CHAPEL HILL, NC – House Bill 76 moved swiftly through committee and then the house floor last week, passing with bipartisan support.
The bill would expand Medicaid under the affordable care act to over 600-thousand low-income North Carolinians. The state is currently one of 11 that still haven’t adopted Medicaid expansion.
The bill has been more than a decade in the making. Nicole Dozier, the director of the health advocacy project, says that the stories of people affected by lack of access to affordable health care gave the bill the final push it needed to pass.
“I think it’s important that over all this time that the media has not let it die, that people in the community have not let it die. you know, they’ve not given up hope,” Dozier says.
Under current rules, many North Carolinians make too much money to qualify for Medicaid, yet too little for federal healthcare subsidies. Adults without children, for example, also fall outside of the qualifications for Medicaid, leaving more than 600-thousand North Carolinians in a coverage gap and without health insurance.
That would no longer be the case if the bill becomes law by changing Medicaid eligibility. Under the new system, any adult under 65 who makes less than 138% of the federal poverty level would qualify for Medicaid.
Abby Emanuelson, the director at care4carolina, says that the right time for expansion… is now.
“I think now is really the time that it’s good health policy and good fiscal policy for our state to expand,” Emanuelson says.
Under Medicaid expansion, the federal government would go from paying around 74 percent of Medicaid costs in North Carolina to 90 percent. The state would only have to pay the remaining 10 percent.
With the state, hospitals and insurance companies have agreed to pay the remaining 10 percent.
Representative Jon Hardister, who was originally against expansion, says that federal funding was a convincing factor for passing it.
“We’re all sending money to the federal government every day, every day of our lives,” Hardister says. “We’re paying taxes. If we can get some of that money back for health care, improve our healthcare system, I believe that is the right thing to do.”
The bill also increases reimbursement rates for hospitals, and would cut the Medicaid reimbursement gap by more than $1.5 billion. Rural hospitals would benefit the most from this program, getting a reimbursement rate of around 90 percent.
Senator Graig Meyer, who represents Orange County, says that this would be a huge boon for rural parts of the state.
“Medicaid expansion would be the single biggest thing you could do to make sure that in those rural areas you have enough money to pay providers to have them live there, to have services available, and to bring down costs for folks,” Meyer says.
Senate Leader Phil Berger has said that he supports Medicaid expansion, but his version of it is very different from the version that just passed the House. Last session, the House and Senate were not able to come to an agreement on a bill largely because of regulation cuts that the Senate wants in any bill, which are notably missing from the House bill.
While there’s bipartisan support for expansion, it’s unclear if the senate will pass their own bill, or consider the one passed by the house which hasn’t been scheduled for committee hearings in the senate yet.