In 2010, President Obama signed the Affordable Care Act into law. This massive bill changed a lot about the U.S. health insurance system – insurance marketplaces were created for all 50 states, young adults were allowed to stay on their parents’ plans until age 26, and insurance companies were banned from denying coverage based on pre-existing conditions. One of the most transformative parts of the ACA was the extra funding it offered for Medicaid. Since the 60s, every state has had a Medicaid health insurance program, which provides coverage for certain low-income people who can’t access private insurance. Before the ACA, Medicaid coverage was mostly limited to low-income families with children, pregnant women, and people with disabilities and long-term health conditions. Under the new law, states could choose to offer Medicaid to low-income adults without kids, closing a gap that had left millions uninsured – and the federal government would foot the bill for the first three years. After that, states would start contributing up to 10% of the cost of expansion. 

In order to expand Medicaid, each state had to pass its own laws (and eventually dedicate some funding in their budgets), and whether that happens has often come down to a governor’s support. Governors hold the power to sign or veto state laws and budgets, so their support or opposition can make or break a big policy change like this. In North Carolina, Governor Pat McCrory blocked Medicaid expansion in 2013 by signing a bill requiring that the state legislature approve it first – and at that time, a majority of lawmakers opposed it. He argued that the state’s Medicaid system was not prepared to handle more participants and that reform was needed before any expansion could be considered. 

Roy Cooper became Governor of North Carolina a few years later, and as a strong supporter of Medicaid expansion, he immediately took an aggressive approach. He formally asked the federal government to override the law McCrory had signed, and expand Medicaid anyway without the state legislature’s approval. State lawmakers sued and eventually won, and Cooper realized he would have to go through the legislature. He then focused on building a coalition of supporters to sway the opposition. One official recalled that over the next six years, Cooper worked “business by business, sheriff by sheriff” to convince anyone he could of the benefits of expansion. Support grew, especially in more rural parts of the state, and the state legislature eventually passed expansion with bipartisan support. Once Cooper signed the law, the next step was negotiating the state budget so the state could implement expansion. After a long budget fight, newly eligible people were able to sign up in December of 2023. A year later, over 600,000 North Carolinians had enrolled in expanded coverage. Governor Cooper’s persistence on this issue is a great example of a governor’s influence on policy, even in the face of a legislature that opposes change at first. 

Sources: University of California-Irvine; US Department of Health and Human Services; Charlotte Observer (archived); Blue Ridge Public Radio; North Carolina Department of Health and Human Services 

Term limits: limited to two terms in a row, but can run again after sitting out at least one term; terms are four years

Eligibility: to run for Governor, you must be at least 25 years old and a registered Louisiana voter, and must have been a U.S. citizen and Louisiana resident for at least 5 years

Louisiana elects its governor through a top-two system. The Governor runs the state government’s executive branch, and has a lot of power over the annual budget, education, criminal justice, and other important issues. Some of their most important powers and responsibilities are:

• Shaping the state budget
  The governor receives requests from different parts of the state government and submits a proposed budget to the state legislature; after lots of negotiation, the legislature sends the governor a final budget, which they can either sign into law or veto
• Line-item veto power
  This power gives the governor the option to reject specific parts of a bill or proposed state budget without vetoing the whole thing
• Appointing important leaders throughout the state government
  Including board chairs of Louisiana’s public colleges and universities, 3 members of the Board of Elementary and Secondary Education, and members of the Board of Pardons
• Appointing a U.S. Senator if there’s a short-term vacancy
  If a U.S. Senator from Louisiana can no longer serve and has less than one year left in their term, the governor can pick a temporary replacement – no election required. This is one of the governor’s most significant powers because it can impact the balance of power in Congress
• Limited pardon power
  The governor can grant pardons and commutations for state crimes, but usually only if the Board of Pardons recommends it 

Sources: the Louisiana Constitution; Louisiana Executive Branch; Louisiana State Board of Elementary and Secondary Education; Congressional Research Service 

Term limits: limited to two terms in a row, but can run again after sitting out at least one term; terms are four years

Eligibility: to run for Governor, you must be at least 30 years old, eligible to vote in North Carolina, and have been a U.S. citizen for at least five years and a resident of North Carolina for at least two years before being elected

The governor runs the executive branch of North Carolina’s state government, giving them a lot of power over the state budget, education, criminal justice, and other important issues. Some of their most important powers and responsibilities are:

