Dive Brief:

• The North Carolina Senate has approved a bill to use a blend of managed care companies and locally created provider-led entities (PLEs) to manage Medicaid. 
• State Sen. Terry Van Duyn, a Democrat, proposed an amendment to expand Medicaid eligibility for those with earnings less than 133 percent of the federal poverty level, which would include about 500,000 people, mostly young adults who fall into coverage gaps. It was defeated.
• Some GOP lawmakers said they might consider Medicaid expansion if they can control costs in the existing system. But, GOP Senate leaders remain adamant in their opposition, saying expansion via the ACA would be economically risky. 

Dive Insight:

The Senate's senior budget chairman, Sen. Harry Brown, R-Onslow, said the expansion could destroy the state budget, despite offers from the federal government to pay more than its typical share during the early years of expansion. "Every state that has expanded Medicaid has created a financial problem in their state budgets," Brown said. However, Ohio has expanded Medicaid and reported a $2 million surplus budget this year, thanks in part, to federal expansion funding. The Senate defeated the Van Duyn amendment 15-29.