RALEIGH, N.C. (WNCN) — One of Gov. Roy Cooper’s signature issues has been the push to expand Medicaid in the state.

Cooper, a Democrat, is facing Republican Lt. Gov. Dan Forest in the general election next month.


CBS 17 took a closer look at one of the key claims in an ad by the Cooper campaign as part of our political pledge to test the factual accuracy of public communications offered by candidates, political action committees or partisan groups.

THE CLAIM: Cooper says Forest “is OK leaving half a million people behind in the middle of a pandemic.”

THE FACTS: That number refers to how many more people would be eligible for Medicaid if the state were to expand the program.

Both Cooper campaign spokeswoman Liz Doherty and Leah Byers, a policy analyst for the conservative-leaning Civitas Institute, say it could be even higher.

Under the Affordable Care Act, states have the option to expand Medicaid to people who are below 138 percent of the federal poverty level.

Supporters of the proposal say it will help those in the coverage gap — who make too much money to qualify for the program now, but not enough to earn subsidies for private insurance. Opponents are wary of costs that could increase in the future and the crowding effect it could have on people currently participating in the program.

Forest has made it clear he opposes expanding Medicaid, dedicating a section of his campaign website to it.

CBS17.com asked the Forest campaign what alternative he favors instead, and spokesman Andrew Dunn said among the specific initiatives he supports are providing improved access to health care for patients by encouraging doctors to practice in rural areas, addressing price transparency for prescription drug and health service costs with the General Assembly and State Treasurer and helping those in the coverage gap to obtain private insurance.

“But right now, the quickest way to get people health insurance is to help them find a job,” Dunn said. “As Governor, Dan will reopen the economy and get people back to work.”

North Carolina is one of 12 states that have not expanded Medicaid, and the issue is a major reason for the state’s ongoing budget standoff. Cooper’s budget proposal for 2019-20 included a price tag of $2.1 billion for the program, with 90 percent of that — or $1.9 billion — coming from federal tax dollars. The remainder would be funded by hospitals and health care plans, Doherty said.

Because North Carolina has not expanded the program, federal taxes paid by its residents are being used at least in part to fund the expansions in other states, said Dr. Wayne Hale, a physician in Greensboro and a member of the Committee to Protect Medicare.

“The commonest thing we hear from our legislators is that they don’t want to commit themselves to a program that will increase their costs over the years,” Hale said. “And of course, the way the ACA was set up was that the vast majority of expansion costs were covered by the federal government, and then it would gradually decrease yearly, but actually minimally. 

“The truth is, we have allowed other states to have the benefit of millions of dollars of coverage for expanded medicaid and we’ve foregone all that so we’re basically covering people in other states with our tax dollars,” he added.

Byers pointed to a study from the Foundation for Government Accountability that says 63 percent of people who would be eligible for an expanded Medicaid already have private insurance, while the 28 percent that has insurance from the individual marketplace would have Medicaid as the only option.

She also said a study from KFF in December 2019 found that 40 percent of the state’s uninsured people — roughly 338,000 people — already qualify for a fully subsidized plan on the individual marketplace.

Supporters of expansion say the move would create more than 37,000 new jobs and increase business activity by nearly $12 billion from 2020-22, according to a study by researchers from George Washington University with funding from Cone Health Foundation and the Kate B. Reynolds Charitable Trust.

“Expansion of medicaid has actually been projected to increase jobs and increase the economy by a significant amount,” said Dr. Aimee Lischke, a family medicine specialist in Winston-Salem and a member of the Committee to Protect Medicare.

The Civitas Institute disagrees, saying those job growth claims depend on those medical services being provided to Medicaid patients and cites a shortage of doctors in North Carolina that accept Medicaid, and says that because the supply of doctors does not meet demand, adding hundreds of thousands of enrollees would exacerbate the problem.