Back in 2013, Gov. Pat McCrory roundly rejected the call for Medicaid expansion in North Carolina, leaving 500,000 constituents uninsured. The bill for the program would have been footed almost entirely by federal dollars, but that wasn’t going to stand in the way of McCrory asserting his categorical opposition to the Affordable Care Act.

At the time, the Koch brothers’ political arm, Americans For Prosperity, applauded McCrory for his denial of expanded health care access. That’s not overly surprising — McCrory has extensive ties to the Koch brothers, from doingrobocalls for AFP in 2011 before he was technically a gubernatorial candidate, to hiring long-time Koch-crony Art Pope as his budget director.

But it turns out denying people healthcare to prove one’s ideological purity isn’t overly popular. McCrory started to waffle on the issue after facing significant political pressure to accept Medicaid expansion. Of course, that didn’t sit too well with the anti-Medicaid expansion crusaders at AFP. Last month, their North Carolina state director and policy analyst penned an op-ed entitled “Governor, don’t cave on Medicaid expansion.”

In said plea, the AFP staffers have trouble conceiving that there would be any merit at all in providing an affordable health insurance option to working North Carolinians: “And what would we be paying for? Nothing that should comfort taxpayers.”

And yesterday, AFP announced their legislative agenda for the new year, making clear that stopping Medicaid expansion is a top priority. They’ll find little resistance to that end from leaders in the GOP-controlled General Assembly, who have already made clear they side with AFP.

So the question remains for the spineless governor — will he finally submit to the pressure to do the right thing and take leadership to reach a deal? Or will he give in to the Koch brothers and friends, who have long been instrumental in setting the agenda in this administration? 500,000 uninsured North Carolinians await the answer…