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McCrory plans talk to Obama about NC-specific health care as GOP states get Medicaid waivers

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RESEARCH TRIANGLE PARK, North Carolina — North Carolina Gov. Pat McCrory says he will talk to President Barack Obama about shaping a state-specific health care plan, an indication the Republican leader is testing the conditions under which the state might expand Medicaid coverage for the poor.

McCrory said he'll meet with Obama and the state's two Republican U.S. senators on Tuesday in an effort "to be allowed to devise a North Carolina solution to health care for families," the GOP governor told about 800 business leaders Monday at a gathering organized by the state's bankers association and chamber of commerce.

McCrory didn't specifically say whether he will discuss the kind of waivers to Medicaid regulations that have been allowed in some of the 10 GOP-led states that have decided to expand the state-federal health insurance program under Obama's health care law. But McCrory said after his speech that the topics he wants to discuss with the president include "being allowed to develop our own program" and "what flexibility the states will have in the future."

McCrory said he is open to expanding Medicaid coverage after he and the General Assembly revamp the program to control costs.

"I've said from the beginning, even last year, that I will not close the door to keeping that option available," he said.

North Carolina is one of 24 Republican-led states that initially refused to expand Medicaid under the federal health care law. About 320,000 low-income workers would have gained health insurance coverage had the state expanded the program.

Medicaid serves 1.6 million state residents. Under the Affordable Care Act, the federal government is committed to paying no less than 90 percent of the costs of expanding coverage.

A study by the Robert Wood Johnson Foundation and the Urban Institute estimates North Carolina will lose $51 billion in Medicaid funding and reimbursements to North Carolina hospitals if the state continues to forgo expansion through 2022.

Republican legislative leaders, though, have consistently expressed skepticism that Washington will live up to its funding promises and that the increased administration costs of expanding Medicaid coverage could fall to state taxpayers.

Tennessee is the latest GOP-led state to forge a deal with Obama administration officials over Medicaid expansion. Gov. Bill Haslam said last month that after a year of discussions with federal officials, the state could launch a two-year expansion experiment in which the state's hospitals have agreed to cover any additional costs to the state.

Brad Wilson, CEO of Blue Cross Blue Shield of North Carolina, the state's largest health insurer, urged business leaders attending the gathering to lobby for Medicaid expansion. Hospitals and doctors are suffering losses as people too poor to qualify for subsidized health insurance sold under the federal law are also shut out of Medicaid coverage, he said.

"They are receiving care and it is not being paid for," Wilson said.

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Emery Dalesio can be reached at http://twitter.com/emerydalesio

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