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The bill, which had been in conference committee, also prohibits the state from setting up online exchanges where people can buy health insurance, allowing the federal government to set up the exchanges in North Carolina.

There is now a fiscal note attached to the legislation that estimates it will cost $45.7 million to develop "an interface with the federally facilitated Health Benefits Exchange."

But the state expects to pay for only 10 percent — or $5 million — of that with federal funds paying for the other 90 percent. The bill allows the state to apply for the federal funds.

GOV. McCRORY SUPPORTS SENATE BILL 4 -- Rejects Medicaid expansion and state-sponsored health care exchange Gov. Pat McCrory issued a statement Tuesday morning announcing he does not support expanding Medicaid to as many 500,000 people in North Carolina, many of them uninsured, and wants the federal government to set up an exchange for the state.

The announcement vanishes any thought McCrory may side with six other Republican governors and accept the money, a move considered a possibility among political observers given his moderate tendencies. His rationale is four-fold: audits show Medicaid is too "broken" to expand right now; the potential long-term costs can't be determined; state government didn't do enough to prepare under Gov. Bev Perdue; and federal matching funds aren't guaranteed given the political uncertainty in Washington

TODAY AT THE STATEHOUSE: The House and Senate convene at 2 p.m. Earlier in the day, House committees will consider a controversial Medicaid expansion bill, measures emphasizing digital learning and legislation about where to locate the Interstate 540 loop around Raleigh. Gov. Pat McCrory's environmental chief, John Skvarla, will appear before a Senate committee.

Killing the state's chance to get more people health insurance, mostly on the federal government's dime, is a rotten idea, said doctors, nurses and medical students who spoke at a news conference Monday.

They came to Raleigh to speak against a bill that would prevent the state from expanding Medicaid under the Affordable Care Act.

'It's nutty," said Dr. Charles van der Horst, a professor of medicine at the University of North Carolina in Chapel Hill. "It's terrible for the citizens of North Carolina."

The Senate passed a bill last week preventing expansion and a state House committee is set to debate it Tuesday.

About 500,000 more people would be insured under the expansion, with the federal government picking up all the costs for most of the new people for the first three years and 90 percent afterward.

Republican governors in Arizona, Michigan and Nevada are going for the expansion in their states, van der Horst noted, because they've determined it makes fiscal sense.

Dr. Mohan Chilukuri, a Durham family physician, called the Senate bill "a travesty of justice" and morally wrong."

State Rep. Jim Fulghum, a neurosurgeon from Wake County, said he did not know how he would vote on the bill, and was looking forward to more debate.

"I just think we have a lot more to learn," said Fulghum, a Republican.

Fulghum said the bill has enough votes to pass, and that the tone of the press conference speakers didn't help their cause.

Senate President Pro Team Phil Berger's campaign website perpetuates one of the bigger myths of the Affordable Care Act: that the government is coming to get your health records.

A lawsuit accuses Blue Cross plans nationwide of driving up health-care costs by illegally carving up the nation's insurance market. It's an issue North Carolina's General Assembly has tried to deal with going back several years.

The state's DMV headquarters on New Bern Avenue has been in the dark -- really -- since a short circuit Thursday morning caused an outage . Repairs should be completed over the weekend.

Seventy-three groups, from AARP North Carolina to YWCA Central Carolinas, sent a note to Gov. Pat McCrory asking him to expand Medicaid as allowed under the federal health care law.

About 500,000 people would be added to the Medicaid rolls, with the federal government paying all the costs for almost all the new people for the first three years. About 1.5 million North Carolinians are enrolled in Medicaid now, with the state and federal governments sharing the costs.

Lots of health associations among the letter's endorsers, including the American Heart Association and the American Diabetes Association.

Community health centers and clinics signed the note, but hospitals, which would lose-out big if the state does not expand Medicaid, aren't that well represented. Duke University Health Systems signed on, but no UNC Health Care or WakeMed.

The state has received a $74 million federal grant to set up an online marketplace for health insurance, a key component of the new federal health care law.

The internet insurance mall would be for small businesses or individuals not insured through their jobs. The money would be used for getting guts of the system ready.

According to the grant application the state Department of Insurance submitted last year, more than half the money would be used by the state Department of Health and Human Services to link the software that creates the website to an existing software program called NC FAST, which is used by DHHS and county social services departments.

Gov. Pat McCrory has not said how he wants the state to approach the health care law - whether he wants the state to run its own exchange, whether the state will run it with the federal government, or if North Carolina will tell the U.S. government to do all the work.

Senate leader Phil Berger said Wednesday he did not want a state or state-federal exchange.

Congressman G.K. Butterfield of Wilson has been appointed to a seat on the influential House Energy and Committee Subcommittee on Health, where he says he wants to protect the Affordable Care Act.

The subcommittee will give him jurisdiction over such issues as Medicare, Medicaid, private health insurance, public health, hospital construction, health information technology, privacy, cyber security, medical malpractice and drug abuse.

“My chief responsibility as a new member of the Health Subcommittee is to protect and defend the Affordable Care Act against Republicans' flagrant efforts to dismantle it,” Butterfield said in a statement.

“I played a leading role in the development of this landmark law that has given millions of uninsured and underinsured Americans access to affordable healthcare,” he said.

Updated: Gov. Bev Perdue faced criticism this week from Senate leader Phil Berger for her choice of a state-federal health exchange, but her office said she had to pick a plan in order for the state to be eligible for millions in federal grants.

Berger, a Republican, said the outgoing Democratic governor should have left the choice to incoming Republican governor Pat McCrory. 

States have three options for internet insurance marketplaces required under the federal law. Perdue chose the middle course so McCrory and the Republican-led legislature can pick something else if they want.

Berger said he didn't object applying for money, as long as it wasn't going to be wasted.

State health insurance agents and brokers say they support Gov. Bev Perdue's decision to opt for a health exchange set up as a state-federal partnership.

The Affordable Care Act requires states have internet shopping centers where people without health insurance can search for plans.

“We support the Governor’s choice to give North Carolina citizens a voice in managing their own health insurance marketplace,” says Teri Gutierrez, president of the N.C. Association of Health Underwriters. “It is critical that we make decisions that best fit the needs of both individual consumers and employers in North Carolina. We also agree with the Governor’s intent to move North Carolina towards a full state-based exchange as quickly as possible.”

States have the choice of setting up their own exchange, having the federal government run it, or working with the feds.

Perdue said she chose the middle course so imcoming governor Pat McCrory can choose to have a state-run exchange or a federally-operated exchange.

Gov. Bev Perdue announced Thursday that North Carolina would establish a health care exchange in partnership with the federal government.

“North Carolina is moving forward with implementing a process that provides much needed health insurance for every citizen,” Perdue said in a statement. “It is critical for our state to participate in decisions that affect our state’s citizens. We will not cede total control to the federal government. It remains my goal to pursue a state-based plan.”

Check back for more details. Read her letter to the feds here.