RALEIGH, N.C. (WNCN) – After years of opposition, Republicans in the state Senate are finalizing details of a bill to expand Medicaid coverage in North Carolina and could file the bill as soon as this week. 

It’s a step Gov. Roy Cooper (D) has asked them to take since before he took office and was a primary issue behind a standoff over the state budget that lasted more than two years. 

According to a draft of the bill obtained by CBS 17, it would expand coverage to about 600,000 people in the state. North Carolina is among 12 states in the country that has not expanded Medicaid as part of the Affordable Care Act.  

Gov. Cooper has repeatedly called for the legislature to expand Medicaid, citing the potential economic benefits, greater access to healthcare for those who are struggling to afford it and the help it could provide struggling rural hospitals. 

He signed a budget into law late last year that did not expand Medicaid, but it did establish a legislative committee that’s been closely studying the issue for the last several months.  

“And, I believe we’re getting closer than ever to an agreement,” Cooper said at a press conference earlier this month in which he called once again for state lawmakers to expand Medicaid during the current legislative session. 

The federal government pays 90 percent of the cost for states to expand Medicaid. Under the American Rescue Plan, which Democrats in Congress passed last year, they included a provision that temporarily increases the federal share to 95 percent in an effort to entice leaders of non-expansion states like North Carolina to approve Medicaid expansion. 

Republicans note that the state would receive about $1.5 billion over two years for expanding Medicaid. 

Republicans also are including a work requirement with certain exceptions, such as people with disabilities that impair them from performing “one or more activities of daily living” and parents with a child under one year of age. 

The Biden administration opposes Medicaid work requirements and has been withdrawing approvals that the Trump administration had granted to states. Federal courts have blocked a work requirement in Arkansas. 

The bill Senate Republicans will file calls for a hospital assessment to pay the state’s share of the cost. The state Dept. of Health and Human Services is also required to submit an annual report accounting for all revenue to pay the state share. If those revenues are insufficient, then people’s coverage would be “discontinued as expeditiously as possible.”  

Republicans also have included a variety of other changes dealing with access to healthcare in the bill that go beyond Medicaid expansion including: provisions to address surprise medical billing and transparency, giving nurses greater ability to practice outside the supervision of a physician, certificate of need law reforms and telehealth regulations. 

Republican leaders in the House have been resistant to expanding Medicaid, so it’s unclear whether the bill actually would pass during the current legislative session. 

This is a developing story and will be updated throughout the day.