By Catherine Clabby and Rose Hoban

In a late night vote, House lawmakers passed their $22.8 billion dollar budget, that includes funding for more than $5 billion for health and human services needs for the coming year.

The vote capped a day that began with Republican budget chairs crowing about their budget plan and ended with lawmakers making jokes on the floor of the House as they waited for their final tally.

The Senate budget had set aside a billion dollars for tax breaks and sequestered another $150 million in Medicaid reserves, which left less for spending.

In the past, Medicaid had created headaches for lawmakers, who struggled to budget the correct amount for the year’s spending, in addition to having program spending spiral out of control during the economic downturn in 2009-2011.

House Speaker Tim Moore was surrounded by members of the House Republican caucus as he presented the House's budget during a press conference Thursday morning at the General Assembly.
House Speaker Tim Moore was surrounded by members of the House Republican caucus as he presented the House’s budget during a press conference Thursday morning at the General Assembly. Photo credit Taylor Knopf

But in recent years, the program has had a smoother ride, with more stable national finances, more robust financial growth in the state that lead to less program growth and a new information technology infrastructure that’s made budgeting more precise.

“So that the last four years, including this year, once again we will have a surplus on the Medicaid budget,” said House Appropriations Committee Chair Nelson Dollar (R-Cary). “I think our sound reforms have fixed that problem I think as sound as anyone in the country.”

Dollar explained that the House instead took $186 million that had already been set aside as a Medicaid reserve and put it into the fund to create a financial backstop for the program once it transforms from its current fee-for-service payment structure into one that’s capped and managed by outside insurance companies.

And House budget writers did not sequester new funds into a reserve, which left them more to spread around.

And spread around they did:

  • The House plan made cuts to so-called “single stream” funding that goes to the state’s mental health management organizations. Senate budget writers cut $171 million from the funding stream over two years, House budget writers cut $88.4 million and phased out those cuts by the end of next year.
  • $10 million in funding to help small group homes housing adults with intellectual, developmental and mental health disabilities bridge a structural problem in their funding.
  • Found $5 million in late funding to cover the costs of substance abuse treatment for people who have been using heroin and prescription opioids.
  • Created $500,000 in funding for a biomanufacturing training center at N.C. State University.
  • Ordered Cardinal Innovations, one of the state’s seven mental health management organizations, to invest $800,000 in cash reserves for capital needs at Carrboro’s Club Nova clubhouse for people with severe and persistent mental illness.

Environmental health takes the floor

One of the issues that generated the most debate on the floor Thursday evening was the House bill’s requirement that the Department of Environmental Quality make progress on testing chemical solutions to nutrient overloading in Falls and Jordan Lakes.

Supporters hope that strategy could delay or replace a next phase of nutrient control plans for the two lakes which would require sewage treatment plants, developers and others to make expensive changes to reduce pollution discharges upstream.

Rep. Pricey Harrison (D-Greensboro), citing safety concerns, proposed an amendment that would have replaced support for the chemical treatment with a command to “restart” Jordan Lake and Falls Lake nutrient reduction rules.

The General Assembly has managed to delay implementation of the full Jordan Lake rules since they were adopted by the state’s Environmental Management Commission in 2009.

Supporters of Harrison’s amendment said the plan to use chemicals resembles another recent plan that failed, namely the use of SolarBees to stir Jordan Lake to slow algae growth, which is stimulated by nutrient pollution. That project cost taxpayers more than $1 million but did not reduce the blooms that make the lake “impaired” by federal standards.

Rep. Larry Yarborough (R-Roxboro) said trying the chemical treatments, a mix of algaecides and phosphorous ”locks,” would not eliminate the rules. But he said he does not want to give up hope for finding an alternative path.

“We’re trying to put off phase II until we get a chance to see if this works,” he said.

One of Harrison’s biggest objections was the possible health effects of adding chemicals to the water.

Other elements of the House bill with environmental health implications that differ from the Senate language include continued funding for the FerryMon program, which uses  state ferries to test water quality in the Neuse and Pamlico rivers, along with Pamlico Sound estuary.

Another difference was continued funding for a program that removes mercury from convenience light switches from older cars before they are crushed or shredded.

No kumbaya

The budget debate was mostly cordial, nonetheless, it featured moments of tension as Democrats proffered multiple amendments, a number of which were quickly killed by parliamentary procedures.

And Democrats said the budget didn’t go far enough in making investments to build up the state in the wake of lean years.

“For two years, I have voted for our budget that we put forth to the senate, but this year, I just cannot vote for this budget,” said Rep. Billy Richardson (D-Fayetteville). “I think that we as a body have missed a golden opportunity.

“For years we have used the excuse that we have carefully spent from 2008 and that we’ve had to adjust for that, but we have more than caught up from that… We have recovered from the downturn in the economy and we’re in a position now where we can reinvest in the infrastructure of the state.”

New Bern Republican Michael Speciale smacked down the Democrats’ arguments.

“We sit here and listen to how great things would be if the other side was in control,” he said. “I get tired of sitting here and listening to that, how bad things are and ‘we can do better.’ I don’t think there’s been a budget in the five years I’ve been sitting here that has not been a budget where the other side of  the aisle hasn’t used that phrase, ‘we can do better.’”

“Of course we can do better, we can always do better… if we had more money,” Speciale said.  “We have opposing views of what should go in the budget. That’s the reality.”

Now the bill goes into conference committee and will likely take weeks for the two chambers to iron out their differences before the final plan sees the light of day.

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Catherine Clabby

Catherine Clabby (senior environmental reporter) is a writer and editor. A former senior editor at American Scientist magazine, Clabby won multiple awards reporting on science, medicine and higher education...