North Carolina lawmakers have chosen to not expand Medicaid eligibility under the Affordable Care Act.
Republican state leaders, including Senate Leader Phil Berger and House Speaker Tim Moore, have said that, even if the federal government initially subsidizes new people enrolling in Medicaid, the program would eventually cost the state more than it saves.
In return, Democrats in the Senate and House minorities, such as Minority Leader Rep. Larry Hall and Sen. Josh Stein, have responded that the state is missing out on an opportunity to give medical assistance to about half a million people.
Gov. Pat McCrory has said multiple times this year that he would be willing to consider expanding Medicaid eligibility, if the federal department is willing to make certain exceptions of the Affordable Care Act for North Carolina.
But top Republicans at the General Assembly are not interested. After Thursday’s U.S. Supreme Court decision, allowing the federal government to provide tax subsidies in states in states such as North Carolina to help poor and middle-class people buy health insurance, most top Republicans said the ruling would hold little or no bearing on their refusal to not expand eligibility.
Senate Leader Phil Berger:
"We still have a system of Medicaid in North Carolina that's broken. I don't think the Supreme Court's decision in this case really makes any difference in terms of what we need to do."
"From where we are now, I cannot see a circumstance in which Medicaid expansion would make sense for North Carolina."
"We cannot contemplate adding more people to the Medicaid rolls at a time when we are having difficulty sustaining the Medicaid system that we currently have. That situation is exactly as it was before this decision."
House Speaker Tim Moore:
"Today’s Supreme Court ruling is disappointing, but does not change the fact that this flawed policy is doing more harm than good for our State."
Rep. Nelson Dollar (R-Wake):
"I think it means that the state of North Carolina just proceeds as it has. There's really no change for North Carolina."
Rep. Donny Lambeth (R-Forsyth):
"It does give us a little bit more clarity as to the future of the program. As we go through Medicaid reform and then reassess the expansion, the exchanges, we'll have to look at all that as we get into these next few months."
"It is another factor that is settled now, and I do think that we have to think through the implications of the expansion or if there's an alternative program that we might want to include, like a voucher program or another program that might achieve some of the same objectives for North Carolina."
Sen. Josh Stein (D-Wake):
“We should accept federal health insurance if we care about the health of our people, our health care system, and our economy.”