The Republican-led U.S. Senate on Monday passed a bill that would block $7,500 in payments to the state of North Carolina for providing health insurance to its residents, effectively ending the federal government’s subsidy program for low-income residents.
The legislation, called the North Carolina Medicaid Expansion Act of 2017, passed in a 24-19 vote.
Republicans had planned to consider it on Thursday, but it was stripped from the agenda by the Senate after it became clear that President Donald Trump would veto it.
The House approved the bill last week, and the Senate will consider it Thursday.
The $7.4 billion in subsidies will help the state pay for the expansion of Medicaid, which covers more than 13 million North Carolinians.
Democrats have vowed to fight the bill in court and argue that the federal subsidy will encourage states to opt out of the program and limit access to coverage for people with pre-existing conditions.
The bill also gives states $2.4 million to expand Medicaid coverage for children who are at or below 138 percent of the federal poverty level.
It also provides $8 million in federal funds to support state Medicaid expansion efforts.
North Carolina had previously offered a similar waiver, but the federal program was expanded by a law that was enacted in 2014.
It is the largest Medicaid expansion under the Affordable Care Act.
North Carolinas Health Secretary Dr. John Wilson said the Medicaid expansion will be in place by the end of the year.
“North Carolina will continue to be a leader in expanding Medicaid,” Wilson said in a statement.
“I’m confident the state will be able to continue to do so.”
The bill would require the state to pay for nearly all of the expansion by 2019.
The federal government provides an average of $6,900 a month for the Medicaid program.
North Cascades health department spokesman Scott Coyle said the agency was working with the state on the bill and would be “committed to working with our fellow state to achieve our objectives.”
The state of New York has already expanded Medicaid, and Republicans have vowed that their plan will be even bigger.
Andrew Cuomo has already proposed a plan that would extend Medicaid coverage to thousands of low- and moderate-income New Yorkers.
But his plan would have to pass the state Legislature, where Democrats hold a majority.
Cuomo has said the program will only cover about a third of eligible adults.
The Republican governor has also said that he supports the expansion in New York, but has not said whether he supports it in the rest of the country.
The Affordable Care Action Fund, a nonpartisan group of insurance industry and nonprofit organizations, said in an emailed statement that the North Dakota Medicaid expansion was a good start but would be better to implement in other states.
The group also said the $2 million in funding would be an excellent start.
“The Medicaid expansion in North Dakota is a critical first step towards a much larger, more comprehensive plan,” the statement said.
The North Dakota Health and Human Services Department did not immediately respond to a request for comment.
The state’s Medicaid expansion has also been met with criticism from health experts, who have said it will make it harder for poor people to afford coverage, especially if they are elderly.
The expansion is expected to cover nearly 700,000 people, but its implementation could cause a surge in uninsured and even deaths among people with medical problems, said Jessica Ditto, executive director of the Kaiser Family Foundation health policy center.
“It’s an absolute disaster,” Ditto said.
“But it’s going to be much better to get the right numbers and make sure people can access care.”
North Carolina and New York were among the first states to expand the Medicaid coverage program under the ACA, which President Barack Obama signed into law in March 2010.
The Medicaid expansion expanded coverage for Medicaid-eligible adults who make less than 138 percent federal poverty guidelines, and those earning up to 133 percent.
The program provides free or reduced-cost coverage to the elderly, children, parents and anyone who is not eligible for Medicaid.
North and New Yorkers will join states in expanding eligibility, including Vermont, Connecticut and Alaska, and are expected to become the first to do it next year.
The health department says the expansion is working to help the number of North Carolinos receive health care.
The new program is also helping North Carolina’s Medicaid recipients, Ditto noted.
North Dakota was one of 13 states that expanded Medicaid under the law, which requires states to do the same, and its Medicaid program has grown in number, and coverage for the poor and disabled has grown.
North American Health Association president Richard Kranish said it was disappointing to see that North Carolina was one more state that was not expanding Medicaid.
“What we need is the full expansion in every state, but we need to see it done in a way that’s more consistent with the ACA,” Kranis said. Kranises