Cooper submitted the expansion proposal to the Centers for Medicare & Medicaid Services in Washington, D.C., saying it will create jobs and support state hospitals.
Republicans condemned the move and urged federal regulators to reject the proposal. U.S. Rep. Robert Pittenger, R-N.C., and Rep. Richard Hudson, R-N.C., sent a letter to federal regulators opposing the expansion.
“(It) would only further frustrate patients who have clearly rejected President (Barack) Obama’s healthcare takeover,” Pittenger stated.
Thirty-one states and Washington, D.C. have expanded their Medicaid coverage since the Affordable Care Act increased eligibility for the program in 2010 — but North Carolina has yet to do so.
Those states pay 5 percent of the annual costs until 2020, which would be up to $600 million per year in North Carolina. Federal funds cover the rest, totaling over $70 billion nationwide every year, according to Cooper.
“Right now, North Carolina tax dollars are going to Washington, where they are being redistributed to states that have expanded Medicaid,” Cooper said in the statement.
Ciara Zachary, a political analyst from the N.C. Justice Center, said expansion will help reach workers in the “coverage gap” who don’t have access to healthcare.
“A lot of times opponents are opposed to Medicaid because they think it is an entitlement or that people are lazy, and that is a huge misconception,” she said.
Andrea Callow, a senior policy analyst from the healthcare advocacy group Families USA, said emergency rooms and free clinics aren’t enough to keep residents healthy.
“With expansion, very low-income people who are in the coverage gap can access preventative services like mammograms, colonoscopies and cancer screenings, which save lives,” she said.
Expanding Medicaid could prompt a $3 billion to $4 billion increase in federal funds for health coverage state-wide, according to Cooper’s statement.
This money could be used to make up uncompensated care costs, which occur when patients cannot pay for health services. The N.C. Hospitals Association said this costs state hospitals $1 billion annually.
Callow said many states with expanded coverage end up saving money in the long run.
“It’s not quite as simple as having to shell out 5 percent; you’re also going to be getting some state benefits and savings,” she said.
But Republican politicians in the state adamantly oppose Medicaid expansion.
Permitting Medicaid expansion conflicts with President-elect Trump’s platform of repealing and replacing the Affordable Care Act.
“(It) would be a slap in the face to North Carolina voters,” Pittenger said in the statement.
The letter sent by Pittenger and Hudson cites laws that forbid the governor from expanding Medicaid without permission from the N.C. General Assembly.
“It is unfortunate that one of Mr. Cooper’s first actions as governor is to directly go against the same state law and constitution he swore to uphold,” they stated in the letter.
Callow said Medicaid expansion is at risk if the Affordable Care Act is repealed by Congress.
“Republicans have started to say they will replace the ACA, but does that make a provision for states being able to retain their Medicaid expansion?” she said.
Zachary said despite the political battle, Medicaid expansion is largely a social issue.
“There are too many lives at risk, so this is a life and death situation for some people,” she said. “We need to focus on that instead of the political ideological battles.”