McCrory also understands "that there are too many unanswered questions remaining about the cost, process and technology necessary to pursue a partnership or state-based exchange in 2014," Steen wrote.
The 2010 health overhaul law requires the establishment of health exchanges — online marketplaces where people can shop for health insurance, much of which would be government-subsidized. If a state doesn't set up an exchange, the federal government will run an exchange for that state.
The North Carolina Institute of Medicine wrote in a study released last Friday that by agreeing to the expansion North Carolina would provide coverage to 500,000 residents — most of whom would remain uninsured without the expansion. Health advocates also argue the expansion would create new jobs and actually save the state money over time.
Several Democrats urged Republicans to delay passage of the bill and lamented how blocking the Medicaid expansion would harm rural hospitals that already treat the uninsured through charity care and the patients themselves. Other states with Republican leaders are agreeing to the expansion, they said.
"That is our taxpayer money, whether it goes to the federal government or the state," said Senate Minority Whip Josh Stein, D-Wake. "What you all are saying is we're going to have North Carolina taxpayer money paid to the federal government go to insure people in Arizona, in Nevada" and elsewhere.
In November, former Gov. Beverly Perdue set North Carolina on course for an exchange run jointly by the state and federal governments. The Democratic governor said she consulted with McCrory before acting, but the former Charlotte mayor expressed reservations.