Dollar: Trump HHS Likely to Kill Cooper's Medicaid Expansion | Eastern North Carolina Now

    Publisher's note: The author of this post is Dan Way, who is an associate editor for the Carolina Journal, John Hood Publisher.

House appropriations chairman says even if Obama's HHS approves plan at last minute, Trump has 90 days to scrap it

    Gov. Roy Cooper's plan to expand Medicaid is likely to die soon after Donald Trump takes office, a key state lawmaker says.

    State House Appropriations Committee Chairman Nelson Dollar, R-Wake, said President Trump will place "a new group in charge" unlikely to support Medicaid expansion in the way the outgoing Obama administration has.

    Cooper's office did not respond to several requests for comment. Nor did representatives of the state Department of Health and Human Services.

    "The current state plan amendment does not fit with what Congress has talked about, and what the Trump transition people have talked about thus far," Dollar said.

    Rep. Tom Price, R-Ga., Trump's pick for secretary of Health and Human Services, believes Obamacare and its Medicaid expansion provisions have failed to lower costs, expand access to care, and improve health outcomes as promised.

    Price chairs the House Budget Committee and sits on the Congressional Health Care Caucus. During his confirmation hearing Wednesday, he was question by Sen. Maggie Hassan, D-N.H., about a replacement bill for Obamacare that he wrote. The budget bill eliminates funding for Medicaid expansion.

    Even if Obama administration holdovers "in the days or hours prior to a confirmation of a new secretary of Health and Human Services or a new director of CMS ... were to somehow approve something on an interim basis," Dollar said, the Trump administration has a 90-day "look-back" period "to fully reconsider anything that the Obama administration does on a state plan amendment, not just for North Carolina, but for any state once the reins formally change hands."


House Appropriations Committee Chairman Nelson Dollar, R-Wake, during a December special session of the General Assembly. Dollar says it's unlikely Gov. Roy Cooper's Medicaid expansion proposal will survive the change of administrations in Washington. (CJ photo by Don Carrington)
    Cooper's proposal was blocked by a 14-day restraining order that runs through Jan. 28. U.S. District Court Judge Louise Flanagan issued the ruling on Saturday. It bars federal approval of Cooper's $6 billion plan to expand Medicaid for 500,000 to 650,000 mostly single, able-bodied, working-age males.

    "I appreciate what the federal judge has done, and I certainly think it's in line with what the normal process is for a state plan amendment," Dollar said. Normally CMS does not consider a state plan amendment unless the executive and legislative branches agree on it.

    Moreover, the General Assembly in 2013 enacted a state law granting the legislative branch sole authority to make Medicaid changes and expansion. Cooper's request is "very much the exception the to rule," Dollar said.

    Senate Leader Phil Berger, R-Rockingham, and House Speaker Tim Moore, R-Cleveland, filed the motion in federal court to block Cooper's plan. They maintain it is illegal and unconstitutional. Dollar says it would be unprecedented for the Obama administration to approve Cooper's plan days after it was filed when the normal approval period ranges from six months to several years.

    The state and outgoing U.S. Health and Human Services Secretary Sylvia Burwell on Monday filed separate motions asking Flanagan to lift her order. The court has not responded.

    Carolina Journal attempted to learn from federal officials how laws and regulations would treat Cooper's plan after President Obama leaves office, but had little success.

    Replying to a list of questions, CMS, the agency that administers Medicaid, issued a brief statement saying "CMS continues to work with the state, and cannot comment on pending legislation or speculate on timetables" on the fate of the governor's Medicaid amendment.

    "Our hope of course is that the request would continue on after the transition," said a spokesman for U.S. Rep. G.K. Butterfield, D-1st District, who co-chairs the House's State Medicaid Expansion Caucus and sits on the House subcommittee on health.

    "We wouldn't be able to say for sure what will happen with the actual request" after Trump assumes office, the spokesman said.

    Neither the state's two Republican U.S. senators, Thom Tillis, and Richard Burr, who sits on the committee that held Wednesday's confirmation hearings for Price, nor U.S. Rep. Richard Hudson, R-8th District, who sits on the House subcommittee on health, responded to requests for comment.