By Rose Hoban

By the time he reached Raleigh after six hours of driving, Dale Wiggins was angry that the lawmakers he was coming to see had already skipped town.

Wiggins, the chair of the Graham County Board of Commissioners, came to Raleigh Tuesday to speak to legislators about enacting Medicaid expansion. But by the time he and several other officials from their rural far western county made it to the capitol, lawmakers who had come to the General Assembly for a “mini-session” had wrapped up their work after only a few hours, and left. They won’t be back until late April.

That frustrated Wiggins, a Republican, who wanted to tell his party leaders about the needs of his constituents in a county where wages are low and rates of uninsurance are high.

“That tells me that their priorities are not ‘we the people,’” he said during a press conference held Wednesday morning to encourage lawmakers to expand Medicaid, the state and federal funded health care program that currently provides coverage to almost 2.2 million North Carolinians.

Under the Affordable Care Act, North Carolina is eligible to expand Medicaid to include as many as a half-million low-income workers who make too much to qualify for the program now, but too little to qualify for health insurance subsidies on the online health insurance marketplace. North Carolina is one of only 13 states not moving to add those extra people to the program.

“The Affordable Care Act, a lot of people were unhappy with that and maybe there’s a better option out there somewhere, but it’s what we’ve got,” said Wiggins, who identified as a Republican as soon as he got up to speak. “We have to work with it and try to take care of the people that really need it.”

Wiggins was part of a group of business leaders, law enforcement and county officials, all of whom identified themselves as conservative or Republican. They were gathered by the Care4Carolina coalition, an advocacy organization that’s been pressing for Medicaid expansion for several years.

But lawmakers weren’t there to hear from them.

Lawmakers came, did little, left

Tuesday’s mini-session was contrived in the fall, when lawmakers wrapped up what had become an increasingly contentious 2019 work session. The resolution adjourning the session to November (and a subsequent one adjourning until January) included a reference giving advocates the impression lawmakers would take up health care access issues once they gathered again.

But by the time legislators arrived in town Tuesday, it was clear their activities would be tightly focused. In the end, the House moved on only two bills: one to adjust tax deductions on medical expenses and another to add to scholarship funding for children of veterans. Then the state House quickly moved to adjourn.

a man in a suit and tie gestures as he speaks to people holding microphones. He has staunchly opposed Medicaid expansion
Senate majority leader Phil Berger (R-Eden) told reporters on Tuesday that none of the Republicans in his chamber would be willing to vote for a Medicaid expansion bill. Photo credit: Rose Hoban

The Senate took action only on two overrides of gubernatorial vetoes while sending the House’s tax deduction bill to committee. Then the chamber adjourned without attempting an override of the state budget bill, which has been held up since June.

Senate leader Phil Berger (R-Eden) expressed his frustration at a morning press conference.

“We could have seen a negotiated compromise resolution of the entire budget, but Gov. Cooper refused to sign any budget including his own unless Medicaid expansion was included,” he told reporters. “Senate Democrats and Gov. Cooper have blocked teacher pay raises, blocked billions, billions for new schools and blocked Medicaid transformation, among other things.”

Berger also insinuated that when lawmakers return in the spring for the traditional “short session” that there would be no changes in the budget stalemate.

He criticized Democrats for not standing up to Gov. Cooper, who is also a Democrat.

“I actually commend Sen. Ben Clark (D-Raeford), who at least was willing to say publicly what Democrats have been saying privately … ‘Until we sit down and negotiate Medicaid expansion, I see no reason to vote to override the veto’,” Berger said. “So it’s clear that Medicaid expansion is the thing that is holding up the budget.”

a man standing at a podium raises his hands and shoulders in a shrug as he speaks to someone off camera.
Senate minority leader Dan Blue (D-Raleigh) told reporters he doesn’t know what it will take to reach compromise over Medicaid expansion, teacher pay and other contentious issues in the legislature during a press conference Tuesday morning at the General Assembly. Photo credit: Rose Hoban

For their part, senate Democrats decried their senate colleagues’ inability to forge any compromise, focusing their ire on pay raises for teachers and school staffers that they deemed were too low. They voted to sustain Cooper’s veto of a teacher raise bill, as well as a veto of a 25-page regulatory “reform” omnibus bill.

