Republican state lawmakers urge federal administrator to reject Coopers anticipated Medicaid expansion amendment

NC Senate and House leaders cite explicit state law and state constitution in letter to feds

Eamon Queeney—The North State Journal
Legislators from left: Senate Pro-Tem Phil Berger

RALEIGH — North Carolina Speaker of the House Rep.Tim Moore (R-Kings Mountain) and Senate President Pro Tempore Phil Berger (R-Eden) sent a letter to the Centers for Medicare and Medicaid Services Thursday, encouraging the administrator to reject Gov. Roy Cooper’s intended State Medicaid Plan amendment to expand the entitlement program in the state.”Yesterday, Governor Roy Cooper publicly announced his intention to submit a State Plan
Amendment to expand Medicaid under the Affordable Care Act to the Centers for Medicare and
Medicaid Services (CI4S) by Friday, January 6,2017,” reads the letter. “We are disappointed by this news, as such
action is clearly prohibited under state law, and encourage CMS to decline the Governor’s illegal
request for expansion.” The letter goes on to cite three state laws and the North Carolina Constitution in building the argument that Medicaid expansion and taxing decisions rest solely with the General Assembly.”Section 3 of Session Law 2013-5, effective March 6,2013, states: “The State will not
expand the State’s Medicaid eligibility under the Medicaid expansion provided in the
Affordable Care Act…No department, agency, or institution of this State shall attempt to expand
the Medicaid eligibility standards provided in S.L. 2011-145, as amended, or elsewhere
in State law, unless directed to do so by the General Assembly,'” continues the letter.Further, the lawmakers cite G.S. 1084-54(f), that says ‘The General Assembly shall determine the eligibility categories and
income thresholds for the Medicaid and NC Health Choice programs.'”It goes on to highlight that state law dictates that the Secretary of the N.C. Department of Health and Human Services can adjust Medicaid program components, “except for eligibility categories and
income thresholds, of the Medicaid and NC Health Choice programs within the
appropriated and allocated budget.”Finally, the letter points to Article II, Section 23 of the N.C. Constitution that states, “”No
law shall be enacted to raise money on the credit of the State, or to pledge the faith of the
State directly or indirectly for the payment of any debt, or to impose any tax upon the
people of the State, or to allow the counties, cities, or towns to do so, unless the bill for
the purpose shall have been read three several times in each house of the General
Assembly.”Legislative leaders claim that Cooper lacks the authority to even request such an amendment unilaterally as he announced in public remarks at an economic forum on Wednesday.”For these reasons, and since Governor Cooper has unfortunately chosen to defy the law, we
respectfully request CMS reject this amendment,” the leaders conclude.While Cooper’s surprise proposal may face insurmountable legal challenges, an outgoing Obama administration may give the Democratic governor hope that the Republicans arguments will be ignored. At the very least, less than a week into office, and on the eve of a long legislative session, Cooper appears to have taken command of the 2017 policy conversation before lawmakers return to develop a two-year budget and tackle a cumbersome redistricting process.