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Cooper, some GOP House members pushing Medicaid expansion

072217 Greg Murphy

Greg Murphy


Carolina Journal

Tuesday, January 29, 2019

RALEIGH — Four state House representative plan to refile a bill that would expand Medicaid but add a work requirement and other conditions in the new legislative session, while Gov. Roy Cooper continues to lobby expansion.

But lawmakers like Sen. Ralph Hise, R-Mitchell said forget about it. It’s not going to happen.

Cooper was in Marion on Thursday for a roundtable discussion about the opioid epidemic and the role Medicaid expansion could play in attacking the crisis. Although that’s in McDowell County, in Hise’s senatorial district, and he is co-chairman of the Joint Legislative Oversight Committee on Medicaid and NC Health Choice, the senator said he was not notified of or invited to the event.

Meanwhile, State Rep. Donny Lambeth, R-Forsyth, a former hospital administrator, and Reps. Greg Murphy, R-Pitt, a doctor; Josh Dobson, R-McDowell, co-chairman of the Joint Legislative Oversight Committee on Health and Human Services; and Donna White, R-Johnston, a nurse, plan to file their Carolina Cares legislation again this legislative session.

“It is a hybrid Medicaid bill that covers persons who fall in the coverage gap,” Lambeth said.

“It is based on a fiscally responsible plan. Persons covered will be required to work with a few exceptions, such as the military in transition to the private sector,” Lambeth said.

Murphy, a surgeon who practices in Greenville, said he does not support Medicaid expansion in its present form

“It is not fiscally responsible,” Murphy said in an email to The Daily Reflector. “However our, alternative, Carolina cares, is.”

Participants would be required to participate in healthy lifestyle options with a focus on wellness, Lambeth said. Participants would pay part of the coverage costs, many would have to be employed and providers would cover the state’s share. This would insulate taxpayers from picking up any costs from people enrolled under the expansion.

“In fact, North Carolina taxpayers will benefit as savings will accrue to the state,” Lambeth said. “Yet 300,000 plus persons will benefit under some estimates.”

He said this is a win-win alternative to expansion of Medicaid.

“Realistically it is hard to know if it will get a fair hearing this session,” Lambeth said.

Hise said he wasn’t surprised Cooper is still plugging to expand Medicaid rolls.

“Medicaid expansion proposals (from) the governor go back to when he first came into office and he tried to illegally sneak it in with a deal cut with the Obama administration that we ultimately had to get the courts to stop,” Hise said.

Not much has changed at the federal level despite congressional promises to revisit the structure of Medicaid expansion under the Affordable Care Act. So the Senate is not on board with growing the rolls, Hise said.

The senators’ biggest objection is Medicaid expansion mostly covers able-bodied men 18 to 55 years old.

Hise left the door slightly ajar, though. He said some senators could change their minds if Medicaid rules were changed to expand services for individuals with intellectual and developmental disabilities, and open to people at the lowest income levels.

Carolina Journal stories are provided by the John Locke Foundation of Raleigh.