GREENSBORO, N.C. (WGHP) – State Rep. Donny Lambeth (R-Winston-Salem) says he shares some of the optimism expressed by Gov. Roy Cooper that Medicaid expansion in North Carolina could happen sooner rather than later.

Cooper told The News & Observer of Raleigh on Wednesday that he hopes a resolution to the disagreement between the state Senate and House “can be reached within the next week or so.

Gov. Roy Cooper (Ethan Hyman/The News & Observer via AP, File)

“With the Senate and House leadership, now supporting Medicaid expansion and saying some of the same things that we’ve been saying for a while about why it’s needed, I think that the potential for agreement is high,” Cooper told the N&O. “We just need to make sure that there is an agreement, compromise and settlement on all of these other issues, so that we can get a bill done and hopefully get Medicaid expansion in place before the end of the year.”

To catch you up on this issue: Sen. Leader Phil Berger (R-Eden) led the passage of an expansion bill during the recently ended short session of the General Assembly that included not only adopting the Medicaid plan from the Affordable Care Act but also took steps to expand health care access to counties where that is a problem. These included easing the way that new medical facilities can be licensed to open, expanding telehealth and allowing nurse practitioners to take on more tasks reserved for physicians.

State Rep. Donny Lambeth (R-Winston-Salem)

The House, though, declined to take up the Senate’s bill and proposed its own new bill, which called for another study team to work through the plans and report back in December for a potential vote. The Senate didn’t like that option.

That’s where Lambeth comes in. He’s cochair of the House Health Committee, and he participated in a study and in 2021 wrote the Medicaid bill that the House passed and the Senate then adjusted and passed. He also was part of creating this most recent bill in the House.

“The governor, just as I am, are optimistic that all involved in these discussions are looking for a workable solution,” Lambeth said in an email response to a question from WGHP. “I think we are past the point of all involved in these discussions wanting a solution. Now we just need to find the right formula for NC.”

The House’s plan

The House’s substitute for SB 408 would create a Joint Legislative Committee on Medicaid Rate Modernization and Savings that would hear a Medicaid Modernization Plan to be developed by the state Department of Health & Human Services by Dec. 15 and for the General Assembly to act on it by Dec. 16. That plan would:

  • Add Medicaid coverage for adults aged 18-64 with incomes up to 133% of the federal poverty level beginning on a date to be proposed by the Secretary of DHHS.
  • Increase hospital assessments to provide funding for the nonfederal share of the cost of the additional Medicaid coverage.
  • Propose legislation to enact increased hospital assessments to pay the nonfederal share of an increase to Medicaid hospital reimbursements through the Hospital Access and Stabilization Program.
  • An investment of $1 billion to address the opioid, substance abuse and mental health crisis using savings from the additional federal Medicaid match available under the American Rescue Plan Act).
  • Include specific proposals to increase access to health care in rural areas.

But the item about expanding health care in rural areas is vague on points that Senate leaders had touted as important to help expand access to health care. They have included an easier process to obtain certificates of need on new medical facilities, expansion of telehealth access and broadening of the medical practice of nurse practitioners that could alleviate the workload on doctors.

North Carolina Senate Leader Phil Berger (R-Eden, right) and House Speaker Tim Moore (R-Cleveland, center) on June 28. (AP Photo/Gary D. Robertson)

‘Getting closer’

Berger and others said then they didn’t think there was much need to study the plans further, but it’s unclear when talks resumed after the session adjourned on July 1. Lawmakers are scheduled to reconvene on July 26.

“Conversations are definitely taking place,” state Rep. Jon Hardister (R-Whitsett) wrote in a text message to WGHP. “I am optimistic that we will reach an agreement with all parties involved.

“My hope is that we can work with DHHS on a cogent plan that is fiscally responsible and predictable.”

State Rep. Pricey Harrison (D-Greensboro) said in a text message that “it does look like GOP leadership is moving in that direction.”

“These are very productive [discussions] and I believe we are getting close,” Lambeth said. “Will we have something by end of July?  Not so sure but I believe all are looking for a solution and getting closer.”