Roy Cooper, the former North Carolina governor now running for the U.S. Senate as a Democrat, benefited financially from healthcare companies that received lucrative state contracts while he was in office, according to a report from Breitbart News. The report, published Wednesday, details how Cooper’s administration awarded Medicaid managed care contracts to companies that had made donations to entities linked to him, while he simultaneously held stock in investment funds that included those same companies.
Cooper served eight years as governor, from 2017 to 2025, after being elected in 2016. His tenure coincided with a major shift in how North Carolina delivered Medicaid services. In 2015, the state legislature passed a law transitioning the program from a fee-for-service model to a managed care system. Under the old approach, the state’s health department reimbursed physicians and providers for each service they performed. The new managed care model gave contracts directly to health insurance companies, with the governor’s administration choosing the winners.
That set the stage for a period in which Cooper’s office handed out contracts worth billions of dollars — and, according to the report, the recipients included companies that had donated to Cooper and his allies.
United Healthcare and the 2019 Contract Round
One of the most prominent examples involves United Healthcare. The company received a coveted Medicaid contract from Cooper’s administration in 2019, the report states. During the same period, Cooper took in $142,184 in contributions linked to the company.
Cooper had spent years pressing the state legislature to expand Medicaid, which finally happened in 2023. That expansion extended coverage to more than 600,000 North Carolinians, further bolstering the enrollment base flowing through the United Healthcare contract — and, reportedly, boosting the value of Cooper’s stock portfolio.
The report notes that Cooper’s financial disclosures show he owned stock in United Healthcare through investment vehicles, although the exact size of those holdings was not specified in the source material.
Centene’s Deep Ties to Cooper’s Network
Cooper’s relationship with Centene, a major healthcare company, is described in the report as connecting millions in donations directly to his time as governor. Centene’s North Carolina-based subsidiary won regional Medicaid contracts from Cooper’s administration in the same 2019 round. The company also later acquired WellCare, which held one of the four statewide contracts awarded in that round.
Centene also gave $1.45 million to the Democratic Governors Association (DGA) during the period Cooper chaired the group, from 2021 to 2022. That donation was timed with Cooper’s continued push to expand Medicaid in the state, the report notes.
Cooper’s personal finances also show substantial holdings in the healthcare sector. According to his U.S. Senate financial disclosures, he owns stock in Centene and has nearly $500,000 invested in healthcare companies overall.
Dark Money Group Sold ‘Access to Cooper’
The report also highlights the role of a dark money nonprofit called Moving NC Forward, which is managed by Cooper allies. PhRMA, the trade association representing drug companies, gave $50,000 to the group in 2023 — the same year Cooper signed Medicaid expansion into law.
Local news outlets reported in 2019 that the group was effectively “selling access to Cooper” during meetings at a lavish resort. Those reports, cited by Breitbart, did not allege illegal activity but raised questions about the intersection of donations and access to the governor.
Cooper’s campaign has not yet responded to requests for comment on the report, and Breitbart’s article does not include any response from Cooper or his representatives.
The flow of money from healthcare interests to Cooper accelerated over the course of his career, according to the report. In January, it was reported that Cooper had taken more than $160,000 from big insurance companies over his political career in North Carolina. By July, that number had grown to nearly $400,000 from the industry.
High Costs and Hospital Closures Under His Watch
While Cooper was soliciting healthcare companies for donations, the report notes, North Carolina suffered from the highest healthcare costs in the nation. Forbes, which published a ranking to that effect, cited the state’s highest average premium for “plus-one” health insurance coverage through an employer, the second-highest average premium for family coverage through an employer, and the fifth-highest average deductible for residents.
The report also says Cooper opposes the $50 billion in additional rural healthcare funding included in the Working Families Tax Cuts proposal. That opposition, the report suggests, is notable given that Cooper oversaw the closing of several rural hospitals in the state during his tenure.
Context and Reaction
Breitbart’s report appears to be an effort to raise questions about Cooper’s ethics and his record on healthcare as he competes for the Democratic Senate nomination in North Carolina. The state’s Senate race is expected to be one of the most competitive in the country in the 2026 election cycle.
Cooper, who previously served as the state’s attorney general, has cast himself as a moderate Democrat who can appeal to independents and Republicans. But the report’s allegations of a pay-to-play dynamic could complicate that narrative.
It remains to be seen whether the report will gain traction in the state’s political discourse or whether Cooper’s team will offer a more detailed response to the specific claims. What is clear is that the intersection of campaign donations, state contracts, and personal stock holdings will likely be a recurring theme in any Senate campaign.
Source: www.breitbart.com — https://www.breitbart.com/politics/2026/08/20/democrat-senate-candidate-roy-coopers-pay-to-play-healthcare-push-made-him-rich/