February 10, 2023 7:00am

Medicaid expansion is a no-brainer for most Triangle respondents, but many unclear on CAN laws

A bill is likely to be debated in the legislature next week.

Photo of Leigh Tauss
Research Triangle Correspondent

Republicans in the state legislature have effectively held up expanding North Carolina’s Medicaid program by grouping the bill with policy changes regarding healthcare providers purchasing power. But according to this month’s poll, most Triangle influencers want to see Medicaid expanded regardless of other policy alterations.

North Carolina is already one of the last states to pass Medicaid expansion, which would allow an additional 600,000 low-income residents to become eligible for the program.

Lawmakers appeared on the brink of passing an expansion last session, but debate over reforms to the state’s Certificate of Need laws stalled a vote.

North Carolina’s Certificate of Need (CAN) law mandates that healthcare providers get state approval to construct new facilities or make big purchases of medical equipment. Industry officials have warned that big changes to the policy could be harmful to smaller community hospitals.

Next week, the latest Medicaid expansion bill will likely be heard and brought to a vote before the North Carolina House. The proposal does not include changes to the CAN policy that Republicans have pushed for.

Senate President Phil Berger hinted to reporters that debate about the bill will likely be contentious.

“It's not the bill that we need in North Carolina expanding Medicaid,” Berger was quoted as telling reporters, according to WUNC.

Power Poll respondents largely disagree. They want to see Medicaid expanded with or without other policy changes, and a significant portion either don’t know or don’t care about CAN reform.

Most folks — 68 percent — unequivocally want to see Medicaid expansion passed. An additional 8 percent want to see it passed only if CAN reforms are enacted as well, while another 9 percent say they want it to pass but only without CAN changes. Just 10 percent say they are against any expansion to the program and only 5 percent say they don’t know.

To our respondents, this isn’t a topic that divides them. Most think Medicaid expansion is a no-brainer and don’t want to see debates stalled on other policy issues.

When it comes to CAN reform, the biggest portion of respondents — 29 percent — said they are either unsure or simply don’t care whether changes are made by the legislature.

The second biggest group of folks polled — 26 percent — said they do want to see reforms made, but only some. Another 15 percent want to see significant reforms and 13 percent would like to see the law repealed entirely. But 17 percent don’t want to see any changes to the policy at all.

But more telling, is that a majority of respondents — 68 percent — don’t think CAN changes need to be grouped with Medicaid expansion at all. Just 16 percent think the two issues need to be addressed in the same bill but 18 percent said they aren’t sure or don’t care either way.

Overall, it seems our respondents don’t share the same priorities as Republican leadership when it comes to industry changes. Expanding Medicaid is the priority, but CAN reform isn’t something they are entirely clear on or care about.

And just out of curiosity, I wondered how expanding Medicaid would affect our Triangle respondents. Well, nearly all of you — 88 percent — have private insurance from your employer, so it won’t. Not a single person responded that they are currently on Medicaid, although 8 percent of folks are on Medicare.

And that is telling. Even though this policy change won’t affect most of you, a majority still want to see it passed.

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About Power Poll: Power Poll asks questions of the most powerful, influential people in U.S. cities. It is not a scientific survey. But because the people responding to the surveys comprise the leadership structure of their cities, the results afford a fascinating glimpse into the thoughts, opinions, and beliefs of those in a position to make change. Power Poll is distinctly nonpartisan.

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