The man in the photograph is the reason we can’t have nice things.

Specifically, Senate leader Phil Berger is the reason the N.C. Senate budget, passed Thursday, includes no provision for Medicaid expansion, which could provide health care coverage for the hundreds of thousands of North Carolinians who currently have none.

The N.C. House budget, passed earlier last week, had no such provision, either, even though sound proposals were made to both bodies.

But it’s not a done deal yet. We’re hanging on to hope that the threat of a veto from Gov. Roy Cooper may finally achieve a long-desired positive outcome.

Support for Medicaid expansion has never been higher — a poll cited earlier this year by the N.C. Fund for a Conservative Future showed more than 70 percent of North Carolinians in favor. That number included not only 90.1 percent of Democrats, but 66.9 percent of unaffiliated voters and 52.4 percent of Republicans. Numerous medical professionals, business leaders and others want it.

Medicaid already serves about 2.14 million North Carolinians — a bit over 20 percent of our population. Expansion could benefit from 450,000 to 670,000 more residents, giving them access to affordable primary physician care and reducing their dependency on expensive hospital emergency department services.

But Berger has been opposing Medicaid expansion for so long it’s probably just second nature now. He’s stood in the doorway since 2013, when the option was first introduced as a function of the Affordable Care Act. Then, Berger argued that the federal government might back out of its promise to pick up the entire cost for the first three years and more than 90 percent after that.

But the claim was a scare tactic and a knee-jerk reaction against President Obama. When has the U.S. government failed to meet its obligations?

Berger has also said that Medicaid expansion “disincentivizes folks to go to work,” which seems to us like a rather negative way to view hard-working North Carolinians. And Berger has failed to exhibit any interest in House Bill 655, sponsored by state Rep. Donny Lambeth of Forsyth County, which includes a work requirement for some recipients.

A statement from Berger’s office last week said that “while Democrats have focused their efforts on expanding socialized medicine via Obamacare Medicaid expansion, Republicans believe that care for people with severe disabilities should be prioritized over taxpayer funding for able-bodied adults.”

Notice the hyperbole: “Socialized medicine via Obamacare.” Thirty-seven states have signed up for Medicaid expansion, including several red states that initially resisted. None of them have turned over the means of production to Marxists.

And why the either/or? Do we really have to choose between health care for people with severe disabilities and health care for able-bodied adults? Everybody needs to see the doctor now and then.

These are not good-faith arguments. They’re excuses. North Carolinians need health care and Berger has not pursued any reasonable course for providing it — he’s only blocked others’ good-faith efforts.

He’s right, though, that providing health care for those left out has been a priority for Democrats. Cooper and leading legislative Democrats say that expanding Medicaid for low-income people is their No. 1 priority.

According to Cooper’s office, “Expanding Medicaid would bring billions of dollars into North Carolina, create thousands of jobs and help 500,000 people get access to affordable health care.”

That sounds pretty good to us.

Even if that picture is overly rosy, it’s a better response to our citizens’ needs than leaving them dangling. We hope, in the ninth inning, to finally see some action on Medicaid expansion that is reasonable, affordable and compassionate.

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