NC Senate Republicans float Medicaid expansion bill

By Rose Hoban and Rachel Crumpler

It finally happened.

In a move that many health care advocates have been pushing for years, the state Senate introduced a bill on Wednesday that would expand the state’s Medicaid program to some half million-plus low-income North Carolinians.

Until this point, Medicaid has been reserved mostly for children from low-income families along with a small number of parents in those families, poor seniors and people with disabilities. Since 2012, the possibility to sweep in many low-income workers has been on the table as a result of the Affordable Care Act, but Republican leaders in the state senate have been staunch opponents. 

Now, after years of saying no, powerful Republicans in the state Senate are saying yes.

“Why now? Why this? First, we need coverage in North Carolina for the working poor,” said state Senate leader Phil Berger (R-Eden), who admitted during a press conference Wednesday that he has likely been the most outspoken person in the state about his opposition to Medicaid expansion.

“Second, there is no fiscal risk to the state budget moving forward with this proposal,” Berger added, noting that the bill includes pay-fors that would have hospitals largely on the hook to pay the 10 percent of the costs for the expansion population not covered by an enhanced federal payment. There’s also a federal incentive that would total some $1.5 billion in extra funds that would flow to North Carolina over a two-year period.

Finally, he argued that since the state has moved Medicaid from being a state-run fee-for-service program to one managed by commercial insurance companies, the program has been “reformed and transformed.” 

“Medicaid expansion has now evolved to a point that it is good state fiscal policy,” Berger continued. “But again, I cannot emphasize this enough: Expanding Medicaid needs to happen with additional reforms.”

Those reforms could make the bill to be titled Expanding Access to Healthcare in North Carolina a hard pill for many to swallow. One aspect of the bill would set up a work requirement for the new beneficiaries, something that’s been repeatedly struck down in other states by federal judges. 

What really might jeopardize passage of the bill is that it contains provisions that already are raising hackles in some powerful health care lobbies, including those that advocate for the state’s physicians and hospitals. 

Resistance from doctors

One reform proposed in the 33-page bill would make it possible for advanced practice nurses such as nurse practitioners, nurse midwives and certified registered nurse anesthetists (CRNAs) to practice without having a contract with a physician for their supervision.

Physician and nursing groups have been divided over the so-called SAVE Act for years, with medical providers — led by the North Carolina Medical Society — usually being able to stop the nurses from having more leeway in their practices. At a Senate Health Care Committee hearing held after the press conference, several Democratic lawmakers also expressed reservations over this part of the bill. 

Chip Baggett, head of the

Read More... Read More

Lyft gets new head of healthcare to lead expansion in nonemergency medical transportation

Lyft has named Buck Poropatich its new head of healthcare, the ride-hailing giant confirmed in an email statement.

Poropatich joined Lyft in 2019 as its healthcare strategy director and has been instrumental to the company’s healthcare expansion, Lyft said in the statement.

Previously, Poropatich spent seven years at McKesson and Change Healthcare in business development and corporate strategy. He will succeed Megan Callahan, who has served as Lyft’s Vice President of Healthcare since 2018.

Lyft expanded its ride-hailing services in April to include nonemergency medical transportation. The offering allows patients to schedule rides to destinations like medical appointments, vaccinations and prescription pickups, on the health organization’s dime.

RELATED: Lyft Pass for Healthcare lets patients book their own rides to the doctor

“Lyft Healthcare is one of the largest non-emergency medical transportation providers in the United States, making up a vibrant and fast-growing sector of Lyft’s U.S. business. I’m excited to lead Lyft Healthcare as the organization continues to invest in products and services to meet healthcare transportation needs and maintain its leadership position in the industry; the future of Lyft Healthcare is bright,” said Poropatich in a statement.

Nonemergency medical transportation services like Lyft can reduce patient no-shows, particularly in low-income populations where lack of transportation is a common reason for missed appointments.

Previously, healthcare organizations would have to schedule the rides for their patients, but the Lyft Pass for Healthcare service allows organizations to control things like budgets and approved locations while letting patients schedule rides themselves.

The move extended the company’s Lyft Pass effort, launched July 2020 to allow businesses to cover the cost of employees’ rides.

Lyft has had its eye on healthcare for a few years, launching efforts like integration with Epic’s electronic health record system, providing rides to and from COVID-19 vaccination sites, and partnering with various health organizations and coordination services to improve healthcare access.

Uber, Lyft’s biggest ride-sharing competitor, has expanded its services into healthcare, too. The ride-hailing giant released its Uber Health service in 2018 to provide nonemergency medical transportation in partnership with more than 1,000 healthcare organizations.

Uber has since launched various other initiatives, including its recent partnership with Papa to coordinate rides for seniors.… Read More...

Read More