Democratic Gov. Roy Cooper announced his plans today to circumvent the Republican-led General Assembly, and expand North Carolina’s Medicaid enrollment, requesting an amendment to the state’s Medicaid plan from the Obama administration.* Sen. Ralph Hise, R-Mitchell, a powerful legislative health care leader, said Cooper does not have legal standing to do that, and if he is spoiling for a fight, he’ll get it.

“He seems to want a contentious fight in the Medicaid field, and I’m quite confident with this decision he doesn’t know Medicaid policies, law, or procedures well enough to even attempt in those areas this type of argument,” said Hise, chairman of the Joint Legislative Oversight Committee on Medicaid and N.C. Health Choice. He chaired other health-related committees that dealt with Medicaid in the past session.

“If he wants to be in this contentious nature with the General Assembly, I think he might find out who writes the laws in the state of North Carolina,” Hise said.

Cooper made his announcement at the N.C. Chamber and N.C. Bankers Association’s 15th Annual Economic Forecast.

Senate leader Phil Berger, R-Rockingham, came out strongly against the proposal. “Just days into his term as governor, Roy Cooper already intends to violate his oath of office with a brazenly illegal attempt to force a massive, budget-busting Obamacare expansion on North Carolina taxpayers. Cooper is three strikes and out on his attempt to break state law: he does not have the authority to unilaterally expand Obamacare, his administration cannot take steps to increase Medicaid eligibility and our Constitution does not allow him to spend billions of state tax dollars we don’t have to expand Obamacare without legislative approval,” Berger said in a statement.

Berger added that legislative leaders would ask the Centers for Medicare and Medicaid Services to reject the governor’s appeal for an amendment. 

Any action by Cooper to issue an executive order to expand Medicaid rolls “is clearly in violation of state law we passed in 2013 as well as 2011,” Hise said. “Any actions of the state require specifically the approval of the General Assembly.”

Hise said he received numerous text messages and phone calls from interested parties the past few days that Cooper was considering his move on Medicaid.

In order for any revisions to the state Medicaid program to be made, the General Assembly would have to go to the Department of Health and Human Services to develop a plan amendment, which then would need to be forwarded to the federal Centers for Medicare and Medicaid Services.

“We have always experienced that to be a very long process,” Hise said of amending Medicaid. “Even if this was something that we as a General Assembly were to come in and pass, and say this is something we’re going to do, that would be a six- to nine-month process very similar to what we’re seeing right now with the Medicaid reform going through CMS.”

It “would not be traditional for CMS in a few-weeks period to even consider or look at an amendment from North Carolina,” Hise said, although he worries that Cooper could be working on “an orchestrated plan with what’s left of the Obama administration. I guess that’s the biggest concern. But, again, I think we would reject it as soon as we receive it.”


*Clarification: The initial version of this story suggested Cooper might use an executive order to request Medicaid expansion, but the governor said he instead would request an amendment to the state’s Medicaid plan.