The issue of Medicaid expansion in North Carolina has long been a battle between Democrats in favor of Medicaid expansion and Republicans opposed.
Since the Republicans have held the majority in the state legislature, Medicaid coverage has not been expanded.
However, the Republican-led state Senate passed a Medicaid expansion bill on Wednesday, June 1 by an overwhelming vote of 44-2, which redraws the battle lines for Medicaid expansion to Republicans in the Senate versus Republicans in the House.
President Pro Tem of the state Senate Sen. Phil Berger (R-Rockingham) is all in on Medicaid expansion. However, state House Speaker Tim Moore (R-Cleveland) has said there is little support for Medicaid expansion in the House.
In 2019, the issue of Medicaid expansion prevented the state from passing a budget. Democratic Gov. Roy Cooper vetoed the budget passed by the legislature and said he would not sign a budget that didn’t include Medicaid expansion. The Republican-led legislature refused to include Medicaid expansion in the budget and, as a result, for an additional two years the state was run based on the 2017 budget plus some “mini-budget” bills that both sides agreed were needed.
In 2021, Cooper signed the state budget despite the fact that it did not include Medicaid expansion.
The turnabout by the Republicans in the state Senate has created a rift among conservatives in the state that goes beyond the state House.
Chief Executive Officer of the John Locke Foundation Amy Cooke is quoted in the Carolina Journal as saying, “For years, most state senators have rightfully recognized that Medicaid expansion is bad medicine for North Carolina. Their changed view is disappointing.”
Cooke added, “Data show that the D.C.-controlled health insurance scheme will leave North Carolinians with less health care access and higher tax burdens because it’s paid for through D.C. deficit spending adding to inflationary pressures and driving costs even higher.”