RALEIGH, N.C. (WNCN) – In what’s likely her final public briefing on the COVID-19 pandemic, state Health and Human Services Sec. Dr. Mandy Cohen spoke this week about her one regret in five years on the job.

“If there was one thing that I regret about this time here in North Carolina is that I wasn’t able to help the governor convince the General Assembly to move forward on Medicaid expansion,” she said.

The issue has been a priority for Democratic Gov. Roy Cooper since taking office, as North Carolina is among 12 states in the nation that have not expanded Medicaid coverage to more lower-income people under the Affordable Care Act.

The Kaiser Family Foundation estimates 372,400 uninsured nonelderly adults would become eligible for coverage if that happened. About seven in ten are in families with at least one person working, KFF notes, and 73 percent are living below poverty.

“We absolutely need to do that to recover from COVID. We need to not only bring those dollars here to help from a health perspective. It’s an economic issue,” said Cohen.

While Cooper was unwilling to sign off on the state budget two years ago because it did not include Medicaid expansion, he did sign the budget into law this time even though Republicans still did not agree to expand Medicaid.

They did agree to form a committee that will more closely study the issue of healthcare access next year.

“Most obviously, this budget fails to extend health care to hundreds of thousands of people by expanding Medicaid. While a study is some progress, real action remains painfully overdue,” Cooper said last month when he announced his intention to sign the budget.

The issue came up again this year in the budget negotiations as Cooper sought again to expand Medicaid. When it became clear that wouldn’t happen, he tried to get Republicans to commit to holding an up-or-down vote on Medicaid expansion. They declined to do that.

“I just don’t think it’s proper to commit to a vote. Any idea has to go through a committee process,” said House Speaker Tim Moore (R-Cleveland). “You wouldn’t necessarily want to put a bill on the floor for a vote that’s not gonna pass.”

While some Republican legislators have said publicly they support expanding Medicaid, Moore said a majority of his party’s members still do not.

“I’ve got an issue with Medicaid expansion that does not have a work requirement,” Moore said.

Republican Senate leader Phil Berger, who has raised concerns about expanding Medicaid for years, said some of those concerns have been alleviated.

In states that have expanded Medicaid, the federal government covers 90 percent of the cost to do that, while the states pay the remaining amount.

Berger said he’s questioned whether the federal government would continue doing that, but now believes that funding formula won’t change.

“I just don’t think that the fiscal concerns that I’ve had in the past about the cost of expansion are things to be worried about,” he said. “I’m firmly convinced that the folks in Washington will not do anything either plus or minus as far as that is concerned.”

The legislature’s short session will come as lawmakers are running for re-election in 2022.

NC Child, a non-profit organization based in Raleigh, surveyed registered Republican voters in late October to find out more about their attitudes toward Medicaid expansion.

They found 52.2 percent favor expansion compared to 38.5 percent who oppose.

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