Medicaid expansion shades North Carolina budget talks

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Photo credit (AP Photo/Gerry Broome)

RALEIGH, N.C. (AP) Medicaid expansion is a significant point of contention in North Carolina's final budget negotiations, even though neither spending proposal approved by House and Senate Republicans contains it.That's because Democratic Gov. Roy Cooper insists that adding hundreds of thousands of people to the state's Medicaid rolls must be part of the budget talks. That was the message Cooper's office relayed to legislators' staffers Tuesday, which Senate Republicans translated as an ultimatum: Negotiations are over unless the upcoming two-year budget expands Medicaid.GOP lawmakers for years have blocked expansion under the 2010 federal health care law. Senators have been particularly vocal about their opposition.``The governor has made it clear that Medicaid is key for him, and we would just hope that one issue doesn't hold up what we think is going to be a pretty good budget in the end,'' Senate Majority Leader Harry Brown of Onslow County told reporters.Cooper spokesman Ford Porter said there was no ultimatum and the governor invited legislative leaders to the Executive Mansion for face-to-face talks Wednesday after Republican lawmakers sent Cooper letters last week discussing negotiation parameters.``Instead of trading letters through the press like a political TV drama, we hope Republicans will engage in a meaningful conversation with the governor,'' Porter said in an email.The fact that Cooper's views matter more reflects this year's new composition of the General Assembly, which now has enough Democrats in each chamber to uphold Cooper's vetoes if they remain united. Republicans had held veto-proof majorities for the past six years, including since Cooper took office in January 2017.A Cooper budget veto that can't be overturned could lead to a stalemate that lasts beyond July 1, when the new budget is supposed to take effect. Although there's no threat for a government shutdown, state employee and teacher salaries and spending to expand government programs could be delayed until an agreement is reached.Cooper and Democratic allies have made Medicaid expansion one of their top priorities this year. Cooper has held weekly roundtable discussions with individuals and groups that would benefit from government coverage. On Wednesday, Cooper and Health and Human Services Secretary Mandy Cohen will hold another gathering with local business leaders.Senate Republicans oppose expansion, but a handful of House Republicans have proposed an expansion option that would include premiums and work requirements for recipients. Still, House GOP leaders contend the issue should be separate from budget negotiations.``It's not appropriate to hold up so much other money for the state on what is ultimately a policy issue,'' said Joseph Kyzer, a spokesman for House Speaker Tim Moore.Still, Cooper's increased leverage requires Republican lawmakers to reconsider their political calculus.House and Senate Republicans are working out their differences on dozens of spending and policy provisions, which Brown said he hopes will be completed by the end of the week. At the same time, they're contacting Cooper to gauge his willingness to find common ground.``We have fought our political battles over the past 30 months,'' reads a Tuesday letter to Cooper signed by Brown and two other Senate budget-writers. ``This budget does not have to be another chapter of that history.''Beyond the absence of Medicaid expansion, Cooper also has expressed unhappiness with what's contained in the House and Senate plans, which would spend $24 billion next year. For example, he's unhappy with further proposed corporate tax cuts when he says those revenues could be used for public education needs.