With those statements, the two parties seemingly put their chips down on what will likely be the talking points for the fall election.

Failure to compromise frustrates

The advocates gathered on Wednesday morning seemed to put their weight behind the idea of coming to agreement on Medicaid expansion.

“The stress levels of parents with autism are comparable to that of combat soldiers. Unfortunately, caring for children with special needs is not a job that comes with health insurance,” said Rachel Radford, a Goldsboro parent of two children on the autism spectrum. “Our current legislature does not seem to appreciate the value we as parents have for our children because of the lack of swiftness to pass Medicaid expansion.”

She decried the tit-for-tat and political spin that often passes for dialogue between the two political parties on Twitter and Facebook.

“You all need to get off social media blame games and pass our budget,” she said.

Alamance County Sheriff Terry Johnson, a conservative stalwart, made his plea for expansion, explaining that he sees the result of untreated mental health problems in his county jail.

“Our staff has saved eight people trying to commit suicide in our detention facility and if you will go back and do the history on some of these people, you will find that issue started in childhood and continued to escalate all the way up until they violated the law,” said Johnson, who noted that one person had actually died by suicide in the jail.

a man stands at a podium gesturing. he's wearing a sheriff's star on his jacket, and is an unlikely support of Medicaid expansion
Alamance County sheriff Terry Johnson told advocates and reporters on Wednesday morning that he ran the county’s largest mental health facility in his jail as he made the case for Medicaid expansion. “We can pay now or we can pay later,” he said about the policy. “And we are paying later with human life and people’s lives being destroyed.”

“What has happened to America? What has happened to our politicians? What has happened to their thought of ‘We the people’?,” Johnson asked. [Politicians are] worried about their reelection, they’re worried about, you know, their party.”

‘Lives on the line’

The meeting came during a fortnight where several new studies pointed to the benefits of Medicaid expansion. A study in the journal Health Affairs found worsening individual health outcomes in the 14 states that have not expanded Medicaid when compared to states that have expanded. North Carolina ranked number two in declining health among non-expansion states.

And a study released this morning by the Commonwealth Fund found that all races have made significant gains in health care coverage in the wake of passage of the Affordable Care Act, but North Carolina has a higher rate of uninsurance (15.7 percent) than the national average (12.4 percent). Those researchers also found that blacks in Medicaid expansion states have higher rates of health insurance than whites in states that have resisted expanding.

McDowell County Chamber of Commerce chair Steve Bush pointed out that many veterans coming back from Iraq and Afghanistan are ineligible for TRICARE or Veterans Affairs health care and lack health insurance.

“[They] are putting their lives on the line, they are risking everything to protect us to come home to a country that does not serve them to protect them in their health,” he said.

His chamber is one of 17 around the state that has endorsed Medicaid expansion.

Mostly, the business leaders in the room worked to make a case that not having access to coverage for low wage workers, and workers in the state’s 870,000 small businesses hurts the economy, hoping that argument might carry weight with politicians.

“We’re made up primarily of small businesses, those small businesses can’t pay their waiters and their dishwashers and their chefs, health insurance,” said Tom Kies, chair of the Carteret County Chamber of Commerce. He said many workers in the tourism-heavy coastal region often work two or three jobs to earn enough money to survive and often come to work sick.

“It’s been said that in Carteret County, a Democrat can’t get elected to dog catcher, it’s a very Republican market,” he said. “However, we have a number of issues that have become bipartisan.”

One of them, he said, is Medicaid expansion.

a bearded man smiles at the camera. He says he's looking to see Medicaid expansion in NC
Carteret County Chamber of Commerce chair Tom Kies said he was unsure what would happen when he brought a measure supporting Medicaid expansion to the chamber for a vote. He got a surprise when the vote was unanimously in support. Photo credit: Rose Hoban
How we reported this story:

  • Talked to multiple, bipartisan sources before and after events.
  • Attended three press conferences, attended/ listened to legislative hearings.
  • Reporter has followed this topic for multiple years.
  • Consulted academic research.
  • Interviewed lawmakers and others in addition to press events.

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Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees...

2 replies on “Legislative mini-session produces little movement on health care issues, despite new call for Medicaid expansion”

  1. Health care and paying teachers should not be a partisan issue. Get us a budget that HELPS low income and middle class individuals and stop being cut throat, selfish, and only interested in the rich.

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