HB 5/SB 3 – Medicaid Expansion Bills

HB 5 / SB 3 Close the Medicaid Coverage Gap

This bill was filed jointly in the House and Senate.

House Primary Sponsors: Rep. Gale Adcock (D-Wake), Rep. Carla Cunningham (D-Mecklenburg), Rep. Verla Insko (D-Orange), Rep. Farmer-Butterfield (D-Wilson)

Senate Primary Sponsors: Sen. Ben Clark (D-Hoke), Sen. Dan Blue (D-Wake), Sen. Gladys Robinson (D-Guilford)

Bill Summary

This bill would allow individuals under the following criteria to be eligible for Medicaid benefits:

  • Adjusted gross income at or below 133% federal poverty level (FPL)
  • Age range: 19-65
  • Not entitled or enrolled in Medicare Part A or B
  • Not otherwise eligible for Medicaid coverage currently

Benefits would be received through an Alternative Benefit Plan established by DHHS. The co-payments for benefits would be the same as current Medicaid beneficiaries.

The start date would be effective on the date that capitated coverage begins.

The bill states that it is the intent of the NCGA to enact legislation to replace the Hospital Provider Assesment with a similar hospital provider assessment. It is the intent to impose upon these same hospital providers a Mediciad Coverage Gap Assesment that will pay for the state share of the program and the administrative costs of Medicaid expansion.

House Movement

This bill was filed on January 31, 2019. This bill was referred to the Health Committee, the Appropriations Committee, and the Rules Committee.

Senate Movement

This bill was filed on January 31, 2019. This bill was referred to the Senate Rules Committee.


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