On Tuesday, N.C. Senate Health Committee leaders unveiled the details of the Medicaid expansion agreement with state House leaders made last week.

During the press conference, Senate leader Berger said his chamber would take up the House’s Medicaid expansion bill and amend it. On Tuesday, the Senate ran a Proposed Committee Substitute to replace the bill with new language according to the deal struck.

Sen. Hise, R-Mitchell, gave a summary of the new bill.

“As we’ve been discussing for the entire 13 years that I’ve been here in the Senate—this bill will expand Medicaid to 138% of the federal poverty under the requirements of the federal government,” said Hise. “It also includes the H.A.S.P. assessment funds that will be through the hospitals, whether through the assessments of intergovernmental transfers, but as hospitals raise the rate, it is how we cover the state’s 10 percent of the expanded population cost.”

“[The bill also] adjusts the postpartum coverage we did last year because those individuals are now covered under full Medicaid,” said Hise. “There’s no reason for a separate program to cover them and limit them to 12 months of coverage.”

Regarding new enrollments in Medicaid, Hise said the county enrollments would shift to marketplace enrollment, taking risk off the counties.

“The expansion of Medicaid is conditional on the passage of a budget in the state of North Carolina,” Hise said, echoing what Senator Berger and Speaker Tim Moore said at the press conference last week.

“There are workforce requirements in the bill,” said Hise. “There’s a requirement for the department to continue to seek workforce requirements and enhancements anytime there’s a change in notification from CMS or the federal government about the acceptance of workforce requirements.”

Hise said this bill would eliminate the following Certificate of Need requirements:

  • Behavioral health beds
  • Chemical dependency beds
  • MRIs in counties with populations above 125,000, effective three years from the first H.A.S.P. payment
  • Ambulatory surgical centers in counties with populations above 125,000, effective two years from the first H.A.S.P. payment

Additionally, the bill will raise the replacement equipment threshold to $3 million and index annually to inflation. The bill will do the same for diagnostic centers. Surgical centers that are exempt from Certificate of Need will be required to have a 4% charity care requirement for centers in counties with populations above 125,000.

At the end of the meeting, Rep. Donny Lambeth, a longtime Medicaid expansion proponent in the House, thanked his Senate colleagues for their work throughout the long process.

“We’ve fought over it; we’ve discussed it; we’ve cussed it,” said Lambeth. “It is the right thing to do today, and I appreciate this committee taking it and running with it, and I particularly appreciate Sen. Hise and my colleagues here on the Health committee.”

“We still need to pass the SAVE Act,” Hise quipped in response. Sen. Gale Adcock, a nurse and Democrat from Wake County, seconded Hise’s comment.