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Republican lawmakers in North Carolina have drafted an alternative to Medicaid expansion, an issue that has bolstered a rift between the parties at the capitol.

The bill, titled the NC Health Care for Working Families Act, will be discussed on the House floor on Thursday. It would offer health care coverage to uninsured working-class North Carolinians who are not eligible for Medicaid and health care grants to rural residents.

NC Health Care for Working Families is a response to Gov. Roy Cooper’s veto of the 2019 budget proposal that excludes Medicaid expansion. Cooper and fellow Democratic leaders on Tuesday presented a replacement budget proposal that adds Medicaid healthcare coverage for about 600,000 residents and makes concessions in other areas. Both sides have publicly voiced a willingness to reach a compromise.

The Republicans new bill moved through the House Health committee Wednesday. 

The Medicaid alternative “generates $4.7 billion into North Carolina, economically to cover many of our health care woes,” said Rep. Donny Lambeth, R-Winston-Salem, one of the bill’s sponsors.

The NC Health Care for Working Families program is designed for state residents between the ages of 16 and 64 whose income does not surpass 133 percent of the federal poverty level. This means a family of four with an annual household income of $34,000 would be at the top end of eligibility. 

Funding for the program will come from federal funds, participant contributions, intergovernmental transfers, tax revenue and hospital partnerships. 

The program participants would pay an annual premium, billed monthly, that is equivalent to 2 percent of their annual income. For instance, that family of four earning $34,000 would be paying about $56 a month for health care costs. North Carolinians who live 50 percent below the poverty level or those already dealing with medical or financial hardships can get the premium fees waived.

There is one stipulation to eligibility: All “able-bodied” adults in the program must be employed, according to the GOP plan. The work requirement excludes pregnant and postpartum women, caregivers, substance abuse treatment seekers, residents with medical conditions and Native Americans and their relatives.

The bill also would establish a Rural Access to Healthcare Grant Fund that would help combat the health care disparities in rural areas of the state. The fund would be built on some of the proceeds from the NC Health Care for Working Families program. Rural Access program applicants could apply for individual grants for up to $1 million.

Critics of the bill say it will create more barriers for working-class families.

“NC Health Care for Working Families bill #h655 would charge costly premiums to low-wage workers who are already living paycheck-to-paycheck and struggling to make ends meet,” a post on the Twitter page for the North Carolina Justice Center said.

Staff Writer

Nyamekye Daniel has been a journalist for three years. She was the managing editor for the South Florida Media Network and a staff writer for The Miami Times. Daniel's work has also appeared in the Sun-Sentinel, Miami Herald and The New York Times.