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A Medicaid expansion deal in North Carolina received final legislative approval on Thursday as the House voted 87-24 in favor of a deal reached between Republican legislative leaders following another required vote on Wednesday. The Senate already approved the legislation last week.

The legislation, known as House Bill 76, now goes to Gov. Roy Cooper who is expected to sign it as he has long been a proponent of the expansion.

Rep. Wayne Sasser, who voted for the expansion, received blowback from several Stanly County Republicans who were not happy with his decision.

“Well I was not very thrilled today to see the NC House voted on Medicaid Expansion and to see our local representative on the Aye side!” County Commissioner Brandon King posted on Facebook Wednesday.

King noted Sasser had agreed to support the will of the Stanly County Republican Party during its convention last month.

“He stood before a large number of county Republican residents at the County GOP Convention and told them he would support the majority rule of the convention and not support Medicaid expansion if that’s what they wanted,” King posted.

About two-thirds of Republicans at the convention approved a resolution encouraging the General Assembly to vote against expanding Medicaid. They opposed expansion for several reasons including because the newly eligible would “crowd out care for more needy populations” and with the federal government being over $40 trillion in debt “the U.S. Constitution does not give the federal government authority to manage healthcare.”

The Stanly County Commissioners, a few weeks later, during its March 6 meeting, voted 4-3 to oppose a resolution against HB 76. King and commissioners Patty Crump and Mike Barbee were against the bill.

The Stanly News & Press has reached out to Stanly County GOP Chairman Matthew Swain for comments about Sasser’s vote.

In a Thursday morning interview with the SNAP, after the House voted the second time to approve the expansion, Sasser, a health committee chairman, explained his motivation to support HB 76.

Sasser said as soon as Cooper signs the bill there will be increased Medicaid reimbursements provided to hospitals through the Healthcare Access and Stabilization Program (HASP). Atrium Health Stanly stands to receive $16 million the first year, Sasser said, which will help keep the hospital’s Mother and Baby Center open — a big motivating factor behind his decision to support the legislation.

“It was the best thing for Stanly Atrium to get federal funding and it was the best thing for the working poor in Stanly County to have insurance where they don’t have to use the hospital emergency room for their health care,” he said.

Medicaid expansion and HASP will bring $8 billion annually to North Carolina with no additional cost to the state, per the NC Department of Health and Human Services.

Sasser admitted he struggled with how he would vote until he talked with one of the county commissioners who told him to “do the right thing.”

While Sasser understands some people will not agree with his vote, he believes supporting the expansion was the right move. (The legislation would have easily passed even if Sasser opposed it).

“I voted yes and I would vote yes again next time and again the next time, under the same circumstances,” he said.

HB 76 will expand Medicaid health care access to people aged 18-64 earning incomes up to 133% of the federal poverty level, which will benefit roughly 600,000 low-income North Carolinians, many of them in rural areas like Stanly County.

The expansion will also establish a workforce development program promoting employment among Medicaid enrollees, Sasser said.

“We’ve got plenty of jobs, we just don’t have enough workers,” he said.

Under the agreement, the federal government will cover 90% of the cost of Medicaid recipients under expansion. The state’s 10% share will be covered by a new tax on hospitals and insurance companies. North Carolina taxpayer money will not go to pay for the expansion, Sasser stressed.

If the federal government reduces its share of funding, the state’s participation in the program will end, Sasser said.