Compromise? In Raleigh? Say it’s so

The Observer editorial board

Gov. Roy Cooper might have found a compromise on Medicaid expansion.
Gov. Roy Cooper might have found a compromise on Medicaid expansion. AP file photo

Things you haven’t seen in Raleigh in a long time: The NHL playoffs. A state fair filled with healthy food. Genuine political compromise.

We have nothing to offer on the first two. But we are excited to report that something remarkable might be developing on the fourth: a potential agreement between Democrats and Republicans on one of the most divisive and consequential issues of recent years.

In a nation awash in abnormally polarized politics, North Carolina’s politics are as polarized as any. Republicans control the legislature, Democrats control the executive branch and they agree on almost nothing. Republicans have stripped Gov. Roy Cooper of some of his power and Cooper has tried to block their excesses wherever he could.

All of which makes what’s happening in the capital now especially noteworthy. Specifically: Cooper’s administration is seeking permission from the Trump administration to require Medicaid recipients to work, if the legislature expands Medicaid to some 400,000 North Carolinians who don’t currently qualify.

The work requirement inflames the left, including many of Cooper’s supporters. And the Medicaid expansion has been DOA with legislative Republicans since it appeared in Obamacare in 2010. Yet Cooper is willing to swallow the work requirement, and four Republicans have filed a bill to expand Medicaid. Could we be on the verge of a rare bipartisan deal?

It’s shameful that North Carolina has not joined the 33 states that accepted the federal government’s Medicaid expansion. It would mean some $13 billion in federal money for the state over the next decade, a healthier population and an economic boost, especially to hospitals and rural areas. It’s true that the state’s own Medicaid bill would go up some, but the federal government would pay 90 percent of the tab.

Republicans’ opposition has appeared to stem more from wanting to issue a political statement against Obamacare than from a detailed cost-benefit analysis. In fact, some Republican governors, including Indiana’s Mike Pence and Ohio’s John Kasich, saw the wisdom of the deal and accepted it.

Now, perhaps, this work requirement can give N.C. Republicans the political cover they need. Medicaid law does not allow states to require recipients to work, but the Trump administration is considering exemptions. It offered the first one to Kentucky last week. Nine other states have asked for waivers, with Cooper being the only Democratic administration to do so.

The left should accept the work requirement in this case, as Cooper has, because of its limited practical effect. It wouldn’t apply to the current 2.1 million recipients, only to the 400,000 in the expansion. A majority of those people already work, plus there are several exemptions – such as for those recovering from opioid addiction – and flexible definitions of what would count as work.

Not all compromises are good ones. But requiring work from a small number of able-bodied adults in return for Medicaid coverage for 400,000? That’s a good deal for North Carolina, and a fine model of bipartisanship.