Senate candidate Cooper focuses on healthcare in affordability plan
The former North Carolina governor says he will work to restore enhanced ACA tax credits and reverse Medicaid funding cuts.
According to the campaign website of former North Carolina Gov. Roy Cooper, the Democratic nominee for the U.S. Senate seat currently held by retiring Sen. Thom Tillis, healthcare is a key part of lowering costs for North Carolina families.
More than a year has passed since President Donald Trump signed H.R. 1, a sweeping budget law that reduces federal funding for Medicaid and other social safety network programs and imposes new eligibility and reporting requirements and for those programs and for insurance policies purchased on Affordable Care Act marketplaces.
The Congressional Budget Office estimates that the law’s Medicaid and marketplace provisions, along with Congress’ failure to renew enhanced tax credits that subsidized the cost of premiums for insurance policies purchased through the ACA marketplaces, will increase the number of uninsured Americans by roughly 10 million by 2034. Some 7.5 million of those are expected to become uninsured because of Medicaid changes taking effect Jan. 1, 2027.
In North Carolina, the affordability pressure is already showing up in both cost and enrollment. The state announced in October 2025 that the cost of individual ACA insurance policies in the state would increase by an average of 28.6% in 2026. Enrollment in marketplace plans in the state fell from 975,110 in 2025 to 761,457 in 2026, a 22% decline that was the largest percentage drop in plan selections in the country, according to a KFF analysis of federal data published in May.
According to his campaign website, Cooper would reverse Medicaid cuts and restore the enhanced ACA tax credits.
The site says Cooper would take the “common sense bipartisanship” of the policies he pursued as governor and use it in Washington to reduce the cost of healthcare.
In March 2023, Cooper signed into law H.B. 76, a bipartisan measure that made North Carolina the 40th state to expand Medicaid coverage to more people. The expansion provide health coverage to over 600,000 newly eligible residents by December 2025. In a statement during the signing, he touted the broad impact of the investments throughout the healthcare system.
“Medicaid expansion is a once-in-a-generation investment that will strengthen our mental health system, boost our rural hospitals, support working families and so much more,” Cooper said. “This is a historic step toward a healthier North Carolina that will bring people to the opportunity of better health and life.”
Under the heading “Let doctors decide about health care, not insurance bureaucrats,” the website says Cooper would work to give doctors the authority to make decisions about what treatments are medically necessary and covered by insurance.
The site says Cooper will work to lower prescription drug costs by requiring Medicare to expand medication price negotiations and capping patients’ out-of-pocket costs; limit out-of-network charges for nonemergency care and designate ground ambulance services an essential benefit; require hospitals to automatically enroll eligible patients in financial assistance programs; strengthen oversight of hospital mergers and takeovers; and enforce existing healthcare cost transparency requirements.
Republican nominee Michael Whatley, a former chair of the Republican National Committee, doesn’t include healthcare on the issues page of his campaign website. Under a section titled “America First Economy,” Whatley’s campaign says economic growth depends on reliable, affordable energy and “reining in Washington’s reckless spending.” “By practicing fiscal responsibility and unleashing American energy, we can empower American workers, create good-paying jobs, achieve energy independence, and build lasting prosperity for every American,” the website says.
Whatley has expressed support for policies enacted by the Trump administration, including its insistence that federal safety net programs are riddled with what he called “fraud and grift..” In a May radio interview with Brett Winterble, a former producer of “The Rush Limbaugh Show,” Whatley said: “When you talk about the billions of dollars that are being spent by the federal government right now, and state governments that are just going nowhere other than fraud, you have to put a stop to it. And unfortunately, you know, we will see what happens on the North Carolina issues that are percolating right now where we’ve seen, you know, autism programs going from $1.9 million to over $500 million dollars in just the last five years. I’m really glad that we have the auditor Dave Boliek is taking a look at this. It matches what we’ve seen in Minnesota and other states, and that the federal government HHS is now conducting an all-50-state audit of these types of programs. You know, it is bad enough that the federal government spends money on things that we don’t necessarily agree with, but for them to turn around and just shovel it out the door and fraud is completely unacceptable.”.
Polling of North Carolina voters conducted by Public Policy Polling on July 10-11 shows Cooper leading Whatley 48% to 44%.
