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State Senate approves second reading of Medicaid expansion bill

State Senate approves second reading of Medicaid expansion bill
Published: Jun. 1, 2022 at 6:21 PM EDT
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RALEIGH, N.C. (WITN) - The North Carolina Senate voted nearly unanimously Wednesday to expand a Medicaid expansion bill.

House Bill 149 passed by a vote of 113 to 1 in its second reading.

The Medicaid expansion bill, if passed, will do the following:

  • Expands Medicaid for people earning up to 138% of the federal property level ($38,295 for a family of four).
  • Establishes the Healthcare Access and Stabilization Program which will pull down at least $600 million from the federal government – and potentially as much as $3 billion – to bolster North Carolina hospitals.
  • Requires the 10% state share to be paid for through modernizing the state’s existing hospital assessment as well as enacting a new one for hospitals.
  • Requires transparency in the form of annual reports from the Department of Health and Human Services on the program’s financials.
  • Gives the DHHS secretary the ability to end expanded coverage if the state share cannot be covered.
  • Requires the expanded coverage to be discontinued if the 90/10 federal medical assistance percentage changes.
  • Establishes a work requirement to receive expanded coverage, similar to work requirements already in law.
  • Reforms the state’s certificate of need laws by creating two separate application pathways.
  • Stops surprise medical bills by requiring healthcare facilities to tell patients if they are scheduled to see out-of-network providers.
  • Requires health insurance providers to cover telehealth services.
  • Allows advanced practice registered nurses to practice at the top of their license, granting them full practice authority.

WITN talked to supporters about the impact it could have.

“If it doesn’t happen, truth be told people are gonna die,” said Adrienne Hayes-Singleton. As someone with diabetes, Hayes-Singleton relies on good healthcare coverage. She’s in between jobs right now and knows she may be stuck making too much money for Medicaid with her next position but not enough to get adequate private insurance.

“Type two diabetes comes with eye issues, other issues, and you know, this is a product of diabetes. Every time I get eye glasses I have to pay out of pocket because the insurance that I’m working with now doesn’t cover it. Medicaid would,” she said.

Hayes-Singleton’s story is one many people share - of being stuck in Medicaid’s coverage gap. It’s something the proposed Medicaid expansion bill is targeting, and would give an extra 1.5 billion dollars to North Carolina under the American Rescue Plan.

In Pitt County alone, it would reach more than 10,000 more people.

“DSS is covering up to 53,100 people with Medicaid in Pitt County. If the expansion were to take place, we can potentially serve up to 65,000,” said Dr. Augustine Frazer, the Interim Director for the Department of Social Service in Pitt County. He said it would impact more than just those getting coverage. “Economists are saying up to $144 million will be added to the economy of Pitt County just by the expansion of Medicaid.”

That bill passed the first reading in the State Senate Wednesday, but now heads to a third reading. If passed through that, it could then go to the house. There is skepticism about where it will go from there though. It could possibly head to the rules committee and die.

The bill is scheduled for a final vote on Thursday, and if it gets final approval, will head to the North Carolina House of Representatives.

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