Opinion

Opinion

Editorial: 'Mini-budgets' give more debate on some issues, take up Medicaid expansion now

Posted October 14, 2019 5:00 a.m. EDT
Updated October 14, 2019 8:34 a.m. EDT

Berger speaks on budget

CBC Editorial: Monday, Oct. 14, 2019; Editorial #8471
The following is the opinion of Capitol Broadcasting Company.


In the war legislative leaders are waging with Gov. Roy Cooper over the state budget, there’s no clear victor. But the skirmishing has given North Carolinians one small, but not insignificant victory.

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The legislature’s retreat to passing “mini-budgets” has forced open discussion on critical and important policy issues that, in past years, were buried deep inside the massive budget package. That was the point, to avoid open discussion and disclosure and keep discussion muffled by the sheer volume of a budget that covered as many as 1,000 pages but legislators would have only hours to review and discuss.

The unfortunate reality is, particularly since 2011, important policy issues that had only tangential connections to the budget, were stuffed into a bloated bill. Here is a small sample of big issues that were shorted on debate and consideration: Abolishing the N.C. Teaching Fellows program, 2011; Instituting private school vouchers, 2013; Creating new state departments and new exemptions to the state’s open records laws, 2015. You get the idea.

As a result of this year’s budget impasse Senate leader Phil Berger and House Speaker Tim Moore, the two Republicans who control the legislature, the non-budget items they’ve wanted now are being discussed and voted upon separately. While a vast improvement, it remains far short of the kind of thorough examination and discussion that should happen in the legislature – OPEN hearings and discussion in committees; full and informed debate on the House and Senate floor. After all that, there should be PUBLIC discussion in conference committees.

As a result of the “mini-budget” bill strategy, legislators have had to engage in – relatively – more detailed discussion of several important issues. Here are just a few that have seen more sunshine in recent weeks: prison safety concerns; new requirements for law enforcement for faster and increased testing of evidence in sexual assault cases; pay raises for state workers; confronting gang violence; providing additional resources as the judicial system implements a law ending prosecution of teenagers as adults; and rural health care.

While far from ideal, this disruption to the ramrod budget process has provided citizens and legislators with a unique opportunity – that should be the rule not the exception -- to be informed and discuss programs and spending.

Given the current circumstances, it is a perfect opportunity for Berger to make good on his promise to hold a session on expanding Medicaid for about half-a-million North Carolinians who now lack health care coverage. Only 14 states, including North Carolina, have not expanded the program that would be paid for almost entirely with federal funds.

Gov. Roy Cooper holds the Republican budget in his left hand, his suggested changes in his right, as Senate Minority Leader Dan Blue looks on.

Berger says he won’t allow any discussion until after Cooper agrees to a budget deal. Berger has termed it Cooper’s “Medicaid or nothing ultimatum.”

While Berger has been unequivocal in his blanket opposition to Medicaid expansion, there have been increasing calls from those in his own party to allow it. Several key Republicans in the state House have drafted a version of Medicaid expansion. Republican officials in rural areas have started to press Berger to relent. They know it is good for the state and the right thing to do.

At the same time he’s doing all he can to block official debate of this crucial issue, even Berger feels compelled to comment on it – issuing four news releases on Medicaid expansion over 12 days.

Sen Berger, rather than debating by firing off news release after news release, why not deal directly, properly and officially with this critical issue of significant concern to the health and welfare of our state?

Statewide voter polls find strong support -- from as much as 68 percent to no fewer than 54 percent favor Medicaid expansion.

This is an issue North Carolina citizens want addressed. The consequences of not acting are being felt every day:

Life and death – From 2,800 to 8,700 deaths due to lack of coverage since 2014.
Dollars and cents -- $20 billion in lost federal Medicaid funding; $5.7 billion in lost hospital reimbursements.

End the stonewalling. Open the debate. Bring it to a vote and pass Medicaid expansion for North Carolina now.


BY THE NUMBERS: COST OF DENYING HEALTH INSURANCE IN N.C.

2014-18 Jan.- Sept 2019 TOTAL
Diabetics Without Medication* 119,228 20,286 150,784
Annual Mammograms Missed* 60,249 9,036 71,305
Deaths* 6,936 to 2,267 1,305 to 342 8,966 to 2,799
Jobs Not Created** 71,852 10,577 88,314

*Opting Out Of Medicaid Expansion: The Health And Financial Impacts, Health Affairs Blog
** The Economic and Employment Costs of Not Expanding Medicaid in N.C., Center for Health Policy Research, The George Washington University, Dec. 2014 and June 2019

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