RALEIGH -- The Supreme Court's ruling to uphold the Affordable Care Act leaves state lawmakers scrambling to comply.
Now, North Carolina must consider opening an affordable insurance exchange and funding medicaid coverage for thousands of additional recipients.
Lawmakers could lose the affordable insurance exchange to the federal government if they can't set up one up by 2013.
"Where as if you do it before Jan. 1, you have better control over whether you can do it," said House Majority Leader Rep. Paul Stam, a Republican.
The insurance exchange will provide people like the uninsured and small businesses with one-stop shops to buy health insurance.
"You can go online and see all your choices. It's a shopping market for health insurance,” said Duke University Prof. Peter Ubel, with the Fuqua School of Business. “You get to compare the prices, you get to compare what's covered."
Last year, the House passed a bill supporting an exchange in North Carolina, but it didn't get through the senate. House Speaker Thom Tillis said it's unlikely they'll meet the deadline.
"If we're not able to defeat Obama care, it would begin with a federal program, but there ways we could actually revert back to a state program as I understand it," said Tillis.
Lawmakers must also consider footing the bill for more Medicaid recipients. The Department of Health and Human Services said the state will now pay for people who are currently eligible for the Medicaid program and enroll to receive their benefits. The federal government funds newly eligible recipients.
"Ninety-five percent of those additional expenses would come from the federal government so North Carolina would only have to chip in five percent to expand Medicaid," said Ubel.
According to a report from the North Carolina Institute of Medicine, the court's ruling means more than half a million North Carolinians will now be able to qualify for Medicaid.
"Whether people are willing to add to the welfare roles a half a million more people in North Carolina remains to be seen, which would then just put our posterity in greater debt," said Stam.
There's a chance next year's budget won't include millions of dollars set aside for medicaid needs.
Lawmakers are wrapping up their short session. Unless they call a special session to discuss the health care concerns, they're not scheduled to meet again until next year.