House rejects budget, passes Medicaid plan

Posted June 23, 2015

NC Flag, Legislative Building, Raleigh

— Members of the state House took two votes Tuesday that set up the coming budget negotiations, while Democrats filed a protest over the controversial vote that overrode Gov. Pat McCrory's veto of a bill dealing with how the state handles marriages.

BUDGET VOTE: Members of the state House unanimously rejected the Senate version of the state budget, officially triggering the conference committee that will work out differences between the two chambers.

Rep. Nelson Dollar, R-Wake, the chamber's senior budget writer, declined to enumerate all of the differences between the two sides, which disagree on everything from how much money to spend overall to how certain programs are funded.

"I do believe we have expressed a concern with the amount of policy placed herein," Dollar said, pointing to items in the Senate budget that would normally be stand-alone bills, such as Medicaid reform, paring back the process through which medical providers obtain new equipment and changes to the state lottery.

He also argued that the House budget, which spends more than the Senate, is not out of line with how much spending has gone up in prior years.

MEDICAID: The House also approved a Medicaid reform package, passing a stand-alone bill 105-6. Senators included their Medicaid reform proposal in their budget bill.

The two plans share some features. For example, both rely on outside organizations to control costs in the state-run health insurance program for the poor and disabled. However, the Senate plan would lean heavily on established managed care companies, while the House would rely exclusively on provider-led entities, home-grown North Carolina companies run by hospitals and doctors. Both approaches would replace the current fee-for-service system under which most providers are paid based on the number of services they provide.

"Our current system is just not sustainable," Rep. Donny Lambeth, R-Forsyth, told his colleagues.

Rep. Marilyn Avila, R-Wake, said she backed the House bill in part because she knew negotiations with the Senate would temper it. She worried the state would have no fallback if provider-led entities were not up to the task of caring for Medicaid recipients.

"What is Plan B? What do we go back to?" Avila asked.

The bill now goes to the Senate.

ABLE ACT: Members of the state House unanimously passed House Bill 556, the ABLE Act, which would allow the families of children with disabilities to save for their care.

The act would clear the way for 529 savings accounts not unlike the plans that help other families save for college. It now goes to the Senate.

PROTEST: House Democrats delivered a protest to how the chamber voted to override McCrory's veto of Senate Bill 2, the measure allowing magistrates and county register of deeds staffers to opt out of participating in marriages if they have a religious objection. The measure was aimed at helping those who did not want to facilitate same-sex marriages.

"We understand the difficulty in bringing all these minds together," Rep. Larry Hall, D-Durham, the House minority leader, said on the floor.

However, he said, the House should allow open debate on contentious matters.

The Republican leadership brought the override vote up with little warning on June 11 after several days of delays, and they then cut off all debate on the measure, points that Democrats made in their protest.

Although the protest records the opinions of the Democratic minority on the chamber's official record, it has little legal significance other than officially recording the dissenting views.


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