Republican leadership in the state House delayed Wednesday — for an 11th consecutive session — a vote on overriding Democratic Gov. Roy Cooper’s state budget veto.
As has been the pattern, neither the veto override vote nor the bipartisan Medicaid expansion legislation House Bill 655 was addressed on the House floor Wednesday.
The next opportunity for a floor vote will come Monday night, which would represent Day 32 of the stalemate.
Cooper vetoed the bill June 28, citing the lack of Medicaid expansion as a primary reason, along with not enough funds in the Republican budget compromise dedicated to public education spending, infrastructure and environment issues.
Republicans need at least seven Democratic House members and at least one Democratic senator to vote for a veto override.
Attempts to reach across the aisle for votes are being decried as interloping, if not bribery, with GOP offers of earmarking money in the budget for special projects in eastern North Carolina to sway those Democratic legislators.
All of which makes it more likely that budget negotiations will go on for weeks, if not months.
House speaker Tim Moore, R-Cleveland, told reporters after the July 8 session — the first session to skip a vote — that “we’re going to wait until the time is right.” He has said there will not be a vote on HB655 until the state budget veto override is approved.
Moore told online legislative media outlet The insider after Monday’s session that he believed House GOP leadership is “close” to having enough votes to make a veto override attempt.
“We have no plans to shut down next week, or the week after; we’re going to continue working,” Moore said Monday.
Berger makes new claims
The lack of a vote Wednesday doesn’t mean that either side has eased up on their public claims about the tightly intertwined issues.
For example, Senate leader Phil Berger, R-Rockingham, cited Tuesday an October 2016 New England Journal of Medicine report about the rate of use of emergency departments by individuals covered since Oregon expanded its Medicaid program through a random lottery mechanism in 2008.
Berger said, citing the report, that “the mean number of visits per person increased... over the first six months by about 65%” compared with people who were not selected for Medicaid expansion coverage. The pattern held for the next three six-month periods that covered 2009 and 2010.
“The objective data debunks the argument that Medicaid expansion will result in fewer emergency-room visits,” Berger said.
He said supporters of expanding Medicaid in North Carolina to between 450,000 and 650,000 residents “argue that new Medicaid beneficiaries would have a primary-care physician, eliminating the need for expensive emergency-room visits for minor medical issues.”
“But the data clearly shows that’s not how it works. Expanding Medicaid is not good policy, and it is not the silver bullet that proponents sell it as,” Berger said.
However, researchers said in the same report that “we estimated that Medicaid coverage increased the joint probability of a person’s having both an ED visit and an office by 13.2 percentage points.”
“We found no evidence that Medicaid coverage makes use of the physician’s office and use of the ED more substitutable for one another. The type of people who use more care when they gain Medicaid coverage are likely to increase use across multiple settings.
“If anything, the results suggests that it makes them complementary ... that primary care providers may sometimes encourage patients to seek such (ED) care,” such as to take emergency measures to reduce an individual’s blood sugar count.
Federal funds keep flowing
The House approved the passage of House Bill 961 on Wednesday.
The bill provides authorization of federal funds while the state is operating on a $23.8 billion continuing budget.
The vast majority of the appropriations go to block grants overseen by the N.C. Department of Health and Human Services, including $970.5 million for fiscal 2019-20 and $913.7 million for fiscal 2020-21.
“The Senate has now passed legislation to ensure that on-going federal funds are not held up during the state budget impasse,” Berger said Monday. “We hope that Governor Cooper will drop his Medicaid expansion ultimatum and negotiate a full budget that delivers on important priorities across the state.”
Berger has opposed HB655, which he has criticized for including a charge to hospital and medical providers that he says will serve eventually as a tax on patients even thought the N.C. Healthcare Association supports the assessment.
The bill has drawn criticism for including a work and premium-payment requirement on recipients, both of which have been halted by a federal judge in Arkansas and Kentucky.
Cooper has said he is willing to accept key elements of the Republican budget, such as supporting all the special local projects that Republican leaders have been promoting to entice Democratic legislators to support a veto override.
Cooper said his counterproposal on the budget includes restoring the $42.2 million to renovate the Stevens Center in downtown Winston-Salem and $15 million for the Hauser building renovation at Winston-Salem State University.
Cooper said his proposal pays for those special projects by eliminating the next round of corporate tax-rate cuts, slated to go from 3% to 2.5%.