Republican NC Senate Passes Medicaid Expansion

Today, I received a press release by e-mail from State Senator Ralph Hise on behalf of Republicans in the North Carolina Senate. I will post the release here; and will interject with my own comments:

NC Senate Passes Conservative Healthcare Access, Reform Legislation

Proposal reforms Certificate of Need laws that drive up costs

House Bill 76 expands healthcare access for the working poor

Sen. Hise: “This healthcare proposal is good for North Carolina”

(Editor’s note: It is an abuse of language to describe as “conservative” the expansion of a major charity/ entitlement program.)

Raleigh, N.C. – Today, the North Carolina Senate approved a conservative healthcare access bill that reforms our state’s Certificate of Need laws and expands access to health insurance.

The Senate’s version of House Bill 76, “Access to Healthcare Options,” expands Medicaid for adults making up to 138% of the federal poverty line, which is nearly $38,300 for a family of four. This will help end the hidden tax that North Carolinians currently pay by covering uncompensated care in the form of higher private insurance premiums.

(Editor’s note: This statement buys into the progressive/socialist myth that one has to spend taxpayers’ money in order to save money).

While the federal government covers 90% of the cost of expansion, the non-federal share in North Carolina will be covered by an assessment to hospitals. That means instead of using taxpayer funds to cover the 10% non-federal share, hospitals will pay that portion.

(Editor’s note: Future sessions of the North Carolina General Assembly will be able to remove this assessment placed upon hospitals. All of the federal government money flowing into North Carolina will be deficit dollars adding to the national debt.)

The expanded coverage would not be effective until the budget becomes law.

(Editor’s note: One can only hope that some legislators will place “poison pills” in the state budget that will sink the entire enterprise).

Hospitals across the state are set to receive an infusion of $3 billion through the Healthcare Access and Stabilization Program.

(Editor’s note: Are we suggesting here that we are passing this bill to give the hospital systems even more access to federal deficit dollars?)

The bill includes a robust Certificate of Need reform package to address impediments to the availability of care and requirements that unnecessarily increase costs for all North Carolinians. These changes will make North Carolina more attractive for providers, healthcare facilities, and hospitals willing to do business and compete here.

The bill eliminates Certificate of Need for:

  • Behavioral health facilities and beds.
  • Chemical dependence facilities and beds.
  • Raises replacement equipment threshold to $3 million and indexes it to medical inflation.
  • Increases threshold for diagnostic centers to $3 million and indexes it to medical inflation.
  • MRI machines in counties with a population above 125,000 effective three years from the first HASP payment.
  • Ambulatory surgery centers in counties with a population above 125,000, effective two years from the first HASP payment for multispecialty and single specialty.

(Editor’s note: Note that the Certificate of Need reforms do not remove the requirements for acute, full-service hospitals themselves. The hospitals are protected from competition. Their main inpatient profit centers– cardiac care, cancer care and orthopedics– are left virtually untouched. This was a major win for the hospital systems, and a loss for citizens.)

The Republican-led legislature has spent a decade reforming North Carolina’s traditional Medicaid program after it was mismanaged and burdened taxpayers with billion-dollar shortfalls. Through Medicaid transformation, the program now has more budget predictability and has had regular budgets with no cost overruns.

(Editor’s note: The message here is that we try to save money so that we can spend much more money.)

“This healthcare proposal is good for North Carolina. Our budget will be stronger because of it and our citizens will be healthier,” Sen. Ralph Hise (R-Mitchell) said. “The reforms included in this package directly address the biggest impediments to healthcare availability and affordability. “

(Editor’s note: There is no shame or remorse over expanding a major entitlement program and increasing the national debt. There is no acknowledgement that the program will turn out to be much bigger than projected, and that it will become very difficult to get people off Medicaid. Once they qualify, they will organize their lives so they can continue to draw benefits.)

Voters in North Carolina overwhelmingly support expansion. A recent poll found that 73% of North Carolinians support Medicaid expansion. Seventy-three percent of rural North Carolinians support expansion. Fifty-five percent of Republican voters also support expansion.

(Editor’s note: These numbers, if true, are a sad commentary on North Carolina residents. But the premise is that politicians should be sticking their finger in the wind, and doing the wrong thing, in the direction of prevailing public opinion. Statesmanship and responsibility are secondary.)

The proposal now returns to the House of Representatives for concurrence.


2 thoughts on “Republican NC Senate Passes Medicaid Expansion

  1. TC: Great Summary. Lots to digest here. I suspect the House will go along. I hope there will be a stalemate. Who knows ?

    1. Fred, the House had already passed its own version. The Senate version is different, and now they have to come to an agreement as to what the final bill will include. It is theoretically possible the House might pass the Senate version because, as you seem to suggest, they all seem determined to do the wrong thing.

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