News & Election Videos

NC lawmakers won't act on part of US health reform

Emery P. Dalesio

North Carolina lawmakers have no plans to meet a deadline to create a new one-stop shop to help individuals and small businesses find affordable health insurance despite Thursday's landmark U.S. Supreme Court ruling.

Senators do not intend to take up legislation this year to create a health benefit exchange, said Senate leader Phil Berger, R-Rockingham. The 2010 federal health care overhaul requires all states to have an exchange, and legislation passed the state House last year.

State plans for the markets are due to the federal government by this fall. The federal government will create exchanges for states that don't have them by 2014. But only 14 states and Washington, D.C., have adopted a plan for carrying out the law creating exchanges that steer middle-class households to private plans.

"The General Assembly needs time to process and understand this mixed ruling on Obamacare," Berger said in a statement.

But with much of the groundwork for a North Carolina exchange already laid, lawmakers could readily adopt changes next year, said Rep. Verla Insko, D-Orange, one of the Legislature's authorities on health policy.

"Even without legislation right now, it's quite possible that we would meet the standards of the federal government," said Adam Linker, a health policy analyst at the left-leaning North Carolina Justice Center in Raleigh. "It's yet to be seen how flexible they're going to be, but in the past what they've shown so far is that they're very flexible about state control."

North Carolina residents and businesses will see no immediate changes in their health insurance coverage from the Supreme Court ruling, and groups siding with President Barack Obama's health overhaul law said that's the decision's main benefit.

"That was really the big fear, that the Supreme Court would roll back those things that we're already taking advantage of," Linker said.

Since the law began to be phased in, more than 95,000 young adults in North Carolina became insured with coverage under their parents' insurance plans, more that 1.1 million people on Medicare received free services such as mammograms and colonoscopies and more than 114,000 seniors received a $250 rebate to help pay for prescription drugs, according to the federal government. Nearly 4,000 residents who were locked out of insurance coverage system because of a pre-existing medical condition are now insured.

It's not clear whether North Carolina will expand Medicaid program for the poor to cover childless adults for the first time. Nearly 1.6 million state residents are uninsured, or about 17 percent. In 2014, the health overhaul law is scheduled to begin covering people with incomes up to 133 percent of the federal poverty level, or nearly $30,000 a year for a family of four.

The expansion would extend coverage to about 560,000 North Carolina residents by 2019, according to state estimates collected by the North Carolina Institute of Medicine, an independent agency that receives state funding. The expansion is estimated to cost North Carolina an additional $830 million to match $15.4 billion in federal funds, an institute report said.

With the General Assembly in its final days of this year's legislative session, aides for Berger and House Speaker Thom Tillis, R-Mecklenburg, did not respond Thursday to questions about the Medicaid eligibility extension.

Gov. Beverly Perdue, a Democrat, spoke to U.S. Health and Human Services Secretary Kathleen Sebelius about the Medicaid portion of the law and will review the court's ruling to determine how it may affect the state's Medicaid program, Perdue spokeswoman Chris Mackey said.

If North Carolina doesn't go along with the higher Medicaid income threshold, the state will miss out on a big new stream of federal dollars, Linkler said.

"Hospitals right now are struggling. Physician's practices are going under because they are seeing all these uninsured patients. These are the very people who are going to be getting Medicaid," he said.

All of that supposes Republicans, who have promised to scrap the health overhaul law, don't win control of Congress and the White House in November's general elections.

"Today's decision has set the stakes for the election in November," state GOP Chairman Robin Hayes said. "North Carolinians will have the ability to elect Mitt Romney, who will repeal Obamacare and bring about true health care reform."


Emery Dalesio can be reached at

The Associated Press