Health Care

N.C. lawmakers reach Medicaid expansion deal

Senate President Phil Berger and House Speaker Tim Moore said their negotiating teams reached a deal late last night.
North Carolina Senate leader Phil Berger, R-Rockingham, right, speaking at a news conference in Raleigh, N.C. on Tuesday, June 28, 2022 (AP Photo/Gary D. Robertson)

North Carolina’s two top Republican legislators said Thursday they reached a deal to expand Medicaid in what is likely to be among the largest extensions of health care coverage anywhere in the nation this year.

Senate President Phil Berger (R) and House Speaker Tim Moore (R) said Thursday morning their negotiating teams had finalized a deal late Wednesday night.

Details were scant, but Berger said the deal included provisions related to certificate-of-need reforms, which limit competition in the health care industry.

“It’s a good agreement for the state,” Berger told reporters Thursday morning. Berger said the Senate would amend a Medicaid expansion bill already passed by the state House.

“This is a process that has taken quite some time, but it has resulted in a, I would submit to you, a product that is going to do a lot for North Carolinians,” Moore told reporters Thursday. “We’re going to have a policy that is going to expand access to working North Carolinians, that is going to ensure there is a more robust supply to a lot of these services, that is going to result in less costs.”

The agreement means North Carolina is likely to become the 40th state to expand Medicaid under the Affordable Care Act, former President Barack Obama’s signature domestic policy initiative. Expanding the program to cover those who make up to 138% of the federal poverty limit is likely to extend coverage to about half a million state residents, advocacy groups said.

The federal government will extend about $1.8 billion in funding to cover the Medicaid expansion.

Gov. Roy Cooper (D) was not part of the negotiations. But in a statement Thursday morning, he praised the deal as a “monumental step that will save lives.”

“Since we all agree this is the right thing to do, we should make it effective now to make sure we leverage the money that will save our rural hospitals and invest in mental health,” Cooper said. “I look forward to reviewing the details of the bill.”

Advocates of expanding the federal program were thrilled.

“The announcement today is a giant step toward making affordable health care accessible to hundreds of thousands of North Carolinians who are currently in the health care coverage gap, including working parents, small businesses and 14,000 of our veterans,” said Abby Emanuelson, executive director of the Care4Carolina coalition of groups that back expansion. “Expanding Medicaid will improve the health of our people, our economy and our entire health care system.”

Berger and Moore had been among the staunchest critics of Medicaid expansion, and their opposition became a regular feature of annual budget negotiations with Cooper.

But both leaders slowly came around in recent years, as it became evident that the ACA would not be repealed.

“It’s pretty clear that the law the Affordable Care Act and the Medicaid expansion portion are not going to be struck down by the courts as being in violation of some constitutional provision,” Berger told Pluribus News in a January interview.

Stephanie Akin contributed to this report.