Republican leadership in the state House opted Thursday to again leave unaddressed the state budget veto override vote and a Medicaid expansion bill.
Instead, the veto override and House Bill 655, which would expand Medicaid, were carried over to the Monday session scheduled to begin at 7 p.m.
Democratic Gov. Roy Cooper vetoed the budget compromise June 28. Republicans need at least seven Democratic House members and at least one Democratic senator to vote for a veto override.
Compared with the informal — and often heated — back and forth on the veto override since Monday and on HB655 since Tuesday, there was minimal acknowledgment of the two agenda items during Thursday’s two-hour floor session.
It appeared a weary acknowledgment of what Democratic Gov. Roy Cooper said Wednesday, that “in recent days, it has become clear that you do not have the votes to override my veto of the budget. I don’t believe you are likely to secure those votes.”
House speaker Tim Moore, R-Cleveland, told reporters after the Monday night session that “we want everybody to have time to think about where they are on this vote. We’re going to wait until the time is right.”
Cooper’s statement came in a letter to Senate leader Phil Berger, R-Rockingham, and Moore.
“I would like for us to meet in person or by telephone as early as (Thursday) to work toward a compromise budget that requires give-and-take from us all,” Cooper said.
“I’m open to discussing the best way to close the health care coverage gap, but North Carolinians expect us to wrestle with the issue now, not ignore it.”
Berger and Senate majority leader Harry Brown, R-Onslow, left Tuesday for a conference in Berlin, Germany, which Berger’s office said “involves leaders of state legislatures from nearly every state in the country.” The conference, which includes topics such as trade tariffs, Brexit and nationalist trends, is scheduled to end Sunday.
Berger’s office said that Cooper’s offer, made at 5:15 p.m. Wednesday, was “clearly not a good-faith attempt to actually speak” with Berger. There was expected to be an effort for Berger and Cooper to speak directly Thursday.
The N.C. Democratic Party began Thursday a digital ad campaign targeting Berger and Brown’s trip during the budget dispute.
State could function without new budget
Berger has accused Cooper of holding the state budget hostage to Medicaid expansion.
“We hope that the leaders and the governor can finally have a productive conversation about a budget compromise, free from the governor’s ultimatum that no budget can move forward without Medicaid expansion,” said Berger’s office.
“As we’ve said, we do not think a $24 billion budget should be held up over a single policy disagreement.”
Meanwhile, HB655 contains language that would not allow it to take effect until a budget bill is signed into law by Cooper.
When recess was called Thursday, 11 amendments to HB655 proposed by Democrats were teed up for consideration.
In any event, time appears to be running out on addressing either hot-button issue during the regular session.
Unlike federal budget fights that often lead to government shutdowns, the vast majority of state government — estimated at 90% — would operate on a status-quo basis via recurring funding at 2018-19 levels, according to the governor’s office.
Senate Republican leadership introduced a bill Wednesday calling for a July 22 adjournment of the current session with an exception of a limited Aug. 27 session for unspecified reasons.
That’s even though several Senate GOP leaders have issued statements through Berger’s office expressing the urgency of passing the budget for the sake of raises for state employees and public school teachers, and start-up funding for several new initiatives.
Medicaid reform could be postponed
One key initiative involves the planned Medicaid managed-care transformation roll out by the state Department of Health and Human Services.
The prepaid health plan contracts within the transformation will represent a $6 billion expense annually for three years, followed by two one-year options, so the total contract could be worth $30 billion.
The rollout has been scheduled to debut Nov. 1 in the Triad and Triangle, and in February for the rest of the state.
Medicaid recipients were scheduled to begin enrollment in prepaid health plans on Monday. If a recipient does not choose a plan by Sept. 30, one would be chosen for them.
However, the rollout is dependent upon $218 million in start-up funding in the 2019-20 state budget. According to Berger’s office, that money would go toward patient enrollment-broker contracts, provider credentialing, data analytics and other program-design components.
The latest version of Senate Bill 212 contains an amendment that would postpone the entire debut until at least March 1 if the budget is not signed into law by Monday.
“Our Medicaid reform plan will stop and be unable to move forward on our timeline, risking major improvements in care to Medicaid patients who need medical care,” said Rep. Donny Lambeth, R-Forsyth, and a key House budget writer.
DHHS said Thursday that “our current mandate is to move forward with implementing managed care, and we are on track for a go-live date of Nov. 1.”
Prepaid health plans represent a major overhaul in how the state pays for Medicaid patients’ care. Currently, health providers are paid under a fee-for-service system.
Prepaid plans, by contrast, will pay providers a set amount per month for each patient’s costs. DHHS will reimburse the plans.
Public pressure ‘just isn’t there’
Easing some of the tension was Wednesday’s House approval of a stop-gap supplemental appropriations bill, House Bill 111, that permits funding for certain state projects that are dependent on federal money to go forward. The Senate must approve HB111 before the funding is released.
“I think legislative leaders would prefer to take some time away from Raleigh, rather than linger in town while the budget stalemate continues,” said Mitch Kokai, senior policy analyst with Libertarian think tank John Locke Foundation.
“This break will give lawmakers time for vacations, catching up on their day jobs, and raising money for their next election campaigns.”
Passing a clean budget without Medicaid expansion “would likely require a lot of external public pressure that just isn’t there right now,” said Zagros Madjd-Sadjadi, an economics professor at Winston-Salem State University.
“The fact that North Carolina simply continues its previous budget when a new one is not in place means that there is less likelihood of such pressure than would be the case in a state where the government is not allowed to spend at all without a budget.”