In politics today, it’s rare to find strong agreement among one of the state’s most powerful Republicans, Senator Phil Berger, and North Carolina’s top Democrat, Governor Roy Cooper.

But when it comes to Medicaid Expansion, they agree on one thing: the Big Hospital Lobby is blocking a bill to protect the profits of multi-billion-dollar hospital systems.

In an op-ed in the Charlotte Observer, Cooper writes that the lack of compromise on Medicaid expansion is over “a fight about allowing more competition for hospitals…Hospital leaders know that no vote will come on Medicaid expansion this year unless they compromise on competition, but the powerful hospital lobby hasn’t yielded out of fear for their profits.

Berger, in an interview with reporters, stated plainly, that “as long as the hospitals remain as intransigent as they are, I don’t see that we’re going to make any progress.

The fight over more competition for hospitals is about making some long-overdue reforms to the state’s “certificate of need” (CON) laws.

A “certificate of need” is essentially a permission slip that must be bestowed on a healthcare facility by the government before they can expand, open a new facility, or offer more services.

The problem with CON laws is they artificially limit competition and cause prices to rise.

Take, for example, Ambulatory Surgical Centers (ASCs). ASCs provide many of the same services a large, fully equipped hospital can, but at a much lower cost.

But, if the government decides that the nearest hospital has enough beds to serve the local community, then it will not bestow a CON for any competitor, including a new ASC.

Without competition, the hospital has more freedom to inflate fees, or at least no incentive to try to reduce them.

In May, the State Senate passed legislation, by a bipartisan vote of 44-2, that would have expanded Medicaid and made some incremental reforms to the state’s CON laws.

The Big Hospital Lobby fought back once the bill made its way to the House and killed it.

Targeted CON reform will lower healthcare costs, improve access, and increase quality.

Medicaid Expansion will help the working poor get insurance, save rural hospitals, and lessen the burden on businesses and workers to subsidize uncompensated care, thus driving down premiums.

That is a lot of wins for the people of North Carolina.

And as Republican Senate Leader Berger and Democrat Governor Cooper agree: the only thing keeping those wins from happening are the Big Hospital Lobby and protecting their billions in profit.  

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