Republican House Speaker Thom Tillis, who is trying to unseat Democratic incumbent Kay Hagan, refused on Wednesday to say if he would support accepting federal dollars to expand Medicaid under the provisions included in the Affordable Care Act. The comments, made during the pair’s first debate and in a post-debate interview, come as Republicans in competitive congressional races are spending less on political spots attacking the law.
Instead of specifically addressing the Medicaid question, Tillis criticized President Obama’s signature health care law for canceling North Carolinian’s individual health care policies and raising premiums. After the debate, Tillis dodged a similar question about Medicaid and reiterated his opposition to Obamacare. But he then went on to praise some of its key provisions, suggesting that he would not vote repeal the measure in its entirety.
“I think what we need to focus on is solving the healthcare challenges in this country without overreaching, over-regulating and over-taxing,” he said. “I absolutely believe that a young adult 26 and under should be on their parents’ healthcare plan. That makes sense. I believe we should have treatment for people with chronic illnesses who may be devastated economically.”
North Carolina is one of 23 states that has not expanded its Medicaid program after a 2012 Supreme Court ruling found that the federal government cannot compel states to accept federal dollars to increase Medicaid eligibility to Americans earning up to 138 percent of the federal poverty line. As a result, as many as 600,000 residents in North Carolina, “many working in such low-wage jobs as home health aides, waitresses, bus drivers and construction workers,” are going without coverage, the Charlotte Observer notes. At least two rural hospitals have also closed as a result of shrinking payment reimbursements and high numbers of uninsured patients who cannot pay their medical bills.
Under the law, the federal government picks up the entire cost of expansion through 2016 and up to 90 percent thereafter. As a result, federal dollars will pay for more than 95 percent of the total cost of the Medicaid expansion over the next ten years (from 2015 to 2024).
Hagan, one of several vulnerable Democrats who has praised portions of Obamacare during her re-election campaign, has repeatedly called on state leaders to grow the Medicaid program. Last week, Pennsylvania received a waiver from the federal government and became the ninth state with a Republican governor to accept federal Medicaid dollars. The GOP dominated states of Wyoming and Tennessee are also hammering out an agreement with the Obama administration that would grow their Medicaid programs.
The issue could come up when the North Carolina legislature convenes in January, thought state leaders have yet to endorse a similar approach.