- [Kelly] Governor Roy Cooper enters a potential presidential level debate over healthcare as North Carolina is officially expanding health insurance coverage through Medicaid.
This is State Lines.
- [Narrator] Quality public television is made possible through the financial contributions of viewers like you, who invite you to join them in supporting PBS NC.
[triumphant music] ♪ - Hello again.
Welcome to State Lines.
I'm Kelly McCullen.
Joining me today for this panel, Mitch Kokai, to my right here with the John Locke Foundation.
Hello, Mitch.
Political strategist, Morgan Jackson.
Former state representative and Campbell law School Professor, Rick Glazier's in seat four.
And then we'll backtrack to seat three, Matt Mercer, you have escaped seat four for at least one show, editor in chief of the North Stage Room.
- Three for Dale.
- Dale Earnhardt.
Gentlemen, thank you so much.
Fairly busy week.
Morgan, let's start with you.
We wanna talk about Governor Roy Cooper, he got a fair amount of attention, at least WREL called him to ask him about participating in what appears to be the national political debate.
The governor joined former US House speaker Nancy Pelosi on a call supporting the Affordable Care Act, which of course would support the Biden-Harris ticket because Republican presidential front runner, Donald Trump, has been posting on social media that he would explore healthcare alternatives should he be elected, would that be reelected president.
Governor Cooper told WRAL TV News, Morgan, when they asked what's he doing, he said, "Our democracy's at stake."
So you've taken our governor and gone national, he's now in it.
- Listen, Governor Cooper may not be on the ballot in 2024, but he's gonna be campaigning as hard as if he was, whether campaigning for President Joe Biden, which he's done a number of events for, or Attorney General Josh Stein, who he's very active for, or breaking these super majorities in the legislature.
You can expect to see him moving around the state, doing interviews, whether it's national or local interviews, raising money, campaigning for candidates.
He's has done a number of events for local Democrats already and you'll see as he always has over the last eight years.
But listen, he felt compelled to be involved in this discussion.
When Donald Trump talks about removing the ACA and taking 1.8 million people in North Carolina who have healthcare coverage, that covers preexisting conditions, now that that could go away, people need to stand up and understand this is...
The Republicans have tried four or five times and I think smartly have finally given up on trying to repeal the ACA, but Trump bringing this back up makes it very real for people.
You're talking about serious diseases, like as you know, diabetes and asthma and things that are really challenging for folks.
If you start having those folk's pre-existing conditions exempt again, folks are in real trouble and it'll cost lives.
- So in a second term of a Biden administration, where would a North Carolina Democratic, former Democratic governor, where would he sit, in which cabinet seat?
- I think Governor Cooper will have a lot of options come November of 2024.
He'll have to make some decisions about what he wants to do with his life.
- Alright, Bat Mercer, of course Morgan's not gonna spoil that surprise.
Roy Cooper on the national stage, gentile fellow, very ballast, he won twice during Trump election years.
What does it say to have Governor Cooper out there, discussing national issues with national players?
- Yeah, I think he's made it pretty clear that he intends to have a role in the discussion passed the end of his second term, whether that's a US Senate campaign in 2026, or a potential cabinet spot, I think that's an option.
And I think if you look at his policies, especially over the last probably five years, he has gone very from the...
He still has this moderate persona, but his has very left wing policies.
I think if you look at everything he's come out with, it's to the left from what he would probably say when he was first elected, the year I was born in 1986, I think he has really changed and so, but he's able to have this moderate persona that I think is helpful and especially for a potential statewide campaign coming up in '26.
- Rick, the governor's leadership style in an era of Republican dominance of the legislature, how much of the credit does he get, not to steal, but to say, "I rightfully crafted policy in North Carolina and that positions me later in this decade for deeper discussions and obviously a more national discussion."
- Yeah, I think he gets a lot of credit.
I think he's had to play an extraordinarily difficult political hand that was been given to him.
Other than 2019, 2020, it's been super majorities for the most part, but he's been able to move positions forward, both at the state level and in his role with the Governor's Association nationally.
And I think that he led us through Covid and people, you can talk one way or the other about that, but our data is pretty darn good compared to the rest of the country in terms of how we fared and how our economy has fared.
And so I think he gets a lot of credit for that.
I think he recognized early on that he wasn't gonna be able to move things through the legislature the way he had done for 20, 25 years, so he did secure his roots and he's also created a really good bond with the White House, as he had with the Obama White House as Attorney General.
