Local legislators have mixed feelings on state’s potential expansion of Medicaid

Published 12:07 am Thursday, March 9, 2023

RALEIGH — Leaders from the GOP-controlled state House and Senate have announced their agreement to expand Medicaid coverage available under the 2010 Affordable Care Act.

If passed, nearly all adults with incomes up to 138 percent of the federal poverty level — $17,609 for an individual in 2020 — would become eligible. That is potentially 600,000 people in North Carolina.  

But local legislators have mixed feelings about the expansion, something that has been at the forefront of state and national politics.

House Bill 76, which passed the House in February with a 96-23 vote, is now being debated in the Senate.

Sen. Carl Ford (R-33) said, for the most part, he was in favor of the Medicaid expansion the bill allows.

“I’m about 80 percent liking the bill. I could get to 100 percent if we make a couple of more changes,” Ford said in a phone interview Tuesday. “Overall it’s looking pretty good.”

But Ford did mention he was not in favor of “growing government” and the expansion of Medicaid will add to the national debt of the federal government, which is something that concerns him. The national debt is currently about $32 trillion.

Ford said a vote in the Senate will most likely happen sometime next week because senators are still making adjustments to certain parts of the bill. He specifically mentioned the “certificate of need” law, which “prohibits health care providers from acquiring, replacing or adding to their facilities and equipment, except in specified circumstances, without the prior approval of the Department of Health and Human Services,” according to the North Carolina Division of Health Service Regulation. Ford said he wants to see that law completely abolished because that would reduce prices for everyone.

Rep. Kevin Crutchfield (R-83) said he voted for the bill when it was on the house floor because he thinks it is a good starting point to help lower-income families. But he does not believe it is a “catch-all solution.”

“It is still difficult for small business owners such as myself. My employees make too much to qualify for Medicaid — even with expansion — and our pool is too small to be able to provide them an affordable health plan; it would severely hurt their livelihood if I were to reduce their income so they would be able to qualify for Medicaid expansion,” Crutchfield said in an email.

He said it is important to find other solutions that might be outside the scope of government programs to help employees needing reliable access to primary care providers.

Rep. Harry Warren (R-76) was one of the 23 House legislators who voted against HB 76. He does not think it is a good idea to add more to the national debt. Covering another state’s cost of healthcare is something he thinks the federal government cannot sustain. Like Crutchfield, he thinks there may be better solutions.

“I do believe we must come up with a way, in conjunction with the insurance industry, to make health coverage affordable and accessible for people in the economic strata that these Medicaid expansion bills keep trying to address,” Warren said. “I think there are other ways to address it other than a blanket Medicaid expansion that I’m pretty sure is fiscally irresponsible of the federal government to try to assume.”

North Carolina is currently one of 11 states that have not expanded Medicaid.