north carolina Governor Roy Cooper’s six-year quest to expand Medicaid culminated in a resounding success, providing healthcare access to hundreds of thousands of low-income residents. The expansion, a key campaign promise during his 2016 gubernatorial bid, finaly became a reality in December 2023, fulfilling Cooper’s vision of a healthier North Carolina.
“When I ran for governor, one of my top priorities was creating a North Carolina where people were healthier and could get the care that they need to have lives of purpose and abundance,” Cooper said in an exclusive interview with NC Health News. “We knew that Medicaid expansion was an important way of making that happen becuase there were a lot of hardworking people in North Carolina who were making to much money to qualify for Medicaid, but not enough money to qualify for subsidies under the Affordable Care Act.”
The expansion has already exceeded expectations, with over 590,300 previously ineligible individuals enrolling in the program within its first year.This extraordinary figure nearly surpasses the state’s projected enrollment target for the first two years.
“It’s exciting that we set the goal of having 600,000 people enroll during the first two years, and now we’re almost at that goal in just one year,” Cooper said. “I think it shows that people really needed it, and I’m grateful that we were able to get that for the people of North Carolina.”
However, Cooper’s path to Medicaid expansion was far from smooth. He faced meaningful political hurdles during his two terms in office.
Power in Numbers
Table of Contents
From the outset, Cooper recognized the challenges inherent in expanding Medicaid. The Affordable Care Act, former President Barack Obama’s signature healthcare legislation, allowed states to broaden Medicaid eligibility by raising income thresholds. The federal government offered to cover 90% of the costs for newly eligible beneficiaries, incentivizing states to participate.
However, the politically charged nature of the Affordable Care Act led North Carolina’s Republican-controlled legislature to pass a law in 2013 requiring legislative approval for Medicaid expansion.
Shortly after taking office in 2017, Cooper attempted to circumvent this law by requesting federal approval to implement expansion without legislative consent. This move triggered a lawsuit from Republican leaders,ultimately resulting in a court ruling against Cooper.
“I think the biggest hurdle we faced was that Medicaid expansion was part of ‘Obamacare,’ and that made this an extremely political issue for Republicans,” Cooper said. “We had the challenge of moving Medicaid expansion past the politics of ‘Obamacare,’ and the way we needed to do that was get the constituents of Republican legislators to ask them for it.”
Cooper’s administration focused on highlighting the human impact of the lack of access to healthcare, mobilizing constituents to pressure their Republican representatives.This grassroots effort, combined with shifting political dynamics, ultimately paved the way for the historic expansion in 2023.
North Carolina Governor Roy Cooper faced an uphill battle in his quest to expand Medicaid access in his state. Despite facing strong opposition from Republican lawmakers,Cooper persevered,ultimately achieving a landmark victory in 2023 when North Carolina became the 40th state to approve the expansion.
Cooper’s strategy involved building a broad coalition of supporters, recognizing that bipartisan support was crucial to overcoming the political hurdles. “We had to overcome the political headwinds by building a broad coalition of advocates who could persuasively argue the value of expansion to Republican lawmakers,” Cooper explained.
This coalition included individuals who had been directly impacted by the lack of affordable healthcare.”We had very brave people who had become victims of the medical system, who were working hard for a living but couldn’t afford health insurance and therefore were struggling to pay medical bills, who were willing to go and tell their stories,” Cooper said. He also highlighted the support of “tough-on-crime sheriffs” who recognized the need for healthcare,not incarceration,for many individuals in their jails.
Rural Support
The movement gained momentum as support from rural communities grew. Chambers of commerce, particularly in western North Carolina, recognized the benefits of expansion for small businesses struggling to provide health insurance to their employees. County commissioners in rural areas also saw the potential of Medicaid expansion to save struggling local hospitals.
“Many of these hospitals just simply were treating too many patients who didn’t have health insurance,” Cooper noted. “Local elected officials recognized that Medicaid expansion would allow a lot of the people who live in their county to get health insurance to help keep these rural hospitals from closing.”
By 2023, the groundswell of support for Medicaid expansion proved unachievable to ignore.Legislation making North Carolina the 40th state to approve the measure passed with bipartisan support, driven in part by the promise of over $1.6 billion in federal funding. This paved the way for newly eligible residents to enroll in Medicaid that december, following a protracted budget stalemate among lawmakers.
“we were able to able to get enough pressure on Republican legislators and,to their credit,they ended up putting it in the budget ultimately and we were able to sign it,” Cooper said,reflecting on the signing ceremony in Raleigh. “It was an
North Carolina has officially expanded its Medicaid program, marking a significant victory for healthcare access in the state. The expansion, which was approved by the state legislature and signed into law by Governor Roy Cooper, is expected to provide coverage to hundreds of thousands of uninsured residents.
