Cooper to hospitals: Push the legislature on Medicaid expansion

The Cooper administration invited the executives to Raleigh for a roundtable Wednesday and invited the press as the legislature returns from spring break to take up the state budget.

That budget represents the next front in North Carolina's expansion fight. Republican majorities in the General Assembly have held the line against expansion, which would draw down billions in federal funding to extend government-paid health insurance to hundreds of thousands of people in North Carolina, particularly the working poor.

Cooper told executives that, if House leadership would let a modified expansion plan proposed earlier this year come to the floor, it would pass. He said the administration is just a few votes away from having the support it needs in the House Republican caucus to bring a bill to the floor, but he declined later to define "a few."

"It's hard to say right now," Cooper said. "Some people aren't showing their hand."

"The governor will do and say anything to push his agenda," Bell, R-Wayne, said in a text message.

Assuming all 55 House Democrats are willing to support the Republican proposal, there are more than enough votes in the House for passage. That legislation, House Bill 655, includes work requirements, premiums and co-pays that some Democrats have opposed, but Cooper has signaled a willingness to accept some version of these things in a compromise.

The Senate – always expected to be the heavier lift in this fight – is another story.

"Right now, we have been focusing on the House," Cooper said.

A number of major issues for hospitals are before the legislature now, including a push to roll back the state's Certificate of Need regulations, which restrict expanding health care facilities to only what's necessary to meet demand in the surrounding area. These rules protect hospitals by limiting the number of imaging and surgery centers that compete with profitable hospital offerings.

Asked whether he'd sign a Certificate of Need rollback backed by Republicans to get Medicaid expansion the governor said "all of those issues are on the table" but that he'd rather keep the issues separate.

Executives at the roundtable largely said their hospitals are on questionable financial footing and struggle to provide emergency room care to people who often can't pay.