Republicans such as Senator Phil Berger opposed Medicaid expansion so tenaciously it almost seemed to be a matter of religious conviction. As Berger himself liked to argue, most of the uninsured in North Carolina were “able-bodied men,” whom he deemed unworthy of public support. This was both tendentious and interesting coming from a man fervently committed to punishing the undeserving. In reality, most people making too little for private-insurance subsidies, but too much for Medicaid, were in the workforce already. That wasn’t enough for Republican austerity hawks.

Until now, perhaps. In the weeks since legislators convened for their short session, Republicans led by Berger himself have notably softened on the issue of expanding Medicaid. It’s hard to overstate the improbability of this development: Medicaid expansion has been the locus of political combat in North Carolina since even before Roy Cooper took office as governor. Disagreements over expansion cost the state a budget in the 2019-2020 biennium, and conservative “think tankers” hailed Cooper’s willingness to sign a budget without it as a signal victory for consevatism.

Yet here we are with Cooper’s long-time goal firmly in sight. House Republicans have toyed with Medicaid expansion for several years, even though they nixed the initiative last year due to Speaker Tim Moore’s insecurities about his place in a GOP Congressional primary. (Thanks, Madison Cawthorn.) It’s the flipping of Berger–pun acknowledged by not intended–that’s most remarkable and significant. For ten years, Phil Berger has roamed the halls of the legislative building as North Carolina’s ruling autocrat. He almost always gets exactly what he wants. And now that list of desires apparently includes Medicaid expansion.

I’m not here to spike the football–not least because Medicaid expansion is not yet on the books. Berger’s embrace of the fiscal argument for Medicaid expansion is as rich as Belgian chocolate. The Republicans, so long committed to rewriting the social contract and repealing a century’s worth of social policy, have now come to the realization that denying people healthcare is not a reasonable price to pay for the sake of poking a stick in the proverbial eye of the American progressive movement. As the legendary scholar-activist Cornel West might say, “that’s a beautiful thing.”

Credit goes for the possible expansion of Medicaid goes, above all, to Governor Roy Cooper. A governor without Cooper’s iron integrity and indefatigable will might have given up on Medicaid expansion years ago. Cooper, on the other hand, has kept driving for expansion year after year no matter how frustrating his quest must at times have become. The governor already has a signature achievement in his unparalleled leadership during COVID-19. Medicaid expansion will be another impressive victory that may just attract the attention of Democrats looking for the next president.

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