Roy Cooper on the “nontraditional coalition” behind N.C.’s Medicaid expansion
North Carolina launched its expanded Medicaid program on Dec. 1, capping a years-long political fight between the Democratic Gov. Roy Cooper and the state’s Republican-controlled General Assembly.
I spoke with Cooper late last month about the road to expansion, its ongoing rollout and his other health-care priorities as he wraps up his second and final term leading the Tar Heel State. Our conversation has been edited for brevity and clarity.
Health Brief: Enrollment in North Carolina’s new coverage for low-income adults launched Dec. 1. Are you pleased with the state’s progress so far?
Cooper: The plan was to enroll 600,000 people over the next two years. Already, we’re close to half a million, so we’re pretty excited. One of the things that shows you how much this health care was needed is the fact that we’ve already had 1.3 million prescriptions written under Medicaid expansion for things like heart health, diabetes and other illnesses. Another thing that stands out is more than $20 million in claims for dental services.
Health Brief: Your administration worked for years to take Medicaid expansion over the finish line. What tactics were most effective?
Cooper: We had a very nontraditional coalition of people that really helped make the difference. For example, we had rural Republican county commissioners who didn’t want to see their hospitals close, and knew that funding from Medicaid expansion could keep those doors open.
We talked with tough-on-crime Republican sheriffs who were very frustrated that their deputies were spending a lot of time with people who had mental illness or substance use disorder. These are people they knew shouldn’t be in jail, but that needed medical attention, and they endorsed Medicaid expansion.
We were able to get the Chamber of Commerce because they realized Medicaid expansion could help control private insurance premiums. And then of course we had the advocates, hospitals and patients who have been with us since day one.
Health Brief: Aside from Medicaid expansion, what do you view as your other big health-care achievements?
Cooper: We worked very hard to fight the opioid crisis. Covid set us back, but we’re now beginning to get back on track and we’ve made significant progress.
And just because we passed Medicaid expansion doesn’t mean we don’t still have uninsured people. We need to find a way to get everyone covered for health care. I think we’re going to be able to leverage these Medicaid funds to be able to help even more people through our free clinics and federal facilities.
Health Brief: What can we expect from you in the final stretch of your term?
Cooper: In the next few weeks, we’re going to walk out some significant proposals on medical debt for lower-income people. We have to find a way to get people out from under this, because they’re really handcuffed when this happens.
I’m also working to help President Biden get reelected and make sure that Josh Stein, our current attorney general, is elected as governor. I’m going to work hard to break the supermajority in the General Assembly.
After that, I’ll survey the landscape and see what’s next for me. But for the next six months, I’m going to make sure that I’m doing everything I can to make North Carolina a healthier, more educated and prosperous place.
Trump allies aim to tie Harris to Biden baggage on health
Donald Trump’s presidential campaign and its allies are unleashing messaging accusing Vice President Harris of covering up the state of President Biden’s health, The Washington Post’s Isaac Arnsdorf, Josh Dawsey and Marianne LeVine report.
“No one has been more central to the coverup than Kamala Harris,” the Republican National Committee said in an email Friday, citing 16 times Harris has vouched for Biden’s fitness. The rhetoric previews a Trump campaign messaging should Biden step aside and Harris become the Democratic nominee.
The White House and the Biden campaign have pushed back against calls for the president to withdraw over his health, but advisers have privately acknowledged they have limited time to reassure his panicking party.
On Thursday, former Trump White House adviser Stephen Miller called for Harris to testify to Congress about her knowledge of Biden’s health status. Republican Rep. Chip Roy (Tex.) also told Fox News on Friday that Harris should be subpoenaed and could be impeached for “lying to the American people” about Biden’s mental state and not invoking the 25th Amendment, which provides for a handoff of power in case the president is unable to discharge his duties.
My colleagues Michael Kranish and Dan Diamond published a deep dive over the weekend into Kevin O’Connor, a doctor of osteopathic medicine who has treated Biden for years and has never recommended that he take a cognitive test.
Why it matters: Biden’s faltering debate performance last month has put new scrutiny on O’Connor’s handling of the president’s health. Unlike some physicians to the president, O’Connor hasn’t appeared at the White House podium to take questions about Biden’s annual physicals and other medical events, including when he contracted covid-19 in 2022.
What’s next: House Republicans on Sunday demanded that O’Connor testify about his refusal to order a cognitive exam for the president, citing Michael and Dan’s story and other reports. The White House didn’t respond to Dan’s questions about whether O’Connor would testify.