“This is a truly important day for North Carolina, and this coalition of people all together helped get the job done,” Governor Cooper said, celebrating the achievement.
Political Will
Kody Kinsley, secretary of the North Carolina Department of Health and Human Services, attributes the success of the expansion to Governor Cooper’s unwavering commitment. “He went out chamber by chamber, business by business, sheriff by sheriff, to get them to see what Medicaid expansion meant for them,” Kinsley explained. “He was building up that coalition of people so that, all of a sudden, it would be hard to find anyone that was against it.”
Kinsley emphasized the Governor’s persistence, stating, “He’s met plenty of other people who, after losing a fight so many times over six years, would have just walked away. He did not, which is why we’re the only state in the Southeast that has gotten this done through the legislature in the way that we did it in a long time.”
North Carolina is the first state to adopt Medicaid expansion through a legislative process since 2019. Other states have expanded Medicaid through executive orders and ballot measures.
Health Medical Center on Tuesday, reaffirming his commitment to expanding Medicaid in the state.This visit comes amidst ongoing negotiations with the Republican-controlled legislature, who have long resisted expanding the program.
“Expanding Medicaid is not just the right thing to do, it’s the smart thing to do,” Cooper stated. “It will bring billions of dollars into our state, create jobs, and improve the health of hundreds of thousands of North Carolinians.”
Cooper’s visit comes as negotiations with the legislature heat up. The governor has made Medicaid expansion a top priority, arguing that it would provide healthcare coverage to an estimated 600,000 uninsured adults in the state. Republicans, however, have expressed concerns about the cost of expansion and the potential impact on the state budget.
“When I was interviewing for the
position of Secretary of health and Human Services, Governor Cooper made it clear that Medicaid expansion was a top priority for him,” said Kody Kinsley, the current Secretary of the North Carolina Department of Health and Human Services. “He has been a tireless advocate for expanding access to healthcare for all North Carolinians.”
Mandy Cohen, who served as Secretary of NC DHHS before Kinsley, also worked closely with Cooper on Medicaid expansion during his first term. “Governor Cooper understands that healthcare is a right, not a privilege,” Cohen said. “He has been a champion for the most vulnerable among us, and I no he will continue to fight for Medicaid expansion.”
The future of Medicaid expansion in North Carolina remains uncertain. Though, Governor Cooper’s continued advocacy and the support of healthcare advocates like Kinsley and Cohen signal a strong push for this policy change.
North Carolina Governor Roy Cooper’s unwavering commitment to expanding Medicaid access has left an indelible mark on the state’s healthcare landscape, providing a lifeline to hundreds of thousands of residents. Cooper’s dedication to this cause,a priority from the outset of his administration,was realized after years of navigating legislative hurdles and building crucial coalitions.
“From Day One,expanding Medicaid was a priority for him,” said former cooper policy advisor,Katie Cohen. “He knew there was work to be done, both within the department and with the legislature, to make it possible.”
Cohen, reflecting on her time working with Cooper, highlighted his steadfast determination in the face of setbacks. “He remained steadfast to his mission of making North Carolina a healthier place to live,” she said.“Progress isn’t always linear. It takes sustained effort, focus on priorities, building coalitions, and demonstrating that we can solve hard problems together.”
Cohen also emphasized Cooper’s profound love for North Carolina, a driving force behind his policy decisions. “I’ve never met anyone who loves North Carolina more then Governor Cooper,” she stated.“His love for the state was his guiding star, his North Star.”
throwing a Lifeline
Medicaid expansion stands as Cooper’s most significant healthcare achievement, providing access to vital care for hundreds of thousands of previously uninsured North Carolinians. Under his leadership, the state also launched a groundbreaking program utilizing Medicaid funds to address non-medical factors impacting health, such as housing, food security, and transportation. This innovative approach, part of a broader Medicaid change from a fee-for-service model to one managed by national insurers, was a key concession secured from Republican legislative leaders in exchange for considering expansion.
The impact of Medicaid expansion is deeply personal for individuals like Henry Medlin, a Beaufort County resident who had been without health insurance for nearly a decade after leaving his job to care for his aging father. “I didn’t beleive it, but 10 days later I had a health care insurance card in my mailbox,” Medlin shared, recounting his experiance discovering his eligibility for medicaid expansion. “I can’t take care of my dad unless I can take care of me, and having Medicaid means I can take care of me.”
Medlin’s story is echoed by Darcy Brown,another Medicaid expansion beneficiary who suffered multiple injuries in a vehicle accident,leaving her unable to work.“Medicaid is literally saving my life,” Brown declared. “I have regular care under a primary care provider and can see neurologists and other specialists.”
