NC Senate Passes Conservative Healthcare Access, Reform Legislation

Senator Berger Press Shop
2 min readMar 15, 2023

Proposal reforms Certificate of Need laws that drive up costs

House Bill 76 expands healthcare access for the working poor

Sen. Hise: “This healthcare proposal is good for North Carolina”

Raleigh, N.C. — Today, the North Carolina Senate approved a conservative healthcare access bill that reforms our state’s Certificate of Need laws and expands access to health insurance.

The Senate’s version of House Bill 76, “Access to Healthcare Options,” expands Medicaid for adults making up to 138% of the federal poverty line, which is nearly $38,300 for a family of four. This will help end the hidden tax that North Carolinians currently pay by covering uncompensated care in the form of higher private insurance premiums.

While the federal government covers 90% of the cost of expansion, the non-federal share in North Carolina will be covered by an assessment to hospitals. That means instead of using taxpayer funds to cover the 10% non-federal share, hospitals will pay that portion.

The expanded coverage would not be effective until the budget becomes law.

Hospitals across the state are set to receive an infusion of $3 billion through the Healthcare Access and Stabilization Program.

The bill includes a robust Certificate of Need reform package to address impediments to the availability of care and requirements that unnecessarily increase costs for all North Carolinians. These changes will make North Carolina more attractive for providers, healthcare facilities, and hospitals willing to do business and compete here.

The bill eliminates Certificate of Need for:

  • Behavioral health facilities and beds.
  • Chemical dependence facilities and beds.
  • Raises replacement equipment threshold to $3 million and indexes it to medical inflation.
  • Increases threshold for diagnostic centers to $3 million and indexes it to medical inflation.
  • MRI machines in counties with a population above 125,000 effective three years from the first HASP payment.
  • Ambulatory surgery centers in counties with a population above 125,000, effective two years from the first HASP payment for multispecialty and single specialty.

The Republican-led legislature has spent a decade reforming North Carolina’s traditional Medicaid program after it was mismanaged and burdened taxpayers with billion-dollar shortfalls. Through Medicaid transformation, the program now has more budget predictability and has had regular budgets with no cost overruns.

“This healthcare proposal is good for North Carolina. Our budget will be stronger because of it and our citizens will be healthier,” Sen. Ralph Hise (R-Mitchell) said. “The reforms included in this package directly address the biggest impediments to healthcare availability and affordability. “

Voters in North Carolina overwhelmingly support expansion. A recent poll found that 73% of North Carolinians support Medicaid expansion. Seventy-three percent of rural North Carolinians support expansion. Fifty-five percent of Republican voters also support expansion.

The proposal now returns to the House of Representatives for concurrence.



Senator Berger Press Shop

Press releases from N.C. Senate Republicans and Senate Leader Phil Berger