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North Carolina's Democratic Governor Announces Uphill Battle to Expand Medicaid

Gov. Roy Cooper announced plans to expand Medicaid by executive action during an address to the business community here on Wednesday -- an action that is against a current state law and will likely face opposition from the Republican-led legislature.

By Zachery Eanes

Gov. Roy Cooper announced plans to expand Medicaid by executive action during an address to the business community here on Wednesday -- an action that is against a current state law and will likely face opposition from the Republican-led legislature.

The call to expand Medicaid came during a speech Cooper gave at the 15th annual Economic Forecast Forum, which outlined some steps his new administration would take to boost the economy in the state.

The forum, hosted annually by the North Carolina Chamber of Commerce and North Carolina Bankers Association at the Sheraton Imperial Hotel & Convention Center in Durham, looked ahead toward the prospects of the national and state economy in 2017.

The Democratic governor said he planned to file an amendment to the state's Medicaid plan by Friday, which would let hundreds of thousands more people sign up for health insurance under the Affordable Care Act.

The Republican legislature passed a bill in 2013 that bans the executive branch from expanding Medicaid -- something Cooper said "invades on the core executive authority of the governor" during a press conference following his speech.

"We have to accept Medicaid expansion," he said. "... It will provide us significant investment.

"There's a reason I am saying this not at a health clinic, not at a hospital. I am saying this at an economic forum, at an economic outlook forum, because of the jobs it is going to bring [and] because it is fiscally responsible."

Cooper said it was an opportunity to bring in $2 billion to $4 billion in investment and 20,000 to 40,000 jobs, along with expanding coverage for up to 650,000 people.

He said that the federal government would contribute 95 percent of the funds for the expansion and that the remaining 5 percent would be covered by the state, adding that he would like the state's hospitals to cover the costs rather than use taxpayer money.

In his speech, Cooper also targeted two other places where the government could improve the state's economy, saying he would make a larger investment in education as part of his budget proposal and continue to work toward a full repeal of House Bill 2.

Cooper said he wants to make sure that the state has a four-year plan to boost teachers' salaries to at least the national average and to continue to invest in the state's community colleges and universities.

The crowd, which numbered around 900, applauded Cooper when he promised to fix HB2 and put it behind the state.

GROWTH FORECAST

In a panel discussion that took place later in the day, a group of North Carolina-based economists forecast economic growth for the nation and the state in 2017.

"We might have some snow [this weekend], but there will be no recession," N.C. State University economics professor Michael Walden said, joking about the weather forecast.

Walden said he thought that the business climate in the country had improved since the election of President-elect Donald Trump, a thought shared by the other three economists participating in the panel. The economists cited a potential decrease in regulations and the tax rate as a boon to business investment in the U.S.

The four economists all agreed that North Carolina would grow faster than the rest of the country in 2017, forecasting the addition of thousands of jobs.

Mark Vitner, senior economist at Wells Fargo, was the most optimistic of the group, saying that he anticipates 100,000 good-paying jobs being added this year. He also predicted that growth will be felt outside of the major cities of Raleigh, Charlotte and Durham in 2017.

He added that Durham had the strongest job growth in the state last year.

Reflecting on the words that the new governor shared with the crowd, the economists noted HB2 was hurting the state's economic development.

Walden said HB2 had already cost the state potentially $500 million to $600 million -- though he added it's probably more that, since many companies have simply stopped considering the state for expansion.

"HB2 has already done the damage, and it is going to be with us for a while," said UNC-Charlotte economist John Connaughton. "When you look at our economic development in this state, we have benefited over the last three decades from a lot in-migration of companies ... That's come to a screeching halt."

On the subject of Medicaid expansion, the economists were more muted, noting that the fate of the Affordable Care Act under a Trump administration is uncertain. Generally, the panel agreed that in the short run the expansion of Medicaid would be a positive, especially for rural parts of the state.

"The trick is, what do you think is going to be the real cost of the program in the future?" N.C. Bankers Association Economist Harry Davis said. "And that's unknown."

(c)2017 The Herald-Sun (Durham, N.C.)

Caroline Cournoyer is GOVERNING's senior web editor.
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