Energized Democrats push for N Carolina Medicaid expansion

RALEIGH, N.C. (AP) — Energized legislative Democrats kicked off Wednesday their strongest push yet to expand Medicaid, seeking to remove North Carolina from the dwindling number of states still refusing a federal bargain to cover hundreds of thousands of additional residents.

House and Senate Democrats — their numbers growing after the November elections that diluted Republican control of the chambers — filed identical bills to accept Medicaid expansion provided through the 2010 federal health care overhaul.

“Now is the time to expand Medicaid in North Carolina and close the coverage gap,” Senate Minority Leader Dan Blue of Wake County said at a Legislative Building news conference, surrounded by party colleagues. “This is the most important bill that we can pass on behalf of our constituents this session.”

Legislators began unveiling bills Wednesday, three weeks after their one-day organizational meeting to elect leaders.

GOP lawmakers passed a 2013 law essentially blocking expansion without their express approval. They still hold majorities in each chamber for the next two years, but Democratic gains eliminated veto-proof control, meaning Gov. Roy Cooper and Democratic allies now have more leverage.

Thirty-six states and the District of Columbia have expanded Medicaid eligibility to more working people and their families or have adopted the idea, according to the Kaiser Family Foundation. They include Republican-leaning states of Utah, Nebraska and Idaho, each of which approved expansion in referendums in November.

North Carolina Republicans have given several reasons against expansion — the state Medicaid system was overspending and the federal government couldn’t be trusted to pay at least 90 percent of the expansion costs. Others were suspicious of the Affordable Care Act championed by then-President Barack Obama. Now the state Medicaid program, which covers 2 million residents, is in sound shape fiscally and there are no signs the health care law will be repealed.

Some House Republicans support expansion and plan again to re-introduce legislation similar to a 2017 bill that required able-bodied enrollees to work and pay small premiums. Senate GOP counterparts have been cooler to expansion. The Democratic plan unveiled Wednesday doesn’t contain work requirements, premiums or co-payments for the additional enrollees, comprised of families making slightly above federal poverty levels.

“The bill that we introduced today is the fastest and best way to cover the gap,” said House Minority Leader Darren Jackson of Wake County, but “we understand that we are not the majority in each chamber, and different ideas will be talked about.”

Depending on details, Medicaid expansion could insure from 300,000 to 500,000 people. Both the Democratic and House Republican legislation would require hospitals to pay the state’s share of expansion costs.

The head of the conservative-leaning Civitas Institute remains unsold on expansion, arguing it will lead to higher Medicaid expenses or hospitals passing along costs to other patients.

“Taxpayers will be the ones footing the bill for expansion, either through direct taxes or higher health care costs,” Institute President Donald Bryson said in an emailed statement.

Also Wednesday, Senate Republicans unveiled a public school construction plan that wouldn’t require a bond package like what GOP House Speaker Tim Moore and Cooper support. The bill would expand a recently created capital construction fund with additional revenues, providing $2 billion over nine years for K-12 school construction and maintenance.

Republican Lt. Gov. Dan Forest spoke at a news conference for an upcoming Senate bill that would make it a felony to perform female genital mutilation on a child. The legislation is a response to a federal judge’s ruling last fall determining a federal law against the practice is unconstitutional but that states can regulate it. The World Health Organization says there is no health benefit to female genital mutilation and it can cause numerous health problems.

Over a dozen House Democrats filed a bill that would repeal a 2015 law restricting the removal of Confederate memorials from government property. The law has limited the ability of officials to move Confederate monuments from Capitol Square in Raleigh and the “Silent Sam” statue, since toppled by protesters, on the campus of the University of North Carolina at Chapel Hill.