NC Medicaid expansion deal still at impasse between Republican legislative chambers
A month after the North Carolina General Assembly session ended and two weeks after Gov. Roy Cooper signed the state budget into law, the chances of a Medicaid expansion deal this summer have stalled.
Medicaid expansion has been the center of legislative impasses for the past few years. Both Democrats and Republicans now hope to broaden the qualifications for Medicaid, but the parties disagree on the finer details of different expansion plans.
When Cooper, a Democrat, signed the budget into law on July 11, he and Republican Senate leader Phil Berger and Republican House Speaker Tim Moore all said they’re continuing to negotiate making expansion happen this year. The policy change would expand Medicaid insurance coverage to as many as 500,000 more North Carolinians who do not currently qualify for it.
As of July 26, during a brief, non-voting legislation session, no progress had been made, despite Cooper’s hopefulness a few weeks ago that a deal could be imminent.
Moore and Berger separately told reporters on Tuesday that they have not had group conversations about it with Cooper this month, though other “stakeholders” have been talking.
Reasons for expansion impasse
Berger blamed hospitals, which support keeping certificate of need regulations in place, for the current impasse. The Senate’s version of a Medicaid expansion bill earlier this year included changes to the certificate process, while the House’s did not.
“There are conversations taking place,” Berger said. “What I would say is there remains a window to get something done, but quite frankly as long as the hospitals remain as intransigent as they are, I don’t see that we’re going to make any progress.”
“We’ve signaled and actually provided concrete proposals on compromises that would be acceptable and there is absolutely no movement,” he said. “We have signaled to the governor’s office, to the hospitals and to the House several proposals with reference for ways to get us to an agreement. The hospitals are refusing to move.”
A few minutes later, reporters asked Moore about the cause of the impasse. Moore noted that the House’s Medicaid expansion bill doesn’t have the additional policy changes that the Senate’s version does.
“We don’t have to deal with those other issues [to expand Medicaid],” Moore said. “...I understand the Senate’s been interested in a broader conversation. I think there’s some room on a few of those things, but that bill the Senate sent over, we’re not going to pass that.”
Moore said that “everybody knows” the House’s and the Senate’s positions.
“I don’t think there’s really any pressure right now to do it,” he said. “I think it’ll happen. I really do. I think it’ll happen this year.”
Berger is less optimistic.
“I just think it’s more likely it’s gonna happen sometime next year. Based on what I’m hearing from folks, I just have not seen the kind of the movement I believe it will take in order for us to get something done this year. I hope I’m wrong, but that’s what I see,” Berger said.
Berger and Moore would like to pass it while the state can still get a signing bonus of $1.5 billion, which could come this or next year.
The proverbial policy football continued to be kicked down the field.
“I think there’s been a good bit of progress,” Berger said, compared to the spring. “I think we’ll get there. It’s not going to be as quick as I would have liked to have seen, or other people would like to have seen, but I think we’re moving in the right direction.”
Ford Porter, a spokesperson for the governor, said that Cooper and his staff “continue to talk with legislators and health care stakeholders about the importance of expanding Medicaid.”
“It’s positive that both chambers now support expansion and right now hospitals hold the key to getting this done. We hope that parties can return to the table soon and work toward a deal,” Porter told The N&O via email.
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This story was originally published July 26, 2022 at 3:10 PM with the headline "NC Medicaid expansion deal still at impasse between Republican legislative chambers."
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