Change In North Carolina Medicaid Expansion Unlikely After Election
Election results in North Carolina did little to resolve the stalemate over Medicaid expansion that’s prevented the governor and state legislators from agreeing on a budget.
Gov. Roy Cooper won reelection after campaigning on the need to expand Medicaid for an estimated 500,000-600,000 poor North Carolinians. But it looks like Republicans will retain control of both the state Senate and House, although without veto-proof majorities. As of Wednesday morning, there were roughly 117,000 absentee mail ballots that were requested but not returned. Some may still be in the mail, but some of those voters may have voted in person instead.
“It’s a status quo situation,” said John Dinan, who teaches state politics at Wake Forest University. “Medicaid expansion ranked as one of the two or three most prominent issues in state legislative campaigns … and it did not carry the day.”
Cooper defeated Republican challenger and Lt. Gov. Dan Forest, who was opposed to expanding Medicaid. Expansion would provide coverage to everyone earning up to 138% of the poverty level. That’s $17,609 a year for one person. But Republicans gained four seats in the state House and lost only one state Senate seat, so Cooper won’t be able to argue there’s a mandate to expand the poverty program.
Still, Dinan says that if Joe Biden wins the presidency, his administration could put pressure on the state to expand Medicaid coverage even if Republicans retain control of the U.S. Senate.
“A presidential administration has a lot of tools to negotiate with states,” he said, so it can offer “inducements for holdout states to strongly consider expanding Medicaid.”
The Medicaid expansion program, which allows states to cover more poor people while the federal government pays for most of the cost, was created by the Affordable Care Act. The U.S. Supreme Court is set to hear arguments on the law next week. The high court's ruling, which is expected next year, could affect whether states can choose to expand the poverty program.