Senate Republicans reject Obamacare expansions

Decline to pursue state-based health exchange, Medicaid expansion
Jan 30, 2013



Raleigh, N.C. – North Carolina Senate leaders introduced legislation Wednesday to opt out of participation in several costly provisions of the federal Affordable Care Act, also known as Obamacare.


Senators Tom Apodaca (R-Henderson), Harry Brown (R-Onslow) and Bob Rucho (R-Mecklenburg) filed Senate Bill 2 to exempt North Carolina from establishing a state-based health insurance exchange or a state-federal partnership exchange.


The bill also directs the N.C. Department of Insurance to return unspent taxpayer funds awarded by the federal Department of Health and Human Services earlier this month to create a state-federal partnership exchange.


“Obamacare was forced on us against our will by the federal government, and they should shoulder the burden of implementing it,” said Sen. Apodaca.  “Any claim that North Carolina would ‘control’ this program is nothing more than an illusion.”


Senate Bill 2 also rules out expansion of the North Carolina Medicaid program.  In its 2012 decision on Obamacare, the U.S. Supreme Court exempted states from the federal mandate to expand Medicaid eligibility.  Based on the court’s ruling, North Carolina has the authority to opt out of expansion.

Costs for North Carolina’s existing Medicaid program have increased significantly in recent years. In 2012, the General Assembly was forced to fill a surprise Medicaid shortfall that totaled more than $500 million.  Recent figures from the N.C. Department of Health and Human Services indicate that an expansion of the program would add hundreds of millions of dollarsin additional state costs to North Carolina’s Medicaid budget through 2019.


“Senate Republicans are committed to ensuring every North Carolinian receives the highest quality health care and outcomes,” said Senate President Pro Tempore Phil Berger (R-Rockingham).  “Saddling our citizens with the enormous costs of a new federal bureaucracy and entitlements is simply not the way to achieve this goal.”



Under Obamacare, each state must have in place a health exchange where individuals and small businesses, which are now mandated to have insurance, can purchase health care coverage.  There are three options:  a state-run exchange, a state-federal partnership exchange and a federally-run exchange. Senate leaders have spent months evaluating the implications of each type of exchange.


In November 2012, former Gov. Beverly Perdue prematurely declared her intent to establish a state-federal partnership exchange – three months before the deadline for the state to make this declaration – while at the same time applying for $73.9 million dollars in federal grant funding to set up the new government program.

Comments (2)
Posted by: Joe Vescovi | Jan 31, 2013 10:40

I wonder where NC got their figures.  Freedom works (Jan. 27) wrote about Nebraska, New Jersey, Wisconsin and Ohio who calculated it would cost considerably MORE to implement a state run exchange. I get worried since I know you can make figures show what you want.  Sure hope those 4 states all calculated wrong and NC is right.

Posted by: Beth G. Johnson | Jan 31, 2013 11:27

I agree with the NC General Assembly.  We should NOT accept another unfunded mandate from the Federal government.  Currently, the Federal government promises to underwrite 100% of the costs for 3 years and then 90% and then what.  Also is that promise for 100% of medical costs or ALL costs, such as bureaucracy and office rental.   I do not trust the fiscal promises of the Federal government and think the NC government is wise to not rely on them.

If you wish to comment, please login.