• Acting as director of the state budget
  The governor prepares a recommended budget and submits it to the state legislature; after lots of negotiation, the legislature passes a final budget, which the governor can either sign into law or veto. Since North Carolina doesn’t give its Governor line-item veto power, those negotiations are really important, because the governor has to accept or reject the whole budget at once.
• Leading the Council of State
  This group is similar to the President’s cabinet, and is made up of all the other executive-level elected officials who run the various agencies of the executive branch.  They advise the governor on important policy issues 
• Appointing important leaders throughout state government
  Including members of the State Board of Education (which sets policy for the state’s public education system), the Utilities Commission (which sets utility rates), and more. Some appointments need to be approved by the State Senate
• Appointing replacement judges if there’s a vacancy on a court
  Replacements serve until the term is over, or until there’s an election to fill the seat
• Appointing replacements if a state-level executive official can no longer serve
  If there’s a vacancy in the offices of Secretary of State, Attorney General, Auditor, Treasurer, Superintendent of Public Instruction, Agriculture Commissioner, Labor Commissioner, or Insurance Commissioner, the governor can appoint a replacement to serve until the next general election. This gives the governor a lot of power over different policy areas
• Granting pardons, reprieves, commutations, and clemency for state crimes
  Except in cases where someone was impeached from state or local government
• Convening special sessions of the General Assembly
  The governor can require the state legislature to meet outside of its normal calendar to address emergencies or specific policy issues
• Some exceptions to veto power
  Redistricting bills, appointments, constitutional amendments, and local bills (bills that affect fewer than 15 counties) cannot be vetoed by the governor

Sources: the North Carolina Constitution, Article III, Article IV and Article VI; the North Carolina General Statutes Chapter 147; Office of the North Carolina Governor; the North Carolina Department of Public Instruction; the North Carolina Utilities Commission; the North Carolina Office of State Budget and Management; the North Carolina General Assembly’s educational resources (see ‘how an idea becomes a law’)

Term limits: limited to two terms in a row, but can run again after sitting out at least one term; terms are four years

Eligibility: to run for Governor, must be at least 30 years old, a U.S. citizen, and a resident of Pennsylvania for at least 7 years (unless you were living somewhere else while doing official business for the U.S. or state government)

The Governor runs the state government’s executive branch, and has a lot of power over the annual budget, education, criminal justice, and other important issues. Some of their most important powers and responsibilities are:

• Shaping the Executive Budget
  The governor receives requests from different parts of the state government and submits a proposed budget to the state legislature; after lots of negotiation, the legislature sends the governor a final budget, which they can either sign into law or veto
• Supervising the Capital Budget
  This budget is for one-time expenses (things like building a new government facility, repairing a bridge, buying public lands or other big public works and infrastructure projects) and is part of the Executive Budget; when a project is authorized as part of the final budget, the governor is responsible for the timeline of the project and managing any debt the state might need to take on to pay for it
• Line-item veto power
  This power gives the governor the option to reject specific parts of a bill or proposed state budget without vetoing the whole thing
• Appointing important leaders throughout the state government
  Including the Secretary of Education, who oversees all of Pennsylvania’s public school districts; all nominees need to be confirmed by a majority vote of the State Senate
• Limited pardon power
  The governor can grant pardons and commutations for state crimes, but only if the Board of Pardons recommends it. Officials who have been impeached and removed from office cannot be pardoned

Sources: the Pennsylvania Constitution; Pennsylvania Office of the Budget 

Term limits: Unlike in many other states, Virginia governors don’t have term limits, but they can’t serve two terms in a row – they need to sit out at least one term before running for office again. Historically, this has meant that Virginia has flipped back and forth between electing Democratic and Republican governors. Terms are four years

Eligibility: to run for governor, you must be at least 30 years old, a US citizen, and have been a resident of Virginia and a registered voter in Virginia for at least 5 years

The governor leads the state government’s executive branch. Because they can serve only one term at a time, Virginia governors usually try to hit the ground running and immediately work on achieving their policy goals when they come into office. Some of their most important powers and responsibilities are:

• Shaping the state budget
  The governor receives requests from different parts of the state government and submits a proposed budget to the state legislature; after lots of negotiation, the legislature sends the governor a final budget, which they can either sign into law or veto
• Line-item veto power
  This power gives the governor the option to reject specific parts of a bill or proposed state budget without vetoing the whole thing
• Proposing amendments to any bill or budget
  Amendments still need to be voted on by the General Assembly
• Appointing the 11 members of the Governor’s Cabinet
  Cabinet members are called Secretaries and they run the major departments in the state government, influencing education, healthcare, public safety, and more. Secretaries are nominated by the governor and confirmed by a majority vote in the General Assembly
• Pardon power
  The governor can issue pardons or reduce sentences for state crimes, unless the conviction came from the House of Delegates
• Restoring civil rights and voting rights for people with felony convictions
• Appointing members to the boards of Virginia’s public colleges and universities

Sources: the Virginia Constitution; the National Governors Association; Library of Congress Research Guides; Get Ready VA; Office of the Virginia Governor