Hospital letter may settle NC Medicaid expansion

House Speaker Tim Moore speaks with Senator Phil Berger as they await the arrival of Gov. Roy Cooper to deliver his state of the state address on Monday, April 26, 2021 in Raleigh, North Carolina

House Speaker Tim Moore speaks with Senator Phil Berger as they await the arrival of Gov. Roy Cooper to deliver his state of the state address on Monday, April 26, 2021 in Raleigh, North Carolina

A Medicaid expansion, which would provide health insurance to an additional 500,000 North Carolina people, is close to taking place.

It came even closer on Friday with a proposal from the North Carolina Health Care Association.

Leaders of both major parties agreed they wanted to expand eligibility for Medicaid, but this summer stumbled about exactly how and when. Now the group representing hospitals in North Carolina says it is willing to support some changes to the state’s “certificate of need” law if the General Assembly approves Medicaid expansion.

So far, hospitals have supported Medicaid’s expansion but have opposed any changes to the Certificate of Need, which outlines medical services available in the state. The law helps reduce competition hospitals may face for lucrative outpatient services that help ensure other parts of their operations.

Certification of the Need Act and other changes in health care policy have been at the center of negotiations between the House and Senate about what the Medicaid expansion bill should include.

on Friday, The association sent a letter To Democratic Governor Roy Cooper, Republican Senate Leader Phil Berger and Republican House Speaker Tim Moore, saying he is open to changes to the testimony of need. NC Tribune / Business NC The first to report the proposal.

Cooper says negotiators are close

Cooper said Tuesday that Medicaid expansion negotiations were “very close” to completion.

“We can turn on the tap to save lives,” he told reporters. He added that North Carolina loses “$521 million every month that passes from the federal government.” “This is unreasonable.”

Explaining what he meant by “this closure,” Cooper said, “If there can be agreement on CON, we can have agreement on Medicaid expansion.”

With the North Carolina Healthcare Association’s speech on Friday, it seems closer.

“In an effort to move the stalled negotiations, and in response to Senator Berger and Governor Cooper’s requirement that Medicaid expansion be coupled with Certification of Need Reform, our Board of Trustees made the difficult decision to propose Certification of Need for Reforms of the Act,” NCHA Chairman Dr. Roxy Wells, President of Cape Fair Valley Health, said. Hook, in a statement.

Offer details

The association said it would support changes to the law regarding ambulatory surgical centers and would support the abolition of certification of inpatient bed requirements for patients with psychiatric and chemical dependence problems.

The association said hospitals collectively could lose $700 million in revenue annually from proposed changes to the certificate of need for outpatient surgical centers. Wells said the changes could be particularly difficult for smaller community hospitals, which rely more on those services to help cover other costs.

Wells said Friday that “changes to CON law could threaten the survival of community hospitals if they are not implemented carefully.”

“We place great faith in legislative leaders to do it right,” Wells said. “If this policy harms access to local health care services, we hope that government leaders will find the resources to maintain important health care services and facilities, including the safety net services that North Carolina residents depend on.”

Legislative Negotiations

Berger wanted the Senate’s passage of an expansion bill that would include changes to health care policy. Moore and House Republican leaders wanted a bill without these changes.

“I’d rather we go ahead and pass it as it is,” Cooper told reporters on Tuesday. But Senator Berger said that in order to support the Medicaid expansion there would have to be some other medical reform. These reforms have advantages. It should be discussed.”

“I don’t think it’s unreasonable for hospitals to come forward and negotiate with (Berger) on this issue,” he added.

Cooper said this week that in order to find a solution to the expansion impasse between the two legislatures, he believes there should be “some compromise on the CON issue so that we can have an agreement that can go through the House and Senate.”

The General Assembly returns for a session expected to be without a vote on Tuesday. That could change now.

Without a compromise soon, Cooper said, the state could lose access to expansion money this year and some federal money next year.

“You know what it’s like with a new legislature, how long it takes to get organized, and the political landscape might be different,” he said. “So you start to worry about whether you’re going to lose all Medicaid coverage payments for the first quarter of 2023. So I think all of that is now at stake, and why everyone needs to step up our game and get that done.”

Neil Inman, Moore’s chief of staff, told the News & Observer Friday night that they are “still reviewing the proposal.”

Writer Richard Stradling contributed to this report.

For more North Carolina government and politics news, listen to the Under the Dome Politics podcast from The News & Observer and NC Insider. You can find it in Or wherever you get your podcasts.

This story was originally published September 16, 2022 7:16 pm.

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Profile photo of Dawn Baumgartner Vaughan

Dawn Baumgartner Vaughan covers North Carolina government and politics at The News & Observer. She has previously covered Durham, and is the recipient of the McClatchy President’s Award, the NC Open Government Coalition Sunshine Award and several North Carolina Press Association awards, including Politics and Investigations.

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