RALEIGH — A top administrator of President Barack Obama’s health care overhaul will lead the department that manages Medicaid in North Carolina, an appointment the state’s new Democratic governor made as he tries to expand coverage through the law that’s now in danger of repeal.
Cooper presented Dr. Mandy Cohen, chief operating officer for the Centers for Medicare and Medicaid Services for the past 18 months, as his choice for secretary of the state Department of Health and Human Services.
Cohen was a top official overseeing the insurance marketplaces created under the 2010 health overhaul law. The marketplaces offer taxpayer-subsidized private insurance to people who don’t have access to job-based coverage. North Carolina uses HealthCare.gov, the federal marketplace serving 39 states.
Last week, Cooper unveiled a proposal to expand Medicaid to more than 500,000 people under the law even as the tide rises in Washington against Obama’s signature legislation. President-elect Donald Trump pledged to repeal the law during his campaign and Republicans, who control Congress, have said they want to do the same. The U.S. House was scheduled Friday to take the first formal step toward gutting the law.
“Clearly we’re going to be entering difficult times in the area of health care. We need a good manager — someone who understands health care policy and the health care arena,” Cooper said at an Executive Mansion news conference. “And we are lucky to get Dr. Cohen.”
In Raleigh, Republican leaders at the General Assembly argue Cooper is acting illegally to seek Medicaid expansion unilaterally, and that the state’s portion of the expansion cost could reach $600 million annually. They’ve asked the administrator at the Centers for Medicare and Medicaid Services to reject the request, citing in part a 2013 state law that specifically requires formal legislative support before the governor can apply.
Cooper, who took office Jan. 1 after narrowly defeating GOP Gov. Pat McCrory, says the 2013 law impedes on the governor’s core executive powers.
Cohen, an internal medicine specialist who got her medical degree at Yale University, said she looked forward to implementing the governor’s expansion proposal.
“I know how important it is to have that critical access to affordable health care,” she said. “I know there’s a lot of work ahead of us but it’s work I know well that I have done at the federal level.”
Cohen soldiered through some of the worst days of HealthCare.gov, when the computer system crashed after the administration rolled out the program in fall 2013. Those problems have long since been overcome, and the Obama administration was hoping to hand off the marketplaces to a supportive Democratic White House under Hillary Clinton.
Cooper said her work history should be considered an asset when she interacts with the General Assembly.
The legislature passed a law two weeks before Cooper took office requiring his Cabinet secretaries to be confirmed by the Senate. Cooper challenged the confirmation requirement in a lawsuit this week. The governor has now announced seven of 11 Cabinet-level officers the law says would be subject to confirmation.
Rep. Greg Murphy, R-Pitt, and a surgeon, said in a news release that he looked forward to working with Cohen but raised concerns about her leadership at the Centers for Medicare and Medicaid Services. Murphy cited her oversight of a program for nonprofit insurance co-ops that were supposed to sell insurance through the health overhaul law. Many of the co-ops closed because of solvency problems.
The finances of the state Department of Health and Human Services have finished in the black for three consecutive years.