North Carolina Senators passed a package of changes to the state's Medicaid program, but not before once again rejecting a bid to expand coverage to roughly 500,000 North Carolinians who are uninsured. The Senate voted to return House Bill 372 to the House. Under the Senate version of the measure, North Carolina would use a blend of managed care companies and locally created "provider-led entities" to manage Medicaid. The House version of the bill relied exclusively on PLEs, and leaders there say the chamber is almost certain to reject the Senate version. That would trigger a conference committee to work out differences and draft a final bill.