Michael Sowyak spends his days making sure homeless women --- without insurance --- get the health care they need.

"Eighty percent of the women do not have Medicaid, so they really rely on the free clinic for their healthcare," he said.

He's executive director of Shelter Health Services, a free clinic for women and children staying at the Salvation Army's Center of Hope.

He's also one of many people against legislation that bans Medicaid expansion in North Carolina.

He says the bill, which passed North Carolina's House and Senate this week, will keep most of his clients from accessing Medicaid and possibly keep them homeless longer.

The legislation refused federal dollars to expand Medicaid to 500,000 low-income people. The expansion is just one of several proposed changes under the Affordable Care Act.

"Health issues can be a very big barrier to leaving homelessness and becoming self-sufficient. If you're chronically sick or ill you can't go out and interview for a job, or find a job," Sowyak said.

Republican Rep. Robert Brawley supports the bill. He said the federal government has offered to fund the plan, but he's skeptical that funding would continue.

"I just don't trust the federal government to pay for it and I don't see any reason why we should turn control of our Medicaid program over to the federal government," Brawley said.

Brawley said the real answer to helping low-income families is lowering the cost of health care.

But Sowyak hopes lawmakers like Brawley will change their minds, once they see the program working in other states.

"And hopefully in a year they come back and reverse their decision," he said.

The only people who qualify for Medicaid are pregnant women, the elderly, children and people with disabilities.