RALEIGH — The effort to expand Medicaid in North Carolina passed a hurdle Wednesday afternoon as the N.C. Senate voted 44 to 2 to pass H.B. 149 Expanding Access to Healthcare. In addition to Medicaid expansion, the bill contains the repeal of some certificate-of-need (or CON) laws and expands practice authority for nurses.
“What we are going to do is monumental,” said Sen. Mike Woodard, D-Durham.
Sen. Ralph Hise, R-Mitchell, addressed the question of “why now?” for the passage of this bill by saying it comes down to inflation and access.
“Inflation has been a gut punch to all North Carolinians this year,” he said. “Everything is going up…. But with the sector of cost rising faster than anything else, and that has been true for decades, is healthcare; and it’s not even close.”
He cited a WalletHub healthcare study from last year that ranked North Carolina 49 out of 51 states for healthcare costs. He said the same study ranked the state 43 out of 51 for access to healthcare, which includes access to insurance and to healthcare providers and facilities.
The reason for the about-face for Senate Republicans, according to Hise, has been due to eight years of solid Medicaid budgets. Hise credits the budgets to Republican leadership in the General Assembly and reform of the system with the Medicaid transformation last year. These successes, he said, lead to a solid footing for Medicaid in the state.
Sen. Kevin Corbin, R-Macon, said as the owner of two insurance agencies that deal with health insurance, he sees situations firsthand on how Medicaid expansion would help some in the state. An example he used is a single mom with two children who can’t afford healthcare because her income is too high to qualify for Medicaid but too low for a tax credit from the Affordable Care Act.
Senate Leader Phil Berger, R-Rockingham, concurred with Hise and Corbin, saying the three reasons he was initially against expanding Medicaid no longer hold. Berger said his view of incentives for the people who would be receiving Medicaid may not have been wrong, but he may not have had the right focus. He cited Corbin’s example to make his point. Berger did, however, mention there may be some people who don’t work and get coverage, but most would fall into the first category
Berger said he used to be concerned about the fiscal risk to the state budget, but the bill has two “offramps” for the state. If the federal government ever changes the 90/10 split, he said North Carolina is out.
The federal government would cover 90% of the bill for Medicaid expansion, with the 10% fiscal gap covered by an assessment levied on hospitals, which will in turn draw that money from the federal government. The offer lawmakers could not refuse was a sweetener put on the table by the Biden administration. In expanding the program, 10% of the expansion cost falls to the state, which means North Carolina could face a funding gap between $119 million and $171 million .
“The fiscal risk to the state of North Carolina is non-existent as far as our state budget is concerned,” Berger said. “In fact, with the recession that is coming, doing this will help provide some buffers for our state budget that would otherwise would not be available to us.”
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A bill to legalize marijuana for medical purposes cleared a key North Carolina legislative committee on Wednesday, moving one step closer to becoming law.
The Senate Rules Committee backed the measure with strong bipartisan support, unanimously advancing Senate Bill 711 to a full chamber vote.
State Sen. Bill Rabon, a Republican who represents a coastal district and chairs the rules committee, said the measure seeks to give those who need compassionate care an additional medical resource.
“It is nothing more than trying to help those people with the care that they need and augment their treatments as decided upon by the patient and by a physician,” he said.
The unanimous approval by the Senate on Tuesday of the Farm Bill, which in perpetuity decriminalizes hemp as a commercial crop for certain uses in North Carolina, is a first step in all of this. There is a June 30 deadline to confirm that fact and align North Carolina under the rules adopted by the USDA.
But Senate Bill 711 is a bipartisan measure drafted and originally approved last year. It has to clear the Senate Rules Committee, but Sen. Berger said he expects that to happen later this week. He also said he plans to vote for the bill.
Jordan Monaghan, a spokesman for Gov. Roy Cooper, reiterated previous sentiments of the governor’s support for legalization of medical marijuana. “Studies have shown medical marijuana can offer many benefits to some who suffer from chronic conditions, particularly veterans, and the Governor is encouraged that North Carolina might join the 36 other states that have authorized it for use,” Monaghan said. “The governor will review this bill as it moves through the legislative process.”
If the bill becomes law, an 11-member commission would be allowed to issue 10 medical cannabis supplier licenses upon the recommendation of the state Department of Health and Human Services. An amendment the rules committee passed doubled the maximum number of cannabis centers each supplier could operate from four to eight. Consumers would also be limited to a 30-day supply of marijuana.
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