- Mitch, having Governor Cooper stand alongside Nancy Pelosi in support of Joe Biden.
This is a gentleman who people voted for Donald Trump and clearly voted for Roy Cooper as well, does he do more good for the National Democrats the National Democrats may do for him?
- I think he definitely helps the National Democrats and I'm not sure how much standing with them helps him if he's continuing to run for office in North Carolina.
I think if he does run in that Senate race, despite the fact that he's been very popular, won what, six statewide elections, including the two for governor, that one thing you will see from the other side would be, "Look, this is not the Roy Cooper you remember from the '80s and the '90s, or even from his days as AG, this is a Roy Cooper who is turning more and more toward the left, as Matt suggested.
But I think if he wants to have a role on the national stage, this is what you do.
You are a popular Democratic governor in a state that has otherwise been voting largely for Republicans in recent years.
That is something for Democrats to be happy about.
And here's someone who you look at as an example of what to do if you wanna win an election in a state like North Carolina.
- It appears the healthcare debate will continue into 2024.
Well, Medicaid expansion is now officially underway in North Carolina.
It took took effect, not APEC, on Friday, 600,000 new people are expected to eventually qualify for health insurance through Medicaid.
If my math is correct, 90%, Rick, of this cost borne by the federal government, as promised long ago by the federal government, 10 % by fees on hospitals.
The state's also starting to boost some payment rates.
They're starting out in behavioral health, drug treatment services, doctors will be paid more.
The state also received a healthy bonus payment with few strings attached because it passed expansion with the state budget.
And I'll pass this huge issue on to you, sir.
Medicaid is here.
Can we call it bipartisan now?
- Well, yes, I think.
But let me start off with, I think the best way to start framing the discussion is to quote Lizzo, "It's about damn time."
And having said that, we're the 41st state that has passed Medicaid expansion.
We've got 600,000 people who will now be covered, who were not covered before.
Billions of dollars to the state.
We get a double bonus because of the Rescue Act plan, which you've referred to, which gives us an additional $1.6 billion above what we were getting anyway on the federal 90% match to the state.
Thousands of jobs.
More importantly, thousands of lives saved.
And I think people have to know this covers primary care, prenatal care, dental and vision.
It covers prescription drugs, it covers wellness, it covers mental health services.
It is in really critical to the lives of North Carolinians.
And it's a long time in coming.
There are challenges in the implementation now.
One of those is to amp up the number of providers to meet the needs of 600,000 more people.
And as you refer to one of the first things that the state has done was to increase reimbursement rates for behavioral health providers to get more providers in the field.
It's also going back and reaching the eligible populations technologically and through social media.
And it's also dealing with about, I don't know, 30,000 or so people who were cut off Medicaid earlier this year under newer rules.
But now that it's expanded as of today, they'll get to come back on.
And so it's reaching them as well.
So there's lots of challenges in the implementation, but this is a great thing for the state and people will be saved because of this.
- Matt, if you're a Republican in this state, large, and you're in the legislature, you voted for Medicaid expansion and we just discussed the national debate where the front runner for the Republican party may say, "I'd like to do something different."
How does that weigh out at the street level and independent of what we're gonna be seeing on the national news outlets in these national debates early next year?
- Yeah, I think in a lot of ways it's a statement that Republicans by and large didn't have and don't have a healthcare plan.
I think Democrats have successfully kind of cornered the market on this one thing.
I'll refer to it again, I said on this show that I think republicans and legislature by and large said that only government can solve this problem, not the free market.
And so I think what Rick said about the implementation is going to be critical.
And who gets the credit for that?
It's going to be Roy Cooper and it's going to be his administration because they're the ones there.
And Republicans, I think that vote for this will say, "Well, hey, we finally supported it.
We agree this is a thing to do."
They're still not going to get the credit for it by and large.
And so we would really see that from a political perspective, it's still not a winner.
And so how that debate shapes and moves forward if there's a lot of problems, I think democrats and we'll say, well, we just should have done this earlier and we wouldn't have these problems.
And so it's gonna be almost a game of whack-a-mole in some instances where it's always going to be Republicans fault from that frame that it's not working as it should.
- Morgan, did a lot of Republicans in this state suddenly go liberal with this Medicaid expansion.
And here your team is talking about repealing and the fear of repeal.
You're striking that into the hearts of voters headed to 2024.
I'm a Republican voter, what do I do about all this?
- Listen, this is a big deal.
And and I love that Rick quoted Lizzo.
It makes my heart warm.
