Should Gov. Roy Cooper hold the N.C. budget hostage over Medicaid expansion?
It might be the only way to stop Republicans from some hostage taking of their own. Republican leaders have yet to allow a Medicaid expansion bill to gain momentum and get to the floor of the N.C. House or Senate, a frustration for the governor and Democratic lawmakers.
One of those lawmakers, Democratic Rep. Darren Jackson of Wake County, said this week that Cooper will veto any budget that arrives at his desk without Medicaid expansion. The governor’s office is a bit more reticent — spokesman Ford Porter told the News & Observer that it’s too early for Cooper to commit to a veto, but that the governor “hopes to see those issues addressed” before the House and Senate send a final budget his way.
Republicans, however, say the budget process is not the place to change Medicaid policy. That’s an interesting posture given that GOP lawmakers regularly make changes to laws and policy in the budget, including pushing Medicaid reform just four years ago. But we agree. It’s a bad idea to sneak policy items into the budget instead of introducing them in separate bills that would be subject to proper debate and a vote. We didn’t like it when Democrats did it in Raleigh, and we called on former N.C. Gov. Pat McCrory to stop his party’s lawmakers from doing it by refusing to sign a budget that changes state laws or policies.
Similarly, Cooper could refuse to sign a budget unless Republican leaders allow a legitimate Medicaid expansion bill to get a vote. Both Democrats and Republicans have introduced versions of such a plan, although the Republican plan has work requirements and premiums that would provide obstacles, not access, to medical coverage. Still, Jackson says well over half the members of the House, at least, support some sort of expansion.
They certainly are not alone. More states each year, including those with Republican-led legislatures, have adopted Medicaid expansion — some because voters told them to do so in ballot initiatives. To date, 37 states (including the District of Columbia) are giving millions more citizens access to critical health care that Medicaid expansion brings.
Republican leaders are doing North Carolinians a disservice by stalling on a plan that citizens overwhelmingly want and that Jackson suggests most lawmakers may support. There’s one way to find out if he’s right: craft a bill and hold a vote. If Republicans don’t want to vote aye themselves to Medicaid expansion, they should put it on the ballot and let voters decide, as several states have.
As for a Cooper ultimatum: We’re wary of officials holding one legislative item hostage for the sake of an unrelated item. Tempting as it might be for the governor to threaten a budget veto if Republicans don’t move toward Medicaid expansion, he should resist. North Carolina voters can have their say at the ballot box — if not specifically on Medicaid expansion, then on the party that’s holding it back.