- Associated Press - Monday, January 16, 2017

RALEIGH, N.C. (AP) - Roy Cooper’s administration asked a federal judge Monday to let the new Democratic governor continue to take first steps toward expanding Medicaid coverage in North Carolina to potentially hundreds of thousands of uninsured people, saying his plan “is not a step past the point of no return.”

In a court filing Monday, attorneys for the state Department of Health and Human Services said Senate leader Phil Berger and House Speaker Tim Moore “have depicted an emergency characterized by a parade of horribles, including a governor who has arrogated unto himself the unilateral right to expand Medicaid and who - if not stopped by this court - will commit the state to spend millions of dollars without legislative approval.”

But the truth, they said, is not sinister: Cooper’s decision to submit a proposed change to expand the eligibility for the state Medicaid plan under President Obama’s signature health care law - effective Jan. 1, 2018 - won’t obligate the state to pay anything without legislative approval.

If the Centers for Medicare and Medicaid Services approved Cooper’s amendment, then the governor would propose, in his upcoming budget, “an expansion of health care coverage that not only allows economically disadvantaged citizens to receive medical care but to do so largely at the federal government’s expense,” the filing says.

Meanwhile, attorneys for the U.S. Justice Department filed a court memo supporting the state DHHS lawyers, who want U.S. District Judge Louise Flanagan to dissolve the temporary restraining order she issued Saturday. That action came after Moore and Berger sued to block federal regulators from approving Cooper’s request.

The U.S. attorneys say the case doesn’t belong in federal court, in part because the legislators lack standing to sue.

While the state’s attorneys sought a hearing Tuesday, Flanagan said in court documents that she plans to hold a conference call Friday with attorneys.

Berger and Moore say the CMS and the U.S. Department of Health and Human Services aren’t allowed to grant Cooper’s request because it violates federal laws and the U.S. Constitution. At the heart of their argument is a 2013 state law saying an expansion request specifically requires formal legislative support, which lawmakers say Cooper lacks.

Cooper has said the 2013 state law infringes on a governor’s core executive powers, and his office, in a news release earlier this month, said the 2013 law “does not apply to this draft plan.” Cooper has said the Medicaid expansion could start in January 2018, generating jobs, helping rural hospitals and reducing expensive emergency care for the uninsured.

Cooper isn’t a named defendant in the lawsuit but the health and human services department he runs is identified. In a statement Monday, Cooper said the state will miss out on jobs and better health without Medicaid expansion. ” … it’s frustrating and disappointing that we’re having to fight our own legislature in court to get it done,” he said. “Tax dollars already paid by North Carolinians are funding Medicaid expansion in other states and we want to bring that money back home to work for us here.”

Saturday’s ruling also prevents state regulators from submitting a formal proposal unless it complies with certain federal laws.

The state would have to provide a financial match to receive the federal Medicaid funds. Cooper has suggested the match could come from hospitals. But the lawsuit says expansion could commit the state to spending more than $500 million through 2021.


Follow Martha Waggoner on Twitter at https://twitter.com/mjwaggonernc

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