Carolina Cares: Four NC GOP file bill to extend Medicaid health-insurance coverage

RALEIGH – Four North Carolina Republicans in the state House have filed a bill to extend Medicaid health-insurance coverage to more adults. North Carolina under Republican control has been among the holdouts against expansion since the Affordable Care Act provided that option.

Thirty-one states and the District of Columbia have expanded Medicaid  removing millions from the ranks of the uninsured. This latest proposal called Carolina Cares charges premiums to people enrolled in the program. The Carolina Cares plan would also add work requirements.

“I want to do whatever I can to increase access to care for rural areas of our state,” Rep. said. “I believe the bill will do that.”

Three of the House Health Committee chairmen are co-sponsors: Reps. Donny Lambeth of Winston-Salem, Greg Murphy of Greenville and Josh Dobson of McDowell County . Rep. Donna White of Clayton is the fourth sponsor. Lambeth is a former hospital administrator, Murphy is a medical doctor, and White is a nurse.

A news conference on the bill is scheduled for Tuesday. Medicaid is the government insurance program for poor, elderly and disabled people. Most of the 1.9 million people covered in North Carolina are children. Most low-income adults younger than 65 don’t qualify.

Adults whose incomes are at or below 133 percent of the federal poverty level – less than $16,000 for a single person – would qualify. They would have to pay annual premiums equal to 2 percent of their household income, with some hardship exemptions. In most cases, adults would have to be working or “engaged in activities that promote employment” to be eligible for the coverage.

The federal government would have to approve a program with work requirements and premium payments.


An estimated 300,000 to 500,000 people would gain health coverage if the state expanded Medicaid without conditions. It is unclear how many adults would gain coverage under the new bill.

The state and federal government currently cover Medicaid costs. Under the bill, assessments on hospitals would cover the state’s share of the expansion costs.

N.C. legislative Republicans have resisted expanding Medicaid, passing a bill about four years ago that prohibits expansion without legislative consent. Newly-elected Democratic Gov. Roy Cooper moved quickly to expand Medicaid when he took office in January, but Republican legislative leaders sued to block it.

U.S. District Judge Louise Flanagan issued a temporary restraining order that blocked any action on expansion before President Donald Trump’s inauguration.

In late January, Trump’s administration informed the court it would take no action on whether to approve Cooper’s plan for nearly three months. The lawsuit was effectively on hold. Late last month both parties involved submitted a status report. Tthe judge agreed to give federal officials until April 7 to respond to the Republican leaders.

That response has not been made publicly available. State officials sued by legislative leaders have asked for the case to be dismissed.

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