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Negotiators for the House and the Senate say a deal on Medicaid is within reach now that House Republicans have tentatively agreed to adopt a "hybrid" insurance model similar to one the Senate put forward earlier this month. ... Through more than three years of negotiations and two legislative sessions, one of the biggest sticking points in the Medicaid discussion has been who would provide insurance for 1.8 million poor and disabled North Carolinians – roughly 18 percent of the state's population. Senate leaders had advocated for large managed care companies, or MCOs, in a bid to control costs as tightly as possible; House members had backed provider-led entities, or PLEs, created by local hospitals or physician groups. Under what negotiators for both chambers say is a tentative agreement reached this week, both managed care companies and provider-led organizations will play a role. (Binker, 8/19)

The North Carolina House is formally rejecting the Senate versions of two key measures that legislative leaders want finalized before adjourning this year. The House voted unanimously Wednesday against the Senate's proposed state Medicaid system overhaul. The chamber followed later with near-unanimous rejection of an economic incentives bill that also contains a retooled formula to distribute more local sales taxes to rural counties. (8/19)

As expected, the state House isn’t going to sign off on the Senate’s version of Medicaid reform rather than its own version. And it’s going to be difficult reaching a compromise this year. The House unanimously voted Wednesday not to concur with the Senate rewrite. That sends the issue to a conference committee to attempt to hash out differences. But there are big differences, and only a few weeks left in the session, so far. (Jarvis, 8/19)

The proposed Medicaid Department would be overseen by a Cabinet secretary appointed by the governor and confirmed by the General Assembly. Senators initially wanted to create an independent Medicaid Benefits Authority to oversee the department. ... John Dinan, a political science professor at Wake Forest University, said the General Assembly finally may have arrived at the point “where the actual bargaining takes place on Medicaid reform and on other issues.” “It’s tough to predict the outcome of the negotiations, but there are reasons to believe, based on recent legislative actions and legislator statements, that a compromise could be reached this year.” (Craver, 8/19)