Doctors and hospitals have spent years pushing for Medicaid expansion in North Carolina. But now that Republican leaders have proposed a bill that would do just that, some are now either lukewarm on the bill or even actively opposed.
In large part, that’s because the bill also contains a number of other health care policy changes that threaten to upend other parts of the medical industry.
Chip Baggett is CEO of the North Carolina Medical Society, an influential lobbying group for doctors. He said they still support Medicaid expansion, but they oppose the way the legislature is currently proposing that it happen — namely, with so many unrelated policy changes tacked on.
“It’s all muddied up,” he said.
The opposition from some outside groups to parts of the bill hasn’t stopped the bill from quickly moving forward at the legislature, at least for now. The Senate backed the measure nearly unanimously Wednesday in the first of two votes.
If approved, the federal government might pay North Carolina $1.5 billion, similar to a signing bonus — plus 90% of the costs of covering uninsured North Carolinians, an estimated $8 billion per year.
Gov. Roy Cooper and other Democrats have long clamored for Medicaid expansion. Republicans in North Carolina have remained largely opposed to it even as GOP-led states elsewhere approved it in recent years. But that has now changed, at least in the N.C. Senate. And while powerful Republicans like Senate leader Phil Berger have changed their position to support Medicaid expansion, it’s also clear that they intend to use the bill to chip away at other rules and regulations in the health care industry.
What’s in the bill?
Industry groups including Baggett’s say some of the various rules and regulations that the bill targets are useful to improve safety in health care settings, or reduce costs.
But critics of those rules — who include, importantly, powerful Republicans who are now supporting Medicaid expansion tied to the other changes — dismiss those claims. They say the industry complaints are really just about special interests looking out for themselves.
“Nobody likes to be knocked off the top and