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North Carolina Gov. Roy Cooper on Monday signed a Medicaid expansion law that was a decade in the making and gives the Democrat a legacy-setting victory, although one significant hurdle remains before coverage can be implemented, thanks to a Republican-backed provision. At an Executive Mansion ceremony attended by hundreds, Cooper celebrated passage of expansion legislation, which he’s ardently sought since being first elected governor in 2016. It took Republicans in charge of the General Assembly all this time to come around to the idea and agree to offer coverage to more low-income adults, with federal coffers paying for most of it. (Robertson, 3/27)

The bill will expand Medicaid to adults who make up to 138 percent of the federal poverty level, or about $41,000 for a family of four. State officials say the expansion will cover an estimated 600,000 people. It will take effect when the state adopts a budget, likely by June, Mr. Cooper said in an interview before the signing ceremony. “Today is a historic step toward a healthier North Carolina,” the governor declared before signing the measure. When a reporter pressed him on when the expansion would take effect, he said, “It’s only a question of when, not if.” (Stolberg, 3/27)

Electric cooperative and public-power groups across North Carolina are reporting that a UnitedHealthcare “UCard” sent this year to dual Medicaid and Medicare enrollees doesn’t work as advertised to pay utility bills. According to energy officials and publications, the flex-card program has caused weeks of difficulty for specific utility customers who often have “complex health and social needs.” (Goldsmith, 3/28)

Since its opening in a converted wood-frame mansion 117 years ago, Greenwood Leflore Hospital had become a medical hub for this part of Mississippi’s fertile but impoverished Delta, with 208 beds, an intensive-care unit, a string of walk-in clinics and a modern brick-and-glass building. But on a recent weekday, it counted just 13 inpatients clustered in a single ward. The I.C.U. and maternity ward were closed for lack of staffing and the rest of the building was eerily silent, all signs of a hospital savaged by too many poor patients. (LaFraniere, 3/28)

KHN: Congressman Seeks To Plug ‘Shocking Loophole’ Exposed By KHN Investigation 

A U.S. lawmaker is taking action after a KHN investigation exposed weaknesses in the federal system meant to stop repeat Medicare and Medicaid fraud and abuse. Rep. Lloyd Doggett (D-Texas) said he decided to introduce a bill in the House late last week after KHN’s reporting revealed what he called a “shocking loophole. “The ability of fraudsters to continue billing Medicare for services is outrageous,” Doggett said. “This is an obvious correction that is needed to safeguard our system. Wherever there are large amounts of government money available, someone tries to steal it.” (Tribble, 3/28)

For the past two months, the health insurance industry has attempted to scare older adults and the public into thinking the federal government is slashing Medicare benefits next year. Op-eds, ads, and industry-backed reports have warned of cuts to prized perks and increases to premiums for Medicare Advantage, the growing alternative to traditional Medicare run by private health insurers. Since any changes to Medicare are politically unpopular, health insurers are hoping the pressure will force the Biden administration to retreat from its February proposals that would specifically change how Medicare Advantage plans are paid. Final regulations are due to come out April 3. (Herman, 3/27)

Health and Human Services Secretary Xavier Becerra, the first Latino to head the powerful, sprawling bureaucracy, often quotes his mother: “It’s better to prevent than to remedy.” The former California attorney general and 12-term House member applies that philosophy when it comes to implementing and enforcing policy, while ensuring such efforts hold up to legal challenges. (Turner, 3/27)