RALEIGH, N.C. (AP) — General Assembly leaders acknowledged Tuesday that a compromise for North Carolina to finally embrace Medicaid expansion is unlikely to come quickly and pinned the success of a deal in the near future in part on the membership of a key Healthcare Center Interest Group.
Speaking separately to reporters as the Legislature convened this week for sessions without a vote, Senate Leader Phil Berger and House Speaker Tim Moore said high-level discussions had dwindled since the end of his main work period for the year three weeks ago.
By then, the Republican-controlled House and Senate had passed various laws that put the state on track to accept federal funds to cover 90% of medical expenses for 600,000 low-income adults who earn too much. for traditional Medicaid. . North Carolina is one of 12 states that have yet to agree to the expansion since Congress first proposed it more than a decade ago.
The Senate proposal defended by Berger accepted the expansion, but it also contained additional reforms that he said would increase the number of providers and services. They included the reduction of “certificate of need” laws that tightly regulate medical providers’ expansion plans and allow highly qualified nurses to practice without the supervision of a doctor.
The House plan leaves out those additional reforms and instead envisions the legislature returning in mid-December to vote on an expansion plan crafted by Democratic Gov. Roy Cooper’s administration that contains several tax and medical benchmarks. keys.
“The bill that the Senate sent is just a no-start,” Moore said. But Berger said his chamber would not settle for a measure that only contains an expansion, but rather one that includes “supply-side increases” for health care providers and medical facilities. . Berger blamed state hospitals for not agreeing to a major rollback of certificate of need laws.
“There is still a window to do something,” he told reporters. “But quite frankly, as long as hospitals stay as intransigent as they are, I don’t see if we’re going to make any progress.”
The North Carolina Healthcare Association, which represents for-profit and nonprofit hospitals, said Tuesday it looks forward to continuing to work with House and Senate leaders to advance expansion and entry. in a program that would allow hospitals to benefit from higher Medicaid reimbursement rates.
But the group told Berger that “elements” of the Senate bill “would harm hospitals and erode the state’s safety net,” NCHA spokeswoman Cynthia Charles said in a statement. a press release sent by e-mail.
As a sign of the association’s influence, Moore said he would want to be sure hospitals agree to change the certificate of need before his chamber votes on them.
“I think we have to be very careful (with) people trying to blame hospitals,” he said. “These are the facilities that are there on the front line, caring for the sickest people in our state.”
While supporters of certificates of need laws say they prevent the use of expensive medical services from becoming unbalanced with demand, critics say they limit competition, to the financial benefit of current health care providers .
Cooper, a staunch supporter of Medicaid expansion and who would be asked to sign off on any final bill, told reporters earlier this month he hoped for a quick deal on the expansion.
Moore said Tuesday there was no need to rush to find a solution. The Legislature is already expected to return monthly for the rest of the year – the next meeting is August 23 – to discuss other potential topics. So there are opportunities to vote for any expansion deal. Berger expressed pessimism about a compromise by the end of the year, after which a new group of 170 lawmakers will be sworn in.
A deal can’t come soon enough for attendees at a Tuesday morning vigil outside the Legislative Building. They identified by name residents of North Carolina who they believe died of serious illness when they did not have Medicaid coverage or insurance.
“I am angry, saddened and frustrated that we have to be here again today to hold another vigil and beg lawmakers to do the right thing and expand Medicaid,” said Rebecca Cerese of North Carolina Justice. Center. “Health care cannot wait. When it waits – as you’ve heard – people die.
