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A do-over on Medicaid expansion

A do-over on Medicaid expansion

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Following the Republican-led state legislature’s recent refusal to support Medicaid expansion in its two-year budget, we’re glad to learn that the topic is still alive. If anything, support for some form of Medicaid expansion has grown. Legislators now have an opportunity to start over with a clean slate and pass an agreeable form of this beneficial provision. They should do so.

Back in June, Gov. Roy Cooper vetoed the state budget, largely because it lacked Medicaid expansion for hundreds of thousands of low-income adults. With Senate leader Phil Berger’s refusal to go back to the drawing board, the state seemed at an impasse. That made legislators on both sides anxious.

Then in September, House Republicans took an unexpected — some say underhanded — vote to override Cooper’s veto, which led to accusations of trickery and a great deal of anger all around.

The Senate has not yet voted on overriding the veto. (Unlike the House, Senate operating rules require 24 hours’ notice before a vote, so at least we don’t have to worry about another surprise.) So the state sits in limbo.

In the meantime, some attention has turned to House Bill 655, a compromise bill that expands health coverage to an estimated 365,000 lower-income North Carolina residents and includes a work requirement and a premium of 2 percent of the person’s income. Its co-sponsors include 14 Republicans and four Democrats, among them state Rep. Donny Lambeth of Winston-Salem.

Lambeth says that while some conservatives don’t like the bill initially, they’re more supportive when he tells them about the work requirement, and that no state money is required for it.

Other supporters of the bill say that while it’s not perfect, it would help a lot of people who really need a hand while benefiting the larger community as well.

Support for HB 655 isn’t unanimous by any means. And one of its original co-sponsors, state Rep. Jon Hardister of Guilford County, now opposes it, citing costly court battles that have risen over similar bills in other states.

But it’s an option.

Meanwhile, some Republicans are tired of all the talk and no action. “We don’t have the luxury of doing things based on some national political party’s stance on some issue,” Dale Wiggins, chairman of the Graham County commissioners, told Berger in a recent letter.

“Here in Graham County, Senator, we are accustomed to being ignored by not only the governor but by our legislature as well,” Wiggins wrote. “We supported Medicaid expansion because our citizens need it. Did you know Senator that our poverty level is near 30%?”

“While some politicians like to operate as ‘one size fits all,’ that approach doesn’t fit rural NC,” Wiggins wrote.

All the talk may still lead nowhere. Berger has announced that his chamber will adjourn for the year by Oct. 31 with or without an enacted budget. He’s also discussed completing the veto override or working out a side deal with Senate Democrats.

“At some point we’ve got to wrap this up,” Berger told reporters recently.

In the meantime, as Wiggins pointed out, people in the state are suffering — and dying. Not only that, but rural hospitals are in decline. Several have closed in the last few years, making life even more difficult for rural residents. Those Medicaid dollars, billions of them, sure could help.

Republicans have had years to come up with a better solution, but they haven’t. In the meantime, 37 other states, including red states, that have accepted Medicaid expansion are benefiting from it.

Business, religious, education and government leaders support Medicaid expansion. Almost everyone supports it — except Berger.

Senator Berger: At some point we’ve got to wrap this up.

Winston-Salem Journal

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