“The argument that this is somehow an endorsement of Obamacare is losing a lot of political currency, even among conservatives,” said Frederick Isasi, the executive director of Families USA, a health care advocacy group based in Washington.
Hospitals, especially struggling rural ones, are eager for the extra revenue that Medicaid reimbursement will bring. The federal government picks up 90 percent of the costs of reimbursement under the expansion, and in North Carolina, hospitals will pay the other 10 percent. The state has revamped its Medicaid program, moving it from a fee-for-service program to one that relies on managed care — a long-sought goal of Republicans.
“This has been a long day coming, but it’s been as a result of a lot of reforms,” Tim Moore, the speaker of the state’s House of Representatives and a Republican, said during the signing ceremony. The changes, he said, “allowed us to be in the position that we’re in today to be able to expand this coverage.”
For Mr. Cooper, who is in his second term and has been mentioned as a possible future Democratic candidate for Senate or even president, the bill signing was a significant victory. He sought to expand Medicaid when he first took office in 2017, and Republicans sued in federal court to stop him from doing it.
The push for expansion picked up steam last year, when the state’s House and Senate approved separate measures. But the two chambers were unable to reconcile differences.
The signing ceremony on Monday was at turns poignant and celebratory. Cassandra Brooks, who operates Little Believer’s Academy, a day care center in the Raleigh area, choked back tears as she recalled two of her teachers who had died, she said, because they could not afford health care.
“They were excellent early childhood teachers who didn’t have health insurance and passed away due to preventable health conditions,” she said. She cast the expansion measure as a boon to small businesses that operate on thin margins and cannot afford to offer their employees coverage.
“Here’s to Medicaid expansion in North Carolina,” she said. “Here’s to supporting small business in North Carolina. Here’s to continued growth in North Carolina. I believe in North Carolina.”
