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House Republicans continue to oppose Medicaid expansion for North Carolina's poorest residents

North Carolina is one of only 12 states that hasn’t expanded Medicaid under the Affordable Care Act. Gov. Roy Cooper has pushed for expansion, but the General Assembly has opposed it. Senate President Phil Berger said on Tuesday he was willing to reverse course, but said House Republicans remained firm in their opposition.


After Berger’s comment, North Carolina House Speaker Tim Moore said Republicans in his chamber oppose expanding Medicaid for an estimated 600,000 poor North Carolinians. When pressed about this opposition, he points to other health care initiatives included in the General Assembly’s budget, such as extending Medicaid benefits for pregnant women, and funding for a new medical school, which will turn out more doctors.

“Statistically, more of them go into primary care, which is a shortage from one end of the state to the other and it's something that we know is needed,” Moore said.

But when asked about the fact that primary care is only good for those who have insurance — or means — to pay for care, he admits one of the biggest problems with expanding coverage is philosophical

“I believe that any kind of benefit program should really be for those who cannot take care of themselves,” Moore said. “If someone is able-bodied, as a state we should to incentivize a person to get a job.”

Moore says he’s open to discussing coverage for the working poor when the General Assembly comes back for the next session. By then, Congress could pass a reconciliation bill that may provide coverage for the poorest Americans in non-expansion states, bypassing the state legislature altogether.

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Dana Miller Ervin is a reporter at WFAE, examining the U.S. health care system.