State Rep. John Ager, D-Buncombe, introduced a bill this week to expand the state’s Medicaid program, but it appears the bill is more of a means to provoke conversation about the idea than something likely to become law in 2016.
Democrats and many in the health care industry have for several years supported North Carolina taking up the federal government’s offer to cover roughly 90 percent of the cost of expansion, which Ager said would give health care coverage to 400,000 to 500,000 people in the state, as part of the Affordable Care Act.
Republicans have opposed the idea, citing cost overruns in the state’s existing Medicaid program and expressing concern that Uncle Sam’s willingness to shoulder most of the burden will diminish over the years and add to the national debt in the meantime. More recently, they’ve said the state should not consider it until a Medicaid overhaul the General Assembly approved last year has had more time to take hold.
Ager is the lead sponsor of the bill, Rep. Susan Fisher, D-Buncombe, is one of four primary sponsors, and most House Democrats have signed on as co-sponsors.
For the bill to pass, “It can’t just be a Democratic bill” in a Republican-dominated General Assembly, Ager said.
“I realize it’s an uphill battle” this year, he said. “Maybe what we’re really doing is setting the stage for 2017.”
Medicaid now covers mostly children in low-income families, older adults and the disabled in North Carolina. Ager’s bill would expand it to anyone making 133 percent or less of federal poverty guidelines. That would mean a single person making $15,800 or less or a family of four with no more than $32,319 of annual income would be eligible.
Expansion would cost the state $54.6 million for the six months the bill would cover and the federal government would pay $1.24 billion, the bill says. The state would save $31 million on existing programs providing mental health care, inmate care and drugs for people with AIDS, it says.
Ager said the increased economic activity expansion would create would probably generate enough taxes to cover the net cost to the state of nearly $24 million for the first six months of 2017, or $48 million annually.
The Affordable Care Act is here to stay, he said, and the state needs to accept that and figure out how to best use the federal government’s offer.
“I’ve talked to so many health care groups and this is always No. 1 on their agenda. This is the low-hanging fruit of things that could be done for the state,” Ager said.
Few expect much to happen with the idea this year, when legislators are supposed to meet for a shorter time and are less likely to take up complicated policy questions. But recent comments by a key player in the House on health care issues suggest Medicaid expansion could at least be discussed when legislators return to Raleigh in 2017, although it is difficult to imagine that all of Republicans’ concerns will have disappeared by then.
“This is a major policy issue and better for the long session,” Rep. Donny Lambeth, R-Forsyth, told the Winston-Salem Journal. “I am working on some options and possible solutions.”