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North Carolina Senate President Phil Berger (R) and House Speaker Tim Moore (R) were scant on details when announcing the agreement, but said expansion will be tied to the 2023 budget.
“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 during a press conference 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 move to adopt Medicaid expansion comes as the federal government in recent years has added even more incentives for holdout states to adopt it.
Under ObamaCare, the federal government pays 90 percent of the costs for states that expand the program. But under the 2021 American Rescue plan, the federal government will cover 95 percent of costs for two years for new expansion states.
“I work every day to bring down health care costs, and I’ve called on leaders to do the same. This is what I’m talking about: This bipartisan deal would expand Medicaid to hundreds of thousands of people,” Biden tweeted Thursday. “That’ll be 40 states who’ve expanded. 10 more to go.”
But after North Carolina, it’s not clear if any other states will step up.
The holdouts: Florida, Tennessee, Georgia, Kansas, Mississippi, South Carolina, Texas, Wisconsin, South Dakota and Wyoming.
South Dakota voted for a Medicaid expansion ballot measure in the most recent election, but it hasn’t been implemented yet.
And while ballot measures worked for seven states since 2017, only voters in Florida and Wyoming have the process available to them. And even then, the barriers are high, and advocates have said getting Medicaid expansion will be virtually impossible.
The only pathway remaining is to convince GOP-majority, and even GOP super-majority legislatures.
For example, Kansas Gov. Laura Kelly (D) has vowed to get Medicaid expansion across the finish line this year. But she has found common ground with GOP state leaders on the issue before, only for the legislature to reject it.
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