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Bill to block Medicaid expansion passes state House and Senate


North Carolina lawmakers have approved a measure that blocks the state from expanding Medicaid under the federal health care overhaul.  While supporters of the bill say it’s prudent to avoid an as-yet undefined obligation, opponents – which include hospitals in the state -- now worry that paying for care for the indigent gets more complicated.

States across the country are making decisions on three options under the Affordable Care Act – popularly known as Obamacare.

  • Option 1:  Set up a state program. 
  • Option 2:  Let the federal government run its program in the state. 
  • Option 3:  Create a hybrid of the two.

The bill approved yesterday stops North Carolina from either expanding Medicaid eligibility or creating an online health insurance marketplace. Senator Thom Goolsby, an outspoken supporter of the bill, says a commitment to fiscal responsibility comes first.

“We don’t know where any of this is going.  We know that when we set up our own state program, we automatically start garnering a large number of costs that we don’t know where the money is going to come from to pay for those.  We also put ourselves under a great deal of federal direction for rules and regulations that are not even written yet.  And all we’re saying is we’re going to hold off before we jump into the pool to make sure there’s water in it.”

Opponents of the bill point to the federal government’s promise to fund 100 percent of the expansion costs through 2016 and 90 percent after that.   They also say forcing the uninsured to use emergency care as the standard – instead of preventive care – is expensive and ineffective.   Gov. Pat McCrory says he'll sign the bill when it reaches his desk.

Rachel hosts and produces CoastLine, an award-winning hourlong conversation featuring artists, humanitarians, scholars, and innovators in North Carolina. The show airs Wednesdays at noon and Sundays at 2 pm on 91.3 FM WHQR Public Media. It's also available as a podcast; just search CoastLine WHQR. You can reach her at rachellh@whqr.org.