I'll quote Joe Biden, "It's a BFD in North Carolina."
- And what does that stand for?
- Yeah, it's on public television.
I'm glad to drop it, but y'all might have to bleep me, and my mother might say something about it.
But think about this.
Today in North Carolina, 300,000 people woke up with healthcare that didn't have it yesterday.
300 additional thousand people have to go through the application process in which they will do.
But 600,000 North Carolinians have access to healthcare that not only is a good moral thing to do, it's good economically, the billions of dollars that'll come into the state, it will save lives.
And it's really smart politically.
And so what we've seen, we talked about the ACA, one of the reasons the ACA has never been repealed is because it is so popular with people that what it gives you, and I think Republicans, I think Matt's exactly right.
Republicans are very late to the party.
But listen, let's be clear, and I say this knowing my bias for reco, but it's a fact.
This is due to his tenacity.
For seven years, he has beat the drum across the state to build support in rural North Carolina in red districts with Republicans.
He was dealing with general assembly that had passed a law that banned Medicaid expansion under any circumstance.
And he got Phil Berger and Tim Moore and the Republicans on board.
It took seven years, but it took him beating that drum every single day.
And he did it because it's going to save lives.
And it's good for North Carolina.
Yes, it happens to be good politically, but things often are when they make economic sense and they save lives.
- Mitch, how does the market react to 600,000 new medical patients entering the North Carolina healthcare marketplace?
- That's gonna be very interesting to see.
And first of all, after hearing Rick talk about Lizzo, and you were quoting Biden, I thought you were gonna quote Biden either talking about Britney Spears or Taylor Swift, but not knowing which one.
But also one of the key things that I think that Rick mentioned is the fact that, Medicaid expansion doesn't change healthcare itself.
It's access to healthcare.
It's in insurance.
It's basically saying, I've got a piece of paper or an insurance card that lets me get healthcare.
It doesn't mean extra healthcare.
And the supply side on healthcare has been the major issue for years and years.
Not having enough doctors, not having enough nurses.
Part of that is because of overregulation, things like certificate of need and not allowing nurses to practice to the full extent of their training.
That's the type of thing that we're going to have to start addressing now because several hundred thousand more people are going to be saying, "Hey, I'm supposed to get healthcare now.
Where is it?"
So this is gonna be a major issue.
- Yeah, and I agree with Mitch on it is gonna be a major issue, but I think people sometimes gloss over a couple of the other effects of what this expansion's gonna do.
One is it's a critical boost for rural hospitals, which gets to the point both of you have made.
It also leads to just undeniably earlier detection and treatment for chronic diseases, which in effect reduces medical costs substantially.
Since that's one of the big drivers of medical costs.
So I think people overlook that sometimes that the benefits are here way beyond just primary care for these folks, it goes into deep economics for the state, but on the supply side it's gonna be critical.
- I wanna marry something here with the first topic and the second topic.
One of the things that I don't think people are talking about enough is the money that's going by and large to rural hospitals, it comes from the federal government, in turn to pay for these new rates.
And so what you're also doing is you're actually kicking people off of private insurance to some extent.
If they were buying their insurance from the marketplace and are now eligible for Medicaid expansion, they're actually losing private insurance for Medicaid.
And I think that just gets us further and further away from addressing the true causes of why healthcare is so expensive and so hard to get.
- One thing I'll say real quick is, in every state that has expanded Medicaid, and this has been one of the Governor's talking points for the last several years, private premiums have gone down for those not on Medicaid.
We're not talking about the 600,000 people that are gonna be on Medicaid.
We're talking about everybody else who is on a private plan, the average has gone down in every state, almost every state.
- All right, well, let's change topics, talk more politics.
A new US House district that serves part of Wake County and kinda wraps around all these other rural counties nearby had a mild shakeup this week.
State Representative Erin Pare, who appears on "State Lines" from time to time, says she'd be ending her US House campaign and will instead seek reelection to the North Carolina House of Representatives.
Ms. Pare says, "The timing isn't right."
She wants to be home while her children are still in high school.
This is the 13th Congressional District, and it's currently served by Democratic US Representative Wiley Nickel, but this newly drawn 13th District now favors the Republicans.
Mitch, size up these races.
It's hard to look into all these congressional races, but Representative Pare, Wake County's a major, major area here in the suburbs.
What does it mean that she's out?
Does it push the GOP nomination more towards a rural-based candidate?
- Well, it'll be interesting to see.
I think one of the things that we saw ever since these last congressional Districts, the ones that we're using now were put in place, was that everyone knew it was gonna be a short-term thing.
