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Medicaid expansion to begin in North Carolina as governor lets budget bill become law

RALEIGH, N.C. (AP) — North Carolina Gov. Roy Cooper announced Friday that he will let the state budget bill before him become law without his signature, paving the way for Medicaid coverage for 600,000 low-income adults, some receiving government assistance. health insurance in a few weeks.

The Democratic governor unveiled his decision on the two-year spending plan minutes after the Republican-controlled General Assembly gave final legislative approval to the measure.

A Medicaid expansion law that Cooper signed in March stipulates that a state budget for this fiscal year must still be passed before coverage can be implemented.

Negotiations on this budget plan, which was to come into force on July 1, continued throughout the summer.

The latest two-year plan accelerates cuts to the personal income tax rate, expands private college scholarships to all K-12 children and contains other elements that weaken the governor’s office while strengthening the Republican Party-dominated legislature and its power over the state courts.

Cooper could have signed the budget, vetoed it, or let it become law after waiting 10 days. Cooper said Friday he would do the latter.

Republicans hold a narrow veto-proof majority, and five House Democrats joined Republican lawmakers in voting in favor of the budget measure.

LEARN MORE: Medicaid coverage has been restored to about half a million people after computer errors interrupted them.

Expanding Medicaid has been one of Cooper’s top priorities since taking office in early 2017. For years, state Republicans have been staunchly opposed to providing Medicaid through the federal health law of 2010, but GOP leaders changed course last year.

“Make no mistake, overall this is a bad budget that seriously harms our schools, prioritizes power grabs, keeps shady behind-the-scenes deals secret, and blatantly violates the constitution, and many of its provisions will be subject to legal action,” Cooper said in a press release.

“However, we must recognize this irresponsible Legislature’s decade of refusal to expand Medicaid, which has caused life-or-death situations for so many North Carolinians and threatened the very existence of many rural hospitals,” he said. he added. “I will not allow people calling for help to wait any longer, which is why I am directing our Department of Health and Human Services to begin the process of expanding Medicaid today by allowing this budget to become law without my signature.”

Cooper’s health secretary suggested last month that Medicaid coverage could be in place as soon as December if lawmakers complete the final step for Medicaid.

Adults who earn too much to qualify for traditional Medicaid but too little to qualify for even heavily subsidized private insurance would benefit from an expansion. About half of that total could be obligated immediately, Secretary Kody Kinsley said.

The House and Senate voted Thursday and Friday on the plan that determines how $29.8 billion will be spent this fiscal year and $30.9 billion next year.

Senate Leader Phil Berger told reporters after Cooper’s announcement that he would have preferred the governor sign the budget “to move things along a little faster,” rather than waiting until early October for the budget. promulgation of the budget.

“But I think it indicates that this is a strong budget,” Berger said. “There are some things in the budget that I’m not so crazy about…but overall it’s in many ways the most significant budget we’ve seen in North Carolina.”

The future of North Carolina’s soon-to-be-implemented expansion was uncertain earlier this week when Republican Party legislative leaders suggested moving the trigger to begin the expansion from the budget to a standalone measure that would have greatly expanded gaming in the state.

But Cooper and Democratic lawmakers and social conservatives balked at the idea, threatening the bill’s success. Berger and House Speaker Tim Moore abandoned that effort earlier this week.

North Carolina was among 11 states that had not agreed to federal expansion before Cooper signed the expansion bill. Cooper and his administration had complained that delays in implementation meant the state was missing out on more than $500 million a month in additional federal funding.

The state government will also receive an additional $1.8 billion in federal payment over two years for Medicaid expansion.

The 10 percent share of state spending for Medicaid expansion beneficiaries would be paid through hospital assessments.

Associated Press/Report for America writer Hannah Schoenbaum contributed to this report.

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