Feb. 01--RALEIGH -- More than one person Thursday referred to Senate Bill 4 as a speeding train, and for good reason.
The bill to prohibit state government involvement in the Affordable Care Act -- commonly known as "Obamacare" -- and to reject any expansion of Medicaid is already at the Senate floor and ready for full debate.
And it's only the third official day of the 2013 session of the General Assembly.
Thursday morning, the Senate convened, performed the necessary ceremonial tasks, sent SB 4 to the Insurance Committee and adjourned until noon. Once in committee, Sen. Tom Apodeca, R-Henderson, and Sen. Floyd McKissick, D-Durham, conducted a debate that will likely be reprised on the Senate floor.
Apodeca is a primary sponsor of the bill, as are Sens. Harry Brown, R-Onslow, and Bob Rucho, R-Mecklenburg.
Apodeca explained that in the Republican majority's belief, it was better for the federal government to run a state health benefit exchange if it wishes, instead of the state dealing with all the strings and constraints that come with operating under the federal government's parameters.
Sen. Louis Pate, R-Wayne, is a co-sponsor of the bill and concurs.
"I think we still have states' rights, and as well as I recall, we're supposed to," said Pate, whose district includes a large portion of Lenoir County. "So, I think each state can make up its own mind. Unless something else changes, we've made up our mind here."
Sen. Michael Walters, D-Robeson, countered on the claim the bill would disproportionately hurt poor and rural counties, where many people are on Medicare and Medicaid.
SB 4 would also block the ACA's federal expansion of Medicaid eligibility. Instead, it states the responsibility for determining Medicaid eligibility should be left to the state.
Brown, whose district includes part of Jones County, said a Medicaid expansion would only make a bad problem worse.
"The only way most hospitals can survive today are people with insurance who can offset some of the Medicaid patients that are arriving in the hospitals today," said Brown, who is also a Jones County native. "Your hospital, if it's that mixed now, they're going to struggle. If that mix gets even worse, I can promise you, they're going to struggle even more."
Brown went on to say the state budget couldn't handle it either, adding, "Look at what happened last year. We had about a $500 million deficit in Medicaid just this last year. It's a big driver of our budget. This year, the trend's the same, and we're looking at a deficit this year with our budget.
"Now we're talking about expanding things, and I've seen numbers that say it may impact our budget by a billion dollars. Can anybody tell me where you're going to find a billion dollars to offset that expansion in our budget today?"
After about 30 minutes, the question was called and the Insurance Committee reported the bill back to the Senate on a voice vote, where it will receive second reading.
Sen. Don Davis, D-Greene, acknowledged the reality facing his party to stop or alter the bill after coming out of a Senate Democratic Caucus meeting.
"I sat through the committee, and this thing seemed to be on the pretty fast track. You either jump on or the train keeps on moving," Davis said. "Right now, I think it would be good if we could slow the train down and have honest debate and discussion about it, and its impact especially on rural communities, such as Eastern North Carolina, or rural communities in the western part of the state -- all over the state. It would be of great benefit to have some debate."
Wes Wolfe can be reached at 252-559-1075 or [email protected]. Follow him on Twitter at WolfeReports.
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