The folks on the Republican side were telling Wiley Nickel and Jeff Jackson, "Rent, don't buy in Washington, D.C. 'cause your districts aren't gonna last that long."
And we all knew that the 13th District would be redrawn in a way that, assuming that it survives court challenge, will be more favorable to Republicans than the district that elected Representative Nickel.
Or, yes, Representative Nickel.
And so there are a lot of people interested in this seat.
Erin Pare was one of them.
She had a number of people who talked to her who said she should run for it.
But I think after she saw some other names get into the race, including some who have some money behind them, that it became clearer that this was gonna be a tougher fight for the Republican nomination than she might have thought initially.
And given the other factors with the ages of her kids and the fact that she could continue to serve in the House and the State House and perhaps get some higher leadership positions, that was a good incentive for her to change her mind.
I think the 13th is going to be very interesting to see what happens there should, if the district stands, be more favorable to Republicans.
But it's also one Democrats can win in a year when Democrats have the winds in their favor.
- Morgan, talk to us about recruiting candidates.
You've recruited probably dozens of them, if not more.
I would think it would be very exciting to have someone like you or on the Republican side come and recruit me.
How long does it take for a person to sit down and really weigh out, this is what it means if you go to D.C. - Well, listen, I think it depends on who you are and it depends on how much ambition you have and something, if you've already thought about running for office, a lot of the best candidates, honestly, have never thought about running for office.
And so you have to get through the process of, what does this actually mean and what is a campaign and what does it take to put my name on the ballot and get tomatoes thrown at me everywhere I go?
I mean, for somebody who is not in a public office or a public-facing job, it's a hard hurdle to climb, but you've gotta have the ambition to wanna do it.
You've gotta have the interest.
What we've seen is a lot of folks are interested in running for office, I can speak on the Democratic side this year.
We've got a lot of interest, and we're also in the silly season, which is right around, you know, filing begins on Monday.
And so you're gonna have a lot of surprises.
People who end up spending more time with their family and don't wanna run and people who all of a sudden you say, "I didn't see that coming, this person filing."
It seems like every day now you have a different candidate announcing for a different Council of State office, much less the hundreds of legislative candidates that are being recruited on both sides of the aisle and getting ready to file.
- And part of that is because we have so many open Council of State races.
- That's right.
- And new districts, congressional and legislative.
- That's right.
- So a lot of people are saying, "Hey, this wasn't a great deal for me when there was this long-time incumbent.
But now that we have a different district and this person's not running again, maybe I should throw my hat in the ring."
- Some of those Council of State races, I mean, I'm hearing this off camera.
These are some jobs that are, you get to run for statewide and get to say you're elected, but they're boring jobs.
I mean, it's not a job that would be razzle-dazzle like it would be to be a senator or a representative.
- No, but they're serious jobs that require serious people, and the challenge with Council of State offices is we often find is they're so low-information with voters is that voters generally vote on them based, they a lot of times fall into line however the presidential and the governor's race sets a baseline of D versus R in the Council of State.
It's hard to get above that or below that, depending on which side you're on.
- All right, Matt from "North State Journal," statewide reach, give us some, I guess, best practices if we care about the congressional races.
There's all these districts.
Should we just concentrate on the individual district we're in that there are enough candidates right there to keep you very heavily engaged in your race for House versus looking at statewide and trying to nationalize this whole discussion?
- Yeah, I think you have to look at, what are the connections that, you know, individuals have to the district and you know, what do they bring?
And I think one of the things that Representative Pare cited was substantial personal financial decisions she had to make to get in.
You know, I think some of the folks in the race now have basically said, "You know, I've got millions of dollars I'm gonna spend in this race."
And whether that's something that, you know, she truly wanted to pursue.
And then one of the things I think with her district, especially if you look at it, whether by coincidence or intentional or both, much of her home base was actually cut out of the 13th District, which is Holly Springs in Southern Wake County, so her State House seat is much more winnable than, you know, this primary would have been and probably a lot less expensive, too.
- Rick, you've been at the top of the Democratic Caucus in the House and you also decided to retire.
When do you know when to hold 'em and when do you know when to fold them and do something else?
- Well, I think for me, I'd served eight years in the majority and five years in the minority position.
And I think these seats are temporary.
We're temporary occupants of it.
We're not entitled to them, it's the people's seat.
And so you have to make a decision both for the best interest of your district when it's time to get new blood in, when you just come upon an exhaustion of your own resources.
