NC Republicans consider tying Medicaid expansion to new casinos
Republican lawmakers are considering legislation that ties Medicaid expansion to the legalization of new casinos.
Legislative leaders had wanted to include a provision in this year’s state budget that would add up to four new casinos in rural counties. But some conservative Republicans, including members of the House Freedom Caucus, said they wouldn’t vote for a budget that included casinos.
House and Senate leaders are now considering a different approach that involves passing two bills: one with the budget, and one that launches Medicaid expansion and casinos. That would likely require them to repeal part of the Medicaid expansion law passed in the spring that starts the program as soon as the budget becomes law.
Republicans hope that pairing would persuade Democrats to vote for casinos, while GOP lawmakers who oppose casinos would then vote for the budget. Rep. Pricey Harrison, D-Guilford, said the GOP is going back on its promise to expand Medicaid.
"Personally, I'm a strong no," Harrison told WUNC on Monday. "I think it makes no sense to tie the health care for 500,000 to 600,000 North Carolinians to casinos and gambling."
Gov. Roy Cooper voiced similar concerns on X, formerly known as Twitter, over the weekend as the proposal surfaced. He also met with the House Democratic caucus on Sunday to discuss his opposition.
GOP demand for passage of their backroom casino deal in exchange for a state budget and Medicaid expansion is the most brutally dishonest legislative scheme I’ve seen in my 3+ decades. People are right to be suspicious. Something has a grip on Republican leaders and it’s not the…— Governor Roy Cooper (@NC_Governor) September 16, 2023
Casino developers have made large donations to leading legislators in the past year, Harrison noted.
"We're looking at tons of campaign money going into leadership," she said. "And I don't know if that's the motivation and momentum behind forcing this terrible vote, but I think we're better than this."
All but one Senate Democrat also signed a letter saying they're "united in opposing this latest political stunt."
House Democrats released a similar letter on Monday afternoon. "It’s time to stop playing politics with people’s lives," they wrote. "We are writing this letter to let Republican leadership—and the public—know we will not be bullied into blindly supporting this bill."
But eight House Democrats didn't sign the letter: Reps. Kelly Alexander, Cecil Brockman, Carla Cunningham, Ray Jeffers, Marvin Lucas, Garland Pierce, Shelly Willingham and Michael Wray. Some of them have a history of voting with Republicans.
It’s unclear when the budget or the new Medicaid and casino bill will be released to the public; spokespersons for Senate leader Phil Berger and House Speaker Tim Moore said they did not yet have a timeline Monday.
Berger's office did release the latest draft of the casino legislation. In addition to authorizing casinos in Nash, Anson and Rockingham counties, and one operated by the Lumbee Tribe in southeastern North Carolina, it also opens up several other counties in the northeast corner of the state to potentially host one of the casinos.