RALEIGH – Pending one more stop in the Senate and the signature of Gov. Pat McCrory, it appears that the majority of North Carolina’s General Assembly members believe an expansion of Medicaid under the Federal health care law is not the right direction to take.

On Thursday, the North Carolina House of Representatives passed a bill that clarifies that the state will neither expand Medicaid nor pursue a state-based health care exchange under the Federal Affordable Care Act.  Senate Bill 4 won by majority vote within that branch of state government late last week, and passed through the House by a 75-42 margin on Feb. 14.

R-C area House Representatives Annie Mobley of Ahoskie and Michael Wray of Gaston, both Democrats, voted against the bill. Mobley said that Medicaid expansion would cover about 500,000 working families in North Carolina, providing them the insurance coverage required when the Affordable Care Act is fully implemented next year. The federal government would pick up the full cost of the expansion for the first three years and 90 percent of the cost for several years after that.

“Expanding Medicaid would have helped working families who are still struggling in this economy,” said Mobley. “I voted against blocking expansion because we shouldn’t let politics stand in the way of expanding health care coverage to 500,000 people, creating 23,000 jobs and preventing the cost of treating the uninsured from being passed on to hard working taxpayers.

“This short-sighted decision to reject Medicaid expansion will hurt our economy and the quality of life for many citizens,” Mobley added.

All 42 of the “nay” votes were cast by Democrats.

On the other side of the issue, Republicans were quick to argue that a recent audit of North Carolina’s Medicaid system showed millions of dollars in mismanagement, the latest in a string of well-documented problems for the system.

“This bill puts the interests of our taxpayers and Medicaid patients first,” said House Speaker Thom Tillis (R-Mecklenburg). “It is clear that North Carolina’s Medicaid system is broken.  This bill is rightly focused on repairing Medicaid to better serve our citizens, rather than expanding a broken program.”

The bill also clarifies North Carolina’s choice not to pursue a state-based health insurance exchange.

“The Affordable Care Act has created incredible amounts of uncertainty in our state,” said Rep. Justin Burr (R-Stanly), who co-sponsored the legislation.  “We simply cannot put North Carolina taxpayers on the hook for two costly tenets of a bureaucratically-operated Federal plan.”

The bill underwent technical changes in the House to protect specific information-technology funds in the Medicaid system.

“We worked closely with Gov. McCrory’s office to address concerns about continuing to draw down funds for the NCFAST software,” said Rep. Marilyn Avila (R-Wake), also a co-sponsor.  “We now have a bill that accomplishes everyone’s goals.”

The bill now returns to the Senate for concurrence, then will move to Gov. McCrory for his signature.