After years of political wrangling, Senate Leader Phil Berger and House Speaker Tim Moore reached an agreement to expand Medicaid and reform the state’s Certificate of Need (CON) laws.

Overall, the deal is a big win for healthcare consumers in North Carolina.

Here is the reported framework.

Medicaid Expansion

Medicaid expansion will provide health insurance coverage to about 500,000 new individuals.

With these working individuals now insured, it will lessen the burden on businesses and workers to subsidize the cost on uncompensated care, and thus drive down premiums for families across the state.

It will also ease medical debt and help save struggling rural hospitals.

CON Reform

Among other CON reforms, the deal importantly repeals CON for behavioral health beds, chemical dependency beds, and ambulatory surgical centers (ASCs).

Because of the current CON laws, if someone wants to open most new healthcare facilities in North Carolina, they must get permission from the government by demonstrating a “need.”

This limits access to new, innovative behavioral health and substance abuse services. The agreement’s reforms will increase access to new and better care.  

Repealing CON laws for ASCs will allow these facilities to offer more affordable care to patients. It will also increase competition will place downward pressure on more expensive hospital system’s prices.

ASCs provide many of the same services as large, fully equipped hospitals, but at a much lower cost. Until now, however, CON laws have prevented ASCs from opening because the hospital system already holds the CON.

Hospital Funds

The agreement allows rural and safety-net hospitals to access federal funding so they can continue providing care to patients.

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