Virginia expanded Medicaid; why can’t we?

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It has been 26 days since Gov. Roy Cooper and the House and Senate Democratic caucuses proposed a compromise budget to Republican leaders in the General Assembly.

There has not been any counteroffer from Republican leaders. That does not mean they’ve been sitting on their hands doing nothing. In the past two weeks, they have:

• Scheduled budget veto override votes to take advantage of Democratic legislators’ illnesses, family medical situations and absences due to out-of-state government conferences.

• Ignored state House rules to defeat Democratic attempts to schedule a budget veto override vote for a certain date.

• Criticized Medicaid expansion that closes the health care coverage gap for 500,000 North Carolinians as a “pet project.”

• Wasted tax dollars on legislative sessions with no meaningful votes.

Every day Republican legislative leaders delay the start of negotiations on a compromise budget means more tax dollars wasted on “do-nothing” legislative sessions and more delay in getting a state budget that invests in public education more, cuts corporate taxes less and closes the health care coverage gap for North Carolinians.


Virginia just expanded Medicaid with a Democratic governor, Republican state House and Republican state Senate. They did it through their state budget bill. 300,000 Virginians now have health care coverage who did not have it just a few months ago. In North Carolina it would be around 500,000. In our area, it would be more than 6,000. If Virginia can do it, why can’t North Carolina?

All it takes is a willingness from Republican leadership to compromise on the state budget and do the right thing. No state that has expanded Medicaid has changed its mind. It means billions of dollars we are sending to D.C. through our taxes would come back to North Carolina for health care jobs and health care coverage for our citizens.

Every year we refuse to close the coverage gap means that money and those jobs are lost. More importantly, it means more North Carolinians will die needlessly or lead less healthy lives.


Every year North Carolina fails to expand Medicaid, billions of tax dollars we send to Washington do not come back to North Carolina. Governor Cooper’s main point in his compromise is expanding Medicaid to cover more than 500,000 additional residents.

What would Medicaid Expansion mean in Wilson County? According to the Cone Health Foundation, here’s what the expansion would do in the county by the year 2022:

• About 6,379 more people would receive Medicaid.

• 268 more jobs will be created.

• $58.5 million more in growth to county economy.

• $695,000 more in county tax revenue

The best part of this Medicaid expansion is that no additional state taxes will be charged. Here’s how the tax breakdown would work:

• Federal government would pay 90% of costs.

• Remaining 10% would be funded by a small assessment on hospitals and other health care providers.

There are so many benefits to Medicaid expansion! We will work our best to make sure everyone has the right to affordable health care.


• HB 184: Improvement to State Health Plans for Teachers and State Workers

House Bill 184 would create a study to determine new practices and payment models for the state employee health plan. Items under consideration would include increased transparency of medical costs, virtual medical costs and data that compares a five-year history of actual costs to the plan versus anticipated costs and spending projections.

Currently, the bill has passed its initial readings in the House but has stalled in the Senate rules committee.

• SB 68: Sewer Costs May Decrease in Some Communities

Under Senate Bill 68, the N.C. Department of Transportation would cover up to 75% of costs of new sewer lines that go through new NCDOT projects in towns with fewer than 50,000 people. Before, that number was 25,000 people.

Currently the bill has passed the House and is up for a vote in the Senate today.

• HB 645: Outdoor Advertising

House BIll 645 will allow companies to relocate outdoor billboards, convert existing ones to electronic billboards and raise the height of certain outdoor billboards.

Currently this bill has passed its initial readings in the House, was amended in the Senate and was sent back to the House for a final vote on Tuesday.

Jean Farmer-Butterfield, D-Wilson, represents the entirety of Wilson County in the N.C. House. This column is adapted from her weekly email newsletter to constituents.