Kansas Supreme Court affirms abortion rights
The Kansas Supreme Court on Friday overturned a pair of laws restricting access abortion, reaffirming its stance that the state constitution protects the right to terminate a pregnancy.
The details: The justices struck down a ban on a common form of second-trimester abortion, called dilation and evacuation. The high court also blocked a Republican-backed law that imposed special licensing restrictions on abortion clinics. Neither policy had been in effect because of temporary injunctions issued by lower courts.
The bigger picture: The Kansas Supreme Court’s 5-1 rulings suggest other state abortion restrictions might not withstand legal challenges, John Hanna reports for the Associated Press.
Currently, there are lawsuits in lower state courts challenging restrictions on medication abortions, a ban on doctors using teleconferences to meet with patients, rules on what providers must tell patients before an abortion and a requirement for patients to wait 24 hours after receiving information about the procedure.
In other news from the courts …
- A federal judge in Mississippi issued a nationwide injunction temporarily blocking enforcement of a Biden administration rule protecting against discrimination in health care based on gender identity and sexual orientation.
- A federal judge in Texas temporarily blocked a Federal Trade Commission rule banning noncompete agreements, The Post’s Julian Mark reports. The new regulation, expected to save billions in health care costs over the next decade, has faced strong opposition from hospitals.
- A federal judge in Connecticut rejected Boehringer Ingelheim’s lawsuit challenging Medicare’s authority to negotiate prescription drug prices, marking the latest setback for drugmakers and trade groups that claim the program is unconstitutional.
White House prescriptions
The White House’s regulatory roundup
The Biden administration dropped its semiannual regulatory update late Friday, teasing potential policies to bolster oversight of federally funded long-term care facilities and beef up cybersecurity in health care.
Bear in mind: The agenda is more wish list than binding document, with agencies often missing their own deadlines for rule proposals. The likelihood of some of the rules also hinges largely on the outcome of the November election.
Yet, it’s worth exploring what’s on the White House’s health agenda, including its long-term ambitions. Among the proposals on the health front: a proposed cap on nicotine levels in cigarettes and tweaks to federal privacy laws. Also in the mix are looming final rules to clarify the remote prescription of certain controlled substances and tighten standards for bulk tobacco production.
You can check out the full regulatory agenda here.
- A dairy worker in Colorado has been infected with bird flu, marking the fourth human case in an ongoing outbreak that started with detection of the disease in cattle this spring, my colleague Lena H. Sun reports.
- Supporters of an effort to enshrine abortion rights up to 18 weeks in the Arkansas constitution turned in thousands of signatures of support on Friday, aiming to put their proposal on the November ballot.
- The Food and Drug Administration’s regulation of lab-developed tests could be in jeopardy after the Supreme Court overturned a long-standing legal precedent last month, The Post’s Jacob Bogage reports.
📅 Welcome back, Congress! Both the House and Senate are in session starting today. Here’s what we’re watching.
On tap this week: The Senate is poised to vote on the Reproductive Freedom for Women Act, which calls for enshrining protections afforded under Roe v. Wade into federal law. The vote is unlikely to garner enough GOP support to move forward, but it marks Democrats’ latest attempt to put Republicans on the spot in an election year on reproductive rights.
On Tuesday: The Senate Budget Committee will examine the Congressional Budget Office’s economic projections for the next decade.
On Wednesday: The House Appropriations Committee will mark up legislation to fund the Department of Health and Human Services and other agencies in fiscal 2025.
On Thursday: The Senate Appropriations Committee will mark up legislation to fund the FDA and other agencies in fiscal 2025. The Senate Health, Education, Labor and Pensions Committee will discuss what Congress can do to address medical debt. The Senate Homeland Security and Governmental Affairs Committee will scrutinize U.S. taxpayer funded research with risky viruses.
On Friday: The House Ways and Means Committee will hold a field hearing in Salt Lake City on health-care access.
Tempers flare as Trump reviews revised abortion plank for Republican platform (By Michael Scherer and Josh Dawsey | The Washington Post)
Isolation, extreme fatigue, lingering misery: What it’s like to survive measles (By Lena H. Sun | The Washington Post)
‘Republicans need to match’: Anti-abortion groups roll out new messaging (By Megan Messerly and Alice Miranda Ollstein | Politico)
Psychedelic mushroom edibles promise health benefits. Be wary, experts say. (By David Ovalle | The Washington Post)
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