The fate of North Carolina's Medicaid expansion could be tied to casinos

North Carolina lawmakers are proposing tying funding to expand the state's Medicaid program to a bill approving four new casinos in the state, the News and Observer reported Sept. 18. 

The state Legislature approved a bill expanding Medicaid in March, but funding for the program was tied to the Legislature passing the state's 2023-2024 budget. The implementation of Medicaid expansion, scheduled to begin Oct. 1, has been delayed by political gridlock. The state has yet to pass a budget. 

Republicans in the North Carolina House proposed moving funding for Medicaid expansion from the budget bill to a separate bill approving new casinos in the state. Opposition to the casino funding in the main budget bill is one sticking point holding up the passage of a budget, according to the News and Observer.

In a post on X, formerly known as Twitter,  North Carolina Gov. Roy Cooper, a Democrat, decried tying funding for the Medicaid expansion to casinos. 

"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 [three plus] decades," Mr. Cooper wrote. 

North Carolina legislators plan to vote on the state's budget and the Medicaid expansion and casino bill this week, the News and Observer reported. 

North Carolina is the 40th state to approve Medicaid expansion. 



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