cost them their livelihood.”

The federal government covers 90% of the cost of Medicaid recipients under expansion. The bill would again pay for the state’s 10% share through assessments paid by hospitals, which in turn benefit from getting reimbursed as they cover patients with Medicaid.

Much of the Republican support for HB 76 is backed by the bill being a “clean bill,” meaning it only features expansion and isn’t accompanied by other provisions. 

“Medicaid Expansion … and that portion is ONLY about expansion,” Lambeth said last week after filing the bill. “No CON [certificate of need], no work requirement and no scope of practice. It is focused only on Medicaid expansion. “The second part does deal with the additional funds NC can draw from the federal funds as a result of NC going to managed care last year.  I linked these two to demonstrate to my colleagues that funding for expansion will not cost the counties or the state and funding to support expansion.” 

While House Republicans offered their support because no additional provisions were included, Senate Republicans might not be as likely to follow suit. Senate Leader Phil Berger (R-Eden) has been vocal about his support of expansion, introducing Senate Bill 408 last year, which unanimously passed the Senate, however has said the House bill isn’t “the bill we need” and wants to see additional items included. 

HB 76 is headed for its third vote in the House today, Thursday, Feb. 16. Once passed, it will be sent to the Senate for consideration. 

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