RALEIGH, NC – September 12, 2023 – North Carolina cannot expand Medicaid until the Republican-dominated General Assembly decides upon the 2023-24 state budget. The House and Senate have been negotiating over the budget for months. The Republicans in the House and the Senate cannot agree upon a budget proposal due to an impasse over casinos. Neither chamber voted on a budget this week when they realized that the versions were different. The Senate version would legalize nontribal casinos. The House did not include this provision.
A state Medicaid expansion (ME) bill was passed by the General Assembly and was signed by the Governor in March. However, the bill is tied directly to agreeing upon the 2023-24 state budget. When the General Assembly agrees upon the budget, six hundred thousand under-resourced North Carolinians will have access to health care, including almost 17 thousand people from Buncombe County. ME and the Healthcare Access and Stabilization Program (HASP) will bring 8 billion dollars annually to the state and almost 2 billion dollars to support behavioral health, public safety, and rural health care. If the ME program is begun this year, North Carolina will receive an almost 2 billion dollar incentive of additional HASP payments. By delaying ME, the HHS estimates that 9 thousand North Carolinians a month are losing their Medicaid coverage who would otherwise be eligible for Medicaid expansion.
Robert Reives, the House Democratic leader from Chatham County, said that the Republican leadership has not asked for Democrat support for nontribal casinos. He added, “I can’t even comment on the budget. Because, the problem is, we’ve not been involved in any part of the process.”
The issue that is holding up this year’s state budget is gambling. The General Assembly may be ‘gambling’ away the health of 600 thousand North Carolinians and billions of dollars of additional federal funding by not making the casino provision a separate bill.
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Contact: Dr. Dick Needleman, Health reporter, 103.3 AshevilleFM, healthyasheville@ashevillefm.org