RALEIGH --Gov. Roy Cooper has set the stage for a battle with the GOP led General Assembly by serving notice that he is seeking federal approval that would allow the state to cover more uninsured North Carolinians through Medicaid.

Cooper, who has called for broader health care coverage by expanding Medicaid, sent a letter to the Centers for Medicare & Medicaid Services (CMS) in Washington. If CMS approves a change, if local matching money can be secured, and if state eligibility requirements are changed, then more than a half-million North Carolinians could receive health care beginning in January 2018.

“This is North Carolina common sense,” Cooper said in a press release. “We can receive between $3 billion and $4 billion to pay for care that hospitals and other providers now give away. That will create jobs, bolster our hospitals, could save some rural hospitals and work toward more stable private insurance premiums.”

According to Cooper, The NC Hospital Association says the state’s hospitals provide about $1 billion in care annually to residents who cannot pay for it. Hospitals would receive a significant share of additional Medicaid dollars that would come back to the state under Cooper’s plan. Cooper believes the contributions can be paid through a combination of savings in existing state expenditures due to the new federal funding and a local matching contribution. Hospitals would contribute a 5% local match that CMS requires. Depending on how many additional residents enroll in the expanded program, the hospitals’ contribution could be between $100 million and $150 million in the first year.

The Cooper Administration says that a 2013 state law that prohibits the governor from seeking to provide health care for low-income North Carolinians does not apply to this draft plan.

“Right now, North Carolina tax dollars are going to Washington, where they are being redistributed to states that have expanded Medicaid,” Cooper said. To date, 31 states and Washington DC have expanded coverage through Medicaid; in 2016 these states received more than $70 billion in federal funds. “Why should North Carolinians pay for Medicaid expansion in states like New Jersey, Ohio and Indiana when we don’t even expand it to our own people?”  Cooper made comments on his intent to a group of business leaders in Durham.

In an interview with NCN radio affiliate WTIB, State Senate President Phil Berger of Eden said that Cooper would be violating state law by making such a request. He also went on to say he believes that the request could be fast tracked before the completion of the term of President Obama, since President Elect Donald Trump and Congressional Republicans are already planning to take steps that would dismantle the Medicaid provisions.  Berger says the matter could wind up in courts.

The state will accept comments for 10 days on North Carolina’s notice of intent to amend its Medicaid plan. The Cooper Administration then will file a State Plan Amendment with CMS.