I think also this gets back to the point Morgan made, you have to really want it.
When it gets to the point that you wake up and you go, I'm not sure why I'm still here, what else can I offer?
Or thinking in the other way, are there other ways I can serve the public and the interests I want to espouse outside of the political office?
I will tell you there is life after the General Assembly and it's pretty good.
- One other thing we need to keep in mind is, with all due respect to Morgan and folks in his business, there are a lot of consultants out there talking to a lot of people saying, you'd be a great candidate for this.
And some of them have to just say thanks, but no thanks.
- Now, I think also one thing that we have to think about, I mean, the costs of running for election.
I mean not only the financial costs, but the personal costs and family costs have risen exponentially over the last 20 years, changes the calculus for a lot of people.
And second, the serious dysfunction in Congress and fairly serious dysfunction at times in the North Carolina Legislature is a disincentive for really excellent people in their profession to get involved.
We better address that as a society, Democrat, Republican, and Independent, or we're not gonna be getting the best and the brightest running for our offices.
- All right, final topic tonight.
US Federal Court Judge James Dever has denied a request for a speedy trial to determine if new North Carolina Senate District maps are unconstitutional racial gerrymanders.
The plaintiffs had hoped the court would issue an injunction stopping, State Senate candidates from filing for office next week.
That begins July December 4th.
Per Morgan, Judge Dever questioned the plaintiffs for waiting nearly a month before filing a suit, Rick, to request a speedy trial.
Republicans have said all along, their district maps in the Senate do not violate the Federal Voting Rights Act, which is where this is headed.
Why wait a month?
Why wait 'til a week before candidate filing?
And did the judge have a point?
- Well, first I have a great deal of respect for Judge Dever and I think he'll do a good job handling the case, but I think it would be 30 days after you know is a limited amount of time to file a complex federal suit.
To really think whether you've got good faith, legal and factual grounds to do it, to get your ducks in a row to do it, I think that's a fairly limited amount of time.
I think we were operating, and the legislature made sure we were operating with a very truncated timetable.
And so I think it was a little unfair to be penalizing the plaintiffs for waiting 28 days.
I do think that the plaintiffs have an uphill battle, both in the federal court that they're in and going up the chain.
They're gonna have to prove, among other things, continued racial polarization of voters, which is easier to prove in rural North Carolina than in urban North Carolina.
This lawsuit focuses primarily on 12 northeastern North Carolina counties that were dominantly high percentage of Black voters that were cut into multiple districts and paired with very conservative white dominated districts.
So there is a legitimate argument here, but it is facing headwinds in terms of the court's view at the Supreme Court level, in my view.
- Got about two minutes, Mitch.
This lawsuit, this is one you can get your hands around and actually think about, even if you're just kind of watching things flow through these courts regarding our elections laws and our redistricting process.
- Yeah, it's gonna be very interesting to see what happens.
I think the main problem for the plaintiffs at this stage, looking to get an injunction to block candidate filing was they filed the suit the Monday before Thanksgiving.
At the same time, they filed a schedule saying in two days, the day before Thanksgiving, we're gonna file a motion for a preliminary injunction.
We want everyone to respond to it the Monday after Thanksgiving, have a hearing the following Wednesday, and a decision by that Friday.
Judge Dever said, no, we're not gonna do that.
You can go for your injunction.
We're gonna follow a more traditional calendar of how that would play out.
The problem for the plaintiffs is that the more that we get into the campaign season, once people start filing for office, it's gonna be harder for a court to say, okay, we go back and now throw it out.
- So I think really that that's a key point.
And the key point is that the Republican view on this is favored the longer the case is delayed, the more likely the maps current will stay as the maps for 2024, even if they're eventually determined to be unconstitutional.
- Alright, there you go.
We are out of time, we'll let the law professor end this.
Mitch, thank you, Morgan.
Matt, always good to see you.
Rick Glazier, always good to have you back, Professor.
- Happy Holidays - Representative.
Happy holidays to all of you too.
Happy holidays to you, hope December's off to a great start for you.
Thanks to our panelists, of course, for joining us.
If you have any thoughts about what we've discussed, any opinions, share them at statelines@pbsnc.org.
I'll even to share some with this crowd.
I'm Kelly McCullen.
Thank you for watching, we hope to see you next time on State Lines, bye-bye.
[driving, upbeat music] ♪ - [Announcer] Quality public television is made possible through the financial contributions of viewers like you, who invite you to join them in supporting PBS NC.