Key Republican legislators in North Carolina say an up-or-down vote on broad Medicaid expansion could occur before the November elections. A joint House-Senate panel created in the current budget law and tasked with studying health care access and possible expansion holds its first meeting on Friday. Senate leader Phil Berger told WRAL-TV on Tuesday he believes there's a pathway for expansion approval. North Carolina is one of a dozen states that hasn’t expanded Medicaid to working adults as provided under the 2010 federal health care law. Many House Republicans still oppose the idea. Democratic Gov. Roy Cooper is a big expansion proponent.