How North Carolina’s Senate candidates differ on rising healthcare costs

Healthcare is getting more expensive for many North Carolinians. With partisan control of the U.S. Senate hanging in the balance, the state’s next senator could determine the policy agenda to address rising costs. 

Republican nominee Michael Whatley and former Gov. Roy Cooper, the Democratic nominee, will face off in the Nov. 3 general election for the Senate seat left open by retiring Sen. Thom Tillis. The candidates have very different views on how to address the cost of living crisis.

Whatley’s campaign website doesn’t lay out a detailed healthcare plan or explain what he plans to do to lower healthcare costs. The North Carolina Independent reached out to his campaign for additional information and comment about his healthcare priorities and did not receive a response before publication. 

Cooper’s campaign website outlines proposals for making healthcare more affordable, which include reversing Medicaid cuts, restoring enhanced Affordable Care Act tax credits that subsidized insurance premiums, and expanding Medicare’s ability to negotiate prescription drug prices. They also call for allowing doctors to make decisions about what is covered by insurance, limiting annual out-of-pocket prescription drug costs and increasing oversight of pharmacy benefit managers.

In 2025, Republicans in Congress passed H.R. 1, the spending bill commonly known as the One Big Beautiful Bill Act that was championed by President Donald Trump. The law, which Trump signed in July 2025, is expected to cut nearly $1 trillion in funding to Medicaid and other healthcare programs in the next decade through new work and administrative requirements expected to result in enrollees dropping out, as well as through changes to how states finance the program.

Whatley backed the bill. After Congress passed the bill, Whatley, then the chair of the Republican National Committee posted on X, “Today is a huge win for all Americans!”

Cooper, on the other hand, says he would work to reverse changes the law made to Medicaid.

The Congressional Budget Office estimated in 2025 that the law’s Medicaid provisions would increase the number of people without health insurance nationwide by 10 million by 2034.

In 2023, Cooper signed into law the state’s Medicaid expansion, which boosted enrollment by 650,000 residents as of 2025.   

Whatley says he plans to tighten guidelines to prevent fraud in the Medicaid program. In an interview with CBS news last year, he said  the budget law showed a unified Republican effort to make the economy stronger.

“We do not need fraud, waste, and abuse in these programs,” he said. “And by setting it up so that we are really, truly protecting America’s most vulnerable, we’re going to strengthen these programs for everybody that is involved.” 

The Health Policy research organization KFF noted in March 2025 that there is no comprehensive, reliable measure of Medicaid fraud and that what documented fraud there is is committed primarily in billing by providers. It said improper payments to beneficiaries are often the result of mistakes in administration or insufficient documentation.