After years of negotiations, GOP leaders reach a breakthrough on Medicaid expansion

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Republican legislative leaders made a major announcement Thursday when they said that after months of talks, they had finally reached a deal on Medicaid expansion.

It’s a significant development for North Carolina, and for both parties. Democrats have been calling for Medicaid expansion since the Affordable Care Act was passed more than a decade ago. Republicans previously were staunchly opposed to expansion, even passing a law in 2013 to reject it as an option.

But all these years later, many Republicans have come around to support expansion. On Thursday, Senate leader Phil Berger and House Speaker Tim Moore said that after expansion talks stalled last summer and negotiations continued throughout the rest of the year, they now had an agreement.

The deal came together on Wednesday night, and was finalized Thursday morning, Moore said. By 11 a.m., reporters had taken their seats in the legislature’s press conference room, and Berger and Moore walked in with other Republican lawmakers, including chairs of the House and Senate health committees, to announce that they had an agreement.

Moore said they rushed to share the news with the public, even before their caucuses had had a chance to see the full agreement, “because it’s something we can all be very proud of.”

The timing of the announcement gives Democratic Gov. Roy Cooper an opportunity to claim a big win when he delivers his State of the State address to lawmakers Monday night.

Cooper has wanted North Carolina to take advantage of the program for years, and made Medicaid expansion a key point while negotiating state budgets with Berger and Moore.

But it’s worth remembering that as of now, Republicans have only announced a deal. The actual bill text most likely will be filed next week, Berger said. And expansion will be tied into this year’s budget process, as well.

That could mean that Democrats may need to stomach a few Republican priorities in the budget too, if they’re getting one of their longtime priorities.

Our team spent the rest of Thursday speaking to lawmakers, advocates and opponents of Medicaid expansion, to figure out what this agreement means for the state, the health care industry, and the uninsured. There’s much more to be reported on, but in the meantime, here are some of the biggest takeaways so far.

▪ “Medicaid expansion deal reached between NC House and Senate.” Dawn Vaughan and Luciana Perez Uribe Guinassi report on what the agreement includes (changes to the state’s certificate of need requirements for certain medical services, but not a full repeal, as some Republicans had proposed) and how the bill will be folded into the budget process.

▪ “‘A monumental step.’ Cooper and Biden praise Republican Medicaid expansion agreement.” Dawn Vaughan and Danielle Battaglia report on how the agreement was received by Cooper, as well as President Joe Biden and the White House.

▪ “Many opponents of Medicaid expansion in NC have changed their minds, but not all.” Expansion used to be staunchly opposed by Republicans, but now they’re moving to finally do it. That doesn’t mean that there isn’t any opposition left in conservative circles, Kyle Ingram and I reported.

▪ “Q&A: What you need to know about the NC House and Senate Medicaid expansion deal.” Luciana Perez Uribe Guinassi breaks down the policies and terms involved.

▪ “Medicaid expansion agreement would also change law governing health care facilities.” Richard Stradling explains the scope of changes to the state’s CON law that are included in the Republican agreement.

Potential hiccup in major SCOTUS case?

The N.C. Supreme Court’s decision last month to rehear an important gerrymandering case raised eyebrows, drawing criticism from Democrats who said the court’s newly seated Republican majority was acting politically, and rebuttals from Republicans who said the court’s outgoing Democratic majority shouldn’t have ruled on the case in the first place, after voters had elected new justices to the bench.

That decision could also have ramifications for Moore v. Harper, the critical elections case that was argued before the U.S. Supreme Court last December.

On Thursday, the court asked parties in the case to submit additional briefs with their view of whether the N.C. Supreme Court’s decision to rehear the gerrymandering case could have any effect on the U.S. Supreme Court’s jurisdiction to rule on Moore v. Harper.

The Supreme Court has ordered parties to submit their briefs by March 20. Oral arguments in the gerrymandering case before the state Supreme Court are scheduled for March 14.

Thanks for reading. See you next week. In the meantime, tune into our stories, our tweets and our Under the Dome podcast for more developments.

— By Avi Bajpai, reporter for The News & Observer. Email me at abajpai@newsobserver.com.