House Speaker Thom Tillis, R-Mecklenburg, and Senate leader Phil Berger, R-Rockingham, created the 46-member committee to examine the effects the law's requirements were having on businesses, individual and group insurance markets, and health care services. Lawmakers have until the end of the year to make recommendations.
"This is an education process," said Rep. Jim Fulghum, R-Wake, a committee co-chairman and retired surgeon. "We want to understand this as best we can."
Speaker Chris Conover of the Center for Health Policy and Inequalities Research at Duke University told the committee that the 2010 law should be repealed. He said it likely will reduce full-time unemployment in North Carolina as employers make potentially hundreds of thousands of workers part time to avoid providing affordable coverage.
The Affordable Care Act "has us moving literally in the wrong direction toward bigger government and handing far too much control over what used to be private decisions by patients and doctors, and handing these to the most dysfunctional part of American government," Conover told the committee.
Conover, who is also affiliated with conservative-leaning think tanks, warned against taking a second look at expanding Medicaid coverage, which Republican legislators and Gov. Pat McCrory refused to do last year and Democrats are urging to have reconsidered. He said the health overhaul law is too shaky financially to assume the federal government will continue to pay nearly all of the costs of covering more of the working poor in the years ahead.
The Kaiser Family Foundation calculated in the fall almost 320,000 people in North Carolina will miss out on the Medicaid expansion.
Already suspicious of Republican leaders who assembled the committee, Democrats in support of the health care law and Medicaid expansion held a news conference before the meeting to highlight the law's positives in North Carolina.
More than 200,000 state residents had enrolled in private coverage through the federally run health exchange by March 1, according to federal records, or more than half of those eligible to apply for a plan.
"We're finally going in the right direction getting our uninsured covered," said Rep. Verla Insko, D-Orange.
Those benefiting from the federal marketplace include small-business owner Retta Riordan, 61, of Apex. She was uninsured for 10 months last year, unable to get knee surgery. A torn meniscus made walking up the stairs a chore.
"I'm no longer living in fear of a catastrophic illness or injury," said Riordan, who got the surgery in January.
Some speakers also said GOP legislative leaders and McCrory were to blame for much of the poor rollout by refusing to create North Carolina's own online insurance exchange, relying instead on the overloaded federal marketplace.
"Not expanding Medicaid is a tragedy," added Dr. Susan Eder, a psychiatrist in Raleigh. McCrory and GOP leaders said in 2013 it didn't make sense to expand Medicaid because the state's program was struggling with large shortfalls, and the state wouldn't have much real control over a health exchange.
Insko and Rep. Beverly Earle, D-Mecklenburg, predicted earlier Tuesday the panel likely would only provide talking points for Republicans in the fall elections. Tillis is also running for the U.S. Senate.
The GOP-led legislature approved a bill in 2011 directing the state to join a legal challenge to the federal law, but then-Gov. Beverly Perdue vetoed the bill.
The health care law is expected to place additional burdens on state agencies. The health insurance plan for current and retired state employees and teachers, as well as their dependents, projects requirements of the law will make up 2 percent of its overall expenses during the 2014-15 fiscal year, or $59 million, according to a committee presentation.
Blue Cross and Blue Shield of North Carolina, the state's largest health insurer with 3.8 million members, is one of only two insurers providing plans to state residents on the health care exchange.
Blue Cross is concerned about preliminary figures showing a disproportionate percentage of insurance exchange applicants from ages 45 to 64 and high utilization levels of certain services, company lobbyist Mark Fleming told the committee. Insurers are counting on younger, healthier residents to buy insurance to counter the costs of older, sicker subscribers.