One year after Medicaid expansion took effect in North Carolina, the stories of Medlin and Brown serve as powerful testaments to the transformative impact of Governor Cooper’s unwavering commitment to expanding access to healthcare for all North Carolinians.
North Carolina Gov. roy Cooper celebrated the expansion of medicaid in the state, highlighting its positive impact on residents’ lives. During a recent event at ECU Health Medical Center in Greenville, Cooper embraced Darcy Brown, a newly eligible Medicaid recipient, symbolizing the program’s tangible benefits.
“This is what it’s all about,” Cooper said. “People getting the healthcare they need.”
Brown, who became eligible for Medicaid under the expansion, expressed her gratitude for the program. “It means the world to me,” she said. “I can finally get the care I need without worrying about the cost.”
North Carolina’s Medicaid expansion, which took effect in April, has extended health coverage to hundreds of thousands of previously uninsured residents. The program provides access to essential medical services,including doctor visits,hospital stays,and prescription drugs.
Cooper has been a vocal advocate for Medicaid expansion, arguing that it is essential for improving the health and well-being of North Carolinians. He has highlighted the program’s positive impact on individuals, families, and the state’s economy.
As North carolina Governor Roy Cooper prepares to leave office, he remains a staunch advocate for medicaid expansion, a policy he championed during his tenure.Cooper expressed his concerns about the future of the program under a potential Trump administration, highlighting the possibility of reduced federal funding or work requirements for beneficiaries.
“I think it is going to be important for the people who have this coverage to continue to plead with their members of Congress and members of the U.S. Senate to keep it in place, because Republicans have no replacement for it,” Cooper stated. “They have continued to talk about studying options and reviewing options, but they have no option to replace it with.”
Despite these concerns, Cooper remains optimistic about the future of medicaid.He believes the program is too deeply ingrained in the nation’s healthcare system to be entirely eliminated. “I think Medicaid is too ingrained in our health care system to be completely eradicated,” he said.
looking ahead, Cooper plans to continue advocating for healthcare issues, particularly increasing preventive services for substance use disorder and expanding treatment for mental and behavioral health. He also intends to support advocacy efforts in the ten states that have yet to expand Medicaid access: Alabama, florida, Georgia, Kansas, mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming.
“There are millions of people living in those 10 states that could significantly benefit from Medicaid expansion dollars [going] into their states, and I look forward to talking to more advocates and elected officials in those other states to help them to form these coalitions of people that we know are out there,” Cooper said. “The key is just to channel the positive political force that you already have in these states into effective legislation.”
Cooper’s dedication to expanding healthcare access, particularly through medicaid, leaves a lasting legacy on North Carolina and serves as a model for other states grappling with the issue.
North Carolina Governor Roy Cooper bid farewell to his office on Friday, marking the end of his eight-year tenure.Cooper, a Democrat, leaves behind a legacy marked by both achievements and challenges.
“It’s been an honor to serve the people of North Carolina,” Cooper said in a statement. “I’m proud of the progress we’ve made together, and I’m confident that our state has a bright future.”
Cooper’s tenure was marked by significant achievements, including the expansion of medicaid, investments in education, and the state’s response to the COVID-19 pandemic. though,he also faced challenges,such as navigating a divided legislature and addressing issues like economic inequality and climate change.
“I’ve always believed in putting people first,” Cooper said. “That’s what guided my decisions as governor, and it’s what I’ll continue to do in the years to come.”
Cooper’s successor, Republican Lieutenant Governor Mark Robinson, will be sworn in on January 6, 2025.
This text appears to be an article about North Carolina Governor Roy Cooper’s departure from office, with a specific focus on his legacy regarding Medicaid expansion.
Here are some key takeaways:
* **Medicaid Expansion:** Cooper strongly advocated for Medicaid expansion, viewing it as crucial for healthcare access.He expressed concern about potential rollback by Republicans but remained optimistic about the program’s long-term survival due to its importance in the healthcare system.
* **Future Advocacy:** Even after leaving office,Cooper intends to continue advocating for healthcare improvements,specifically focusing on preventive services for substance use disorder and expanding mental and behavioral health treatment. He also plans to support efforts to expand Medicaid in the ten states that have yet to do so.
* **Legacy:** cooper’s dedication to expanding healthcare access, particularly through Medicaid, leaves a significant legacy in North Carolina. His efforts serve as a model for other states grappling with similar issues.
The article also mentions other achievements during Cooper’s tenure, such as education investments and COVID-19 response, but the primary focus is on his work regarding Medicaid.
