Healthcare was a winning issue for Democrats in North Carolina and across the country in 2018. Republicans in Raleigh seem bound and determined to make it an even bigger winner for Democrats next year.

Governor Roy Cooper is building on 2018 by making Medicaid expansion a big part of his budget showdown with the Republican-led General Assembly. But that’s just one of the healthcare issues Republicans are giving Democrats for 2020.

Earlier this year, Republican Treasurer Dale Folwell declared he was going to single-handedly change how the State Employees Health Plan pays hospitals and doctors. If the current standoff holds, teachers, state employees and retirees can expect longer drives and higher bills in 2020 as they search for a doctor or hospital that has agreed to accept the Treasurer’s new payment scheme.

Last week, the Republican-led Senate declared war on its own rural Eastern NC political base. The Senate passed a budget that eliminates payments to Vidant Medical Center, payments that help sustain the viability of ECU Medical School. Senate leaders are apparently attacking ECU and Vidant in defense of the Republican-led Board of Governors, its Chairman Harry Smith and UNC Healthcare. Just last week, the media uncovered a secret report to a committee of the Republican Board of Governors discussing a possible acquisition of ECU/Vidant by UNC Healthcare.

I had a front-row seat for the political fight that ECU undertook to get its Medical School in the 1970’s, over strong opposition from Chapel Hill and its supporters. Trust me: This is a political landmine. And Senate Republicans stepped on it.

The move enraged the one Democrat who sided with Republicans on the abortion override, Sen. Don Davis of Pitt County. He called it an “attack on eastern North Carolina” and “a nuclear option.” He said, “I believe this is actually downright evil. This is why we have bullying policies….I am not going to sit around and take this and be bullied.”

Also in the Senate budget is the elimination of certificate of need laws. That would force more rural hospitals to close their doors or sell themselves at a bargain price to more expensive mega-systems. Just in time for an election year!

Last but not least, 2020 is the year the state will turn over its Medicaid program to out-of-state insurance companies. Why? Because legislative Republicans mandated it. Democrats will remind voters whose bright idea this was when patients struggle to get care and doctors and nurses struggle to get paid.

Republicans are forcing some bad medicine on North Carolina, and Democrats have just the cure.