North Carolina Gov. Roy Cooper knows better than anyone how hard it is to push for Medicaid expansion in a red state.
The Democrats tried to expand Medicaid in 2017, but the Republicans in the state legislature sued him in federal court to stop them. Like the GOP blockade here in Mississippi, their years-long resistance to expansion was based on nothing more than blind politics.
The Affordable Care Act, which may be President Barack Obama’s most important legacy, is, of course, what the expansion scheme is based on. The tired argument that Republicans in North Carolina used to fight Cooper’s plan to expand Medicaid: Obamacare is bad, and Republican power is good.
Cooper went to work, but at first he wasn’t successful. He went around his state to talk to people and for years led a coordinated effort to support growth. Along with Democrats and Republicans, he built a coalition that was too strong for Republicans to dismiss. Leaders from business groups lobbied, health groups pleaded, and faith groups prayed.
Finally, North Carolina became the 40th and most latest state to expand Medicaid in 2023. A huge majority of Republicans in the legislature voted yes in the end, including most of the strongest opponents in the beginning.
A week ago Tuesday, Cooper told me, “That was one of the best days of my life.” “So many lives were changed that day, and North Carolinians are better off in every way now.”
With all the attention on the Mississippi Capitol this year, Cooper has been keeping up with the fight over expanding Medicaid. In Jackson, the House of Representatives passed a growth plan by a large majority on February 29. But Republicans in the Senate are holding out and coming up with their own plan. It’s so weak and ineffective that Mississippi wouldn’t be called an expansion state if it passes.
Even though important dates are coming up and politics are getting heated, Mississippi’s expansion is still a long way off.
The governor of North Carolina said he saw a tweet from Gov. Tate Reeves, a Republican, in which he used another tired “Obama is bad” line.
“Isn’t it really sad?” Cooper asked me in a roundabout way.
To be honest, Republicans in Mississippi don’t really care what Cooper has to say. But before you dismiss what he said, keep this in mind: No less than twice, people in North Carolina chose Cooper on the same vote that Republican Donald Trump won. Take that in: On the same ticket, most people in North Carolina chose a Democrat as governor while also voting for Trump. A lot of Republican people in his state clearly trust and respect him. These days, very few politicians in the US could say they have that much backing from each party.
Many people in the Tar Heel State think that his success led to the expansion of Medicaid, which will cover the health care of about 600,000 North Carolinians.
So, when I had a chance to talk to the political expert this week, I had to ask: What would he tell Mississippi lawmakers who are thinking about expanding the state’s borders?
Cooper replied, “Listen to your constituents instead of the partisan rhetoric.” You will hear from small business owners that it’s hard for them to pay for health insurance for their workers. People who work for rural county governments and local governments will tell you that their country hospitals are in danger of closing. Police officers in your area will tell you that they spend a lot of time dealing with people who are mentally ill or have a substance use problem. Hearing doctors and other health care workers say they have trouble taking care of poor people is very interesting. People who work hard and make a living but can’t afford health insurance will tell you this is a great deal for Mississippi.
Did you get that? Cooper doesn’t care if politicians in Mississippi pay attention to him; he just wants them to pay attention to the people who live in Mississippi. Given that Mississippi’s health care leaders, business leaders, and voters of all parties strongly back expansion, it’s clear that this basic political idea has been put on hold in recent weeks.
There hasn’t been much time yet since North Carolina’s growth began in December 2023. But what have we seen so far?
“Already we’re seeing thousands of prescriptions filled, so obviously there were a lot of people who weren’t getting the regular preventative drugs that they should have,” Cooper said. This could be seen as a reference to the fact that Mississippians are consistently ranked as the least healthy people in the country.
“And look, this will help the private sector,” he said. One reason many local chambers of business backed Medicaid expansion is because of this. When poor people who need medical care are treated and the providers can’t get the money back, they turn to the business sector. A huge number of studies have shown that expanding Medicaid can help keep private health care costs down.
That answer makes sense and is in line with the many studies that show expansion in Mississippi would have the same results. But in this Mississippi argument, politics have been more important than logic too often. This might be the best place to use Cooper’s unique point of view.
So, I have a question: Why are so many so-called conservatives in Mississippi making this only about politics? They are saying that growth is not conservative enough. If you were on the other side of this fight, what would you tell them?
“It’s honest because it saves money for people.” Since it helps companies save money, it’s a sensible choice. He said, “It’s conservative because it saves lives.” “… After we passed it, it’s been hard to find people in North Carolina who are against it. After all was said and done, a huge majority of lawmakers from both parties agreed with this.
The people in Mississippi can choose not to listen to Cooper. But the guy has been down the path they are on now. And so many people in Mississippi have a lot at stake.