Raleigh, NC -- Governor Pat McCrory is expected to sign a bill that would exempt North Carolina from expanding Medicaid.
State lawmakers passed Senate Bill 4 Tuesday in the state capitol after months of uncertainty about whether North Carolina would sign on to the provision in the Affordable Care Act; the federal health care bill some have dubbed ObamaCare.
Currently, 1.5 million people in North Carolina are covered under Medicaid.
The expansion would have added 500,000 - 640,000 more low income individuals to the roll and given them access to health insurance and care.
Democrats say the decision to block Medicaid expansion will end up hurting everyone in North Carolina.
"The longer we wait, the more we're losing in terms of providing health care for those who need it," Representative Pricey Harrison said during a phone interview on Wednesday.
"I think ultimately it increases everybody's cost when folks who are not insured end up in the emergency room and hospitals have to cover the costs. So, it impacts everybody's insurance rates and health care costs and seek health care coverage."
Republicans argue that among other reasons, SB4 will keep state taxpayers from having to pick up the tab when the federal government decides to no longer fund 100% of the expansion.
According to the plan laid out in the Affordable Care Act, states that choose the expansion would get federal dollars to cover 100% of the changes for the first three years. After that time the federal contribution would drop to 90%.
"The federal government would cover all the costs for the first three years but the federal government is more than $16 trillion in debt which I believe is a serious problem. And if we were to go along with the expansion, then we would be contributing to that problem," Hardister explain over the phone.
"If we continue just to spend and spend and expand and expand, then we're just making the problem worse and I think we really need to keep that in mind and take that very seriously. "
Hardister adds that there's no certainty the federal government would not shift more of the cost to states after the first three years even though it has agreed to 90%.
The representative also points to several reports from the North Carolina State Auditor which reveals the state's health department is broken, inefficient and has been badly mismanged.
The Department of Health and Human Services is the state department that administers the Medicaid program. Republicans, along with Governor Pat McCrory, say it's not ready to take on the expansion.
"We have problems with our existing Medicaid system and I feel that it's wiser to work on improving our current system before we expand bureaucracy," Hardister said.
Hardister emphasizes that no one will be hurt by SB4 because those currently covered under Medicaid can still stay in the program and in effect nothing changes.
Rep. Harrison disagrees.
"It hurts low income North Carolinians, usually this is the working poor. I honestly can't see who it helps. unless maybe the base of the majority party," she said. "Coming on the heels of last week's bill to cut unemployment benefits, I think we're watching a real blow at the middle class and the working poor in North Carolina."
A study by the State Health Department says the expansion would have added 23,000 new jobs as hospitals hire to meet the demand of new patients.
But, just as North Carolina could have opted out of the expansion after taking it on, Republicans say the state can always opt back in if it's the right option for citizens.