Dec 4, 2023 - News

Meet North Carolina Republicans' favorite Democrat, Kody Kinsley

NCDHHS Secretary Kody Kinsley poses for a portrait

North Carolina Department of Health and Human Services Secretary Kody Kinsley. Photo: Julia Wall/The Assembly

You may not have heard of Kody Kinsley, the secretary of North Carolina's Department of Health and Human Services, but you oughta know him.

Driving the news: Leaders throughout the state and country celebrated on Friday when the long-awaited expansion of Medicaid became a reality, extending coverage to 300,000 of the state's poorest residents immediately and eventually as many as 600,000.

  • But the person who may be most responsible for bringing politicians from all sides together to make it happen is Kinsley, a relatively low-profile, gay, 38-year-old Democrat who grew up in Wilmington without health coverage.

State of play: I spent the weeks leading up to the rollout of Medicaid expansion with Kinsley, for a story Axios reported in collaboration with the statewide magazine The Assembly.

  • I joined Kinsley on a morning walk with his partner and dog, tagged along with him and his team on multiple long car rides, sat in on meetings, watched him give speeches and chatted with him over coffee.
  • My goal was to better understand how he managed to forge unlikely alliances with conservative Republicans in the legislature to make all of this happen.

Context: Many doubted that North Carolina would ever make the jump as 39 other states had. For more than a decade, the state's Republican-led legislature opposed expanding Medicaid, the government health-insurance program for lower-income people, primarily fearing it would be too expensive.

  • But in May 2022, Republican senators reversed themselves after the federal government sweetened the pot, just six months after Democratic Gov. Roy Cooper appointed Kinsley to lead NCDHHS.
  • Kinsley replaced the high-profile Mandy Cohen, who served as the director during the heart of the pandemic and gave weekly press conferences alongside Cooper.
  • Cohen went on to become director of the CDC, but it was Kinsley who carried Medicaid across the line in his home state.

How it happened: In an era of politics often defined by an us-versus-them mentality, Kinsley is soft-spoken and known for being a straight shooter and a bridge builder.

  • For more than a year and a half, he spent many of his waking hours in talks with health-care industry leaders, Republican legislators, and fellow Democrats about how to make expansion happen.
  • He answered late-night and early-morning questions from lawmakers, and listened to opponents' concerns. He met with top healthcare lawmakers and hospital executives, encouraging them to find common ground. And when an expansion deal looked like it might fall apart, Kinsley took calls while sightseeing and sipping beer in Germany on a trip with his partner.

What they're saying: Medicaid expansion would have happened eventually, said Republican state Rep. Donny Lambeth, a former hospital administrator and longtime supporter of expansion. But it may not have gotten done in 2023 without Kinsley, he said.

  • "The role he played," Lambeth said, "helped push it across the finish line this year."
Kody Kinsley, his partner Angelo Mathay and their dog, Kopuk, on their morning coffee run.
Kinsley, right, and his partner Angelo Mathay on their morning coffee run with their dog, Kopuk, the real star of the show. Photo: Julia Wall/The Assembly

Flashback: In many ways, I found, Kinsley has come full circle to this moment.

  • Kinsley remembers the weight that being without health insurance brought on his family. It was the first thing his mother mentioned when he fell out of a tree in middle school and sliced his leg open on a jagged limb. And it was at the top of their minds when Kinsley's dad had a stroke while Kinsley was in college: How are we going to pay for this?
  • Kinsley was working at the Obama White House during the implementation of the Affordable Care Act, which his parents signed up for during his time there.
  • A decade later, he's expanding that same program in his home state.

Plus: Some fun nuggets I learned about Kinsley while he let me hover over him for three weeks, because it's always nice to know more about the people who run our state:

  • He shops for clothes at Costco. One day, I asked Kinsley what he was wearing. Except his tie and socks, everything (including his underwear) was from Costco, he said.
  • Kinsley likes to order a Reese's with extra Reese's at Cook Out. He calls it a "post good job milkshake."
  • His dog, Kopuk, gets two boiled eggs every morning from Kinsley and his partner's favorite coffee spot.
  • He goes to the gym everyday around 5:30am, and after he's done, he calls Republican state Sen. Jim Burgin. I think it's safe to say they're best friends.

Read the full profile in The Assembly.

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