Budget squabbles threaten to delay Medicaid expansion; Cooper urges legislature to hurry
A fast-approaching federal deadline would delay Medicaid expansion by months in North Carolina, potentially leaving billions of dollars on the table, if the state legislature doesn't quickly approve a new budget. A top Republican leader indicated that could now be the case.
Despite both being led by Republicans, the chambers have found themselves disagreeing on numerous budgetary issues. Top lawmakers met Monday to discuss how to reconcile the House’s budget plan with the Senate’s budget plan.
A spokeswoman for House Speaker Tim Moore said it now appears the budget negotiations could continue beyond Sept. 1 — a change from a more expedited and optimistic outlook he gave last week. September is the deadline Democratic Gov. Roy Cooper and other proponents of Medicaid expansion are worried about.
"The legislature needs to get to work," Cooper, a Democrat who has made Medicaid expansion one of his top priorities while in office, told reporters Monday. "They continue to walk off the job and stay on vacation, like they're in Europe or something."
Lawmakers in March approved a plan to expand Medicaid — a deal that would give taxpayer-funded insurance to hundreds of thousands of North Carolina’s working poor. But expansion is tied to the passage of the state budget.
If the budget passes this month, Medicaid expansion will go into place in October. But if the budget doesn't become law until September or beyond, Medicaid expansion can't happen until December at the earliest.
The state budget is over a month overdue now; the new fiscal year began July 1. Republican leaders have been stymied in passing a new spending plan, however, as they found themselves disagreeing over a number of issues both big and small. A vacation break for Independence Day, which lasted most of July, also didn't help speed up the negotiations.
The program is expected to give health coverage to around half a million uninsured North Carolinians, and pump billions of dollars from the federal government into the state's health care industry.
Republican leaders pushed the GOP-led legislature to approve Medicaid expansion earlier this year, after spending a decade forcefully opposing the idea. But it didn't go into place immediately, instead being tied to the new state budget.
The September deadline from the federal government has complicated matters.
Cooper largely has his hands tied. Republicans hold veto-proof supermajorities in both chambers of the legislature, giving the Democratic governor little leverage in budget negotiations. Asked Monday if there's anything he can do to speed things along, he said the ball is in the legislature's court now. And he seemed discouraged.
"From things that we are hearing, it doesn't look promising for them to meet that Sept. 1 deadline that we need to begin Medicaid expansion on Oct. 1," Cooper said. "And that's very frustrating."
Legislative leaders, however, had held out some hope that they could get a budget passed in August, but that hope appears to be fading. On Thursday, Moore told reporters a budget agreement could be only "a couple of weeks out," in a best-case scenario. On Monday, that optimism seemed to evaporate as he predicted the negotiations could extend into September.
Also speaking with reporters Thursday, Senate leader Phil Berger said he didn't want to make predictions as to when the budget would pass. He cautioned that even if they missed the September deadline for Medicaid expansion, that wouldn’t mean negotiations were doomed.
He added that he'd rather not move too quickly on the budget, if doing so led to other problems in other areas.
"We could step on the gas, and we could probably do some things faster," Berger said. "But my experience has been that sometimes when you do that, you miss things."
One of the biggest stumbling blocks was that leaders in the state House wanted to prioritize higher raises for state employees, while leaders in the state Senate wanted to instead speed up a series of income tax cuts that are set to phase in over the next several years.
Berger and Moore have said that's resolved now, although they have declined to give the details of what the raises or tax cuts might look like. The items causing a holdup now, WRAL reported last week, seem to be where lawmakers want to spread money around for new construction and infrastructure projects, among other priorities.
