How North Carolina's new governor is going around the law to expand Medicaid

Newly sworn-in North Carolina Gov. Roy Cooper plans to circumvent a 2013 law barring state officials from expanding Medicaid coverage, marking a push to secure Affordable Care Act funding before President Obama leaves office.

Jonathan Drake/Reuters/File
North Carolina Governor-elect Roy Cooper speaks to supporters at a victory rally on Dec. 6, the day after his Republican opponent, incumbent Pat McCrory, conceded in Raleigh.

North Carolina Gov. Roy Cooper (D) said Wednesday he plans to expand Medicaid to cover an additional 650,000 people, despite his predecessor having signed a law that expressly prohibits such a move.

The state is one of 19 that has yet to expand Medicaid coverage under the 2010 Affordable Care Act, and the newly sworn-in governor seems eager to secure a Medicaid expansion before President Obama hands power to President-elect Donald Trump, who repeatedly promised to repeal the legislation.

The governor said he will file paperwork with federal regulators by the end of the week, to secure the funding before Mr. Obama leaves office.

North Carolina’s delay in adopting the federal measures stems from a 2013 state law and the combined efforts of a former GOP governor and Republican legislature. Together, they enacted a statute that declared the state wouldn’t issue an expansion and required the General Assembly to sign off on any proposal issued by state officials to do so. But Governor Cooper says such a measure strips away his authority to accept federal funds and make decisions in the best interest of his constituents.

Facing a GOP-controlled assembly, Cooper is likely to see pushback, possibly furthering the political divide over the federal health care law that congressional Republicans are poised to repeal.

“I would hope that they would not try to stop us, but I believe it would be important to get their input,” Cooper said.

Some state lawmakers have already said they will ask federal regulators to block the request on the grounds that it violates the state statute, calling Cooper’s push an overstep of his authority.

While North Carolina seeks to expand the program, others are hoping to curtail it. On the same day Cooper announced his push for expansion, Gov. Asa Hutchinson (R) of Arkansas said he asked Mr. Trump to give more states the authority to set the parameters of Medicaid eligibility without losing federal funding from the health care programs.

The push comes after the state was required to cover some 70,000 more people than expected, leading some to argue that the law shouldn’t be used to cover those hovering above the poverty level. While the federal government previously covered the full cost of newly eligible recipients, the state is now responsible for 5 percent of those costs, set to increase annually until it reaches 10 percent in 2020.

"The battle is getting broader waivers from the Trump administration, having more flexibility for the state and more controls over those numbers that are much higher than what we anticipated from the outset,” Governor Hutchinson told Arkansas Online.

This report contains material from the Associated Press.

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