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Edwards explains why he changed his mind on Medicaid expansion

N.C. Sen. Chuck Edwards N.C. Sen. Chuck Edwards

A $1.5 billion "cash injection" into the state treasury plus almost $5 billion a year in Medicaid payments makes it "fiscally irresponsible" to continue to resist Medicaid expansion, state Sen. Chuck Edwards in explaining why he joined other Senate Republicans in changing his position on the subject.
"Due to the promise from our federal government for billions more in Medicaid payments, it is now fiscally irresponsible for NC to not consider the benefits," he wrote in his weekly newsletter. "For the last six years, I've heard from constituents on both sides of this issue and until now I've resisted the deal Washington, D.C., has offered states to expand."
Last week, the Senate passed a bill expanding Medicaid by a lopsided 44-2 margin and sent it on to the House, where it faces an uncertain fate.
Here is Edwards's entire statement:
"The Affordable Care Act has caused healthcare prices to sky-rocket making them unaffordable to many. A recent healthcare study across all 50 states and the District of Columbia ranked North Carolina 47th overall for cost, access, and outcomes. With high prices, poor access, and inefficient outcomes, it has become very evident that the time to act is now. 
"Since the beginning, Republican members of the General Assembly - including myself - have been opposed to Medicaid expansion because, unless enacted alongside additional reforms, Medicaid expansion is terrible federal policy. So I'm sure you're wondering, why now? The reality is: The Affordable Care Act is not going away. All legal and legislative attempts to overturn it have been exhausted. The federal government continues to offer up"sweeteners" to states that haven't expanded Medicaid under the ACA and, with an additional 5 percent federal cost-share for NC's traditional Medicaid enrollees upon expansion, it has become good state fiscal policy.
"What this means to our state is a $1.5 billion cash injection into our general fund. Then about $4.8 billion more in Medicaid payments made annually to our state, plus another $3.2 billion annually for our struggling rural hospitals, and about $45 million annually for local governments.
"Safeguards have been put in place in this bill. If the feds ever break their promise on the incentives, then NC will no longer participate. We've also added a work requirement for able-bodied participants to join the plan. 
"In the past, North Carolina's existing Medicaid program has been broken and mismanaged. It has regularly burdened taxpayers with billion-dollar shortfalls, but fortunately, over the past decade and during my last six years with the General Assembly, my Republican colleagues and I have turned Medicaid around in North Carolina. We have had eight straight years of solid Medicaid budgets without cost overruns and completely reformed the system by implementing Medicaid Transformation last year. 
"The new federal incentives coupled with North Carolina's strong financial management and completely reformed system have created the premier opportunity to expand Medicaid while addressing the supply-side issues wanted by Conservatives that have until now prevented further access to care and address the mental health crisis our citizens are facing. 
"I voted YES on HB149, our bill to expand access to healthcare. This bill creates the Healthcare Access and Stabilization Program. This program will serve as a lifeline to NC hospitals, especially our rural hospitals. The program will ensure that hospitals are funded, healthcare workers are paid, and both the economy and jobs are secured. The bill also targets outdated restrictions on Advanced Practice Registered Nurses (APRN) and their full practice authority, saving taxpayer money and allowing registered nurses to supply medical care to the best of their abilities. We also included medical billing transparency that will protect patients from surprise medical bills.
"This bill expands access to health insurance while addressing regulations that prevent providers from practicing and removing barriers that drive up costs. Because of the expansion of Medicaid, our state budget will be stronger and the longevity of our rural hospitals will be better protected. Now is the time to make this change, before we are forced to do it in the future."