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Near-unanimous NC Senate votes to expand Medicaid

Rusty Jacobs
Senate Leader Phil Berger opposed Medicaid expansion for years, but changed his views last year, paving the way for the agreement up for a vote this week. Berger is pictured addressing reporters in Raleigh on Jan. 14, 2020.

A nearly unanimous North Carolina Senate voted Tuesday to expand Medicaid.

For years, Republican lawmakers had opposed efforts to expand the government health care program to an additional half-million people. Tuesday’s vote is the result of changing views and a compromise with the House.

Sen. Joyce Krawiec, R-Forsyth, says she’s no longer worried that the move could hurt the state’s budget. Expansion is expected to add billions of federal dollars to the state’s health care system.

“It’s now a financial win for our state, and many of our rural hospitals particularly have been really struggling,” she said. “I see this as a lifeline for some of our rural hospitals. I think it’s going to be great for them.”

Only two Republicans, Sens. Norm Sanderson, R-Pamlico, and Eddie Settle, R-Wilkes, voted against the bill.

A final vote in the Senate scheduled for Wednesday will send the measure to the House for a final vote. That means the bill could go to Gov. Roy Cooper within days. The change still won’t take effect until after this year’s state budget is passed, likely this summer.

House leaders support the final compromise, which solves a disagreement over the Senate’s proposal to pair expansion with the rollback of health care facility regulations known as Certificate of Need.

Sen. Mike Woodard, D-Durham, compared North Carolina’s long effort to expand Medicaid to Homer’s The Odyssey. He says there’s still more to be done to address the state’s health care needs.

“It never was intended to be a panacea for building a healthier state,” he said. “We still have much work to do. Our odyssey continues.”

The bill would also add North Carolina to another federal health care funding program known as HASP.

Between HASP, which sends funding directly to health care providers, and a federal “signing bonus” for new Medicaid expansion states, the N.C. Department of Health and Human Services says the state will get $8 billion annually.

Under the Certificate of Need changes in the bill, health care providers would no longer need to compete for regulatory approval to build new behavioral health and addiction treatment facilities, as well as new surgical centers in urban counties.

Colin Campbell covers politics for WUNC as the station's capitol bureau chief.