by Nicholas Patti
September 24, 2023, Wake Forest, NC—When it comes to enacting Medicaid expansion in North Carolina, ya gotta do what you gotta do.
At least, that is, according to Democratic Governor Roy Cooper. Calling the 2023 NC state budget a “bad budget,” the Governor has decided to allow it to become law after 10 days from its passage this past Friday, without his signature, according to Dawn Baumgartner Vaughan, writing for the News and Observer (Raleigh, NC, 9/23/2023, digital edition).
Gov. Cooper’s reason for allowing this budget to become law was Medicaid expansion: “I will not allow people who are crying for help to wait any longer, so I am directing our Department of Health and Human Services to begin today the process for expanding Medicaid while allowing this budget to become law without my signature,” Cooper was quoted as saying in the News and Observer (Raleigh, NC, 9/23/2023, digital edition).
Medicaid expansion will provide health care coverage to roughly 600,000 uninsured people in North Carolina, according to Gov. Roy Cooper, as quoted in the News and Observer (Raleigh, NC, 9/22/2023, “NC State Budget Passes GOP-controlled Legislature, Cooper Will Let it Become Law. Here’s Why,” newsobserver.com). Allow me to explain the context. Medicaid expansion will fill in a gap left over a decade ago when Obamacare passed, federally, and covered most Americans. These 600,000 uninsured North Carolinians represent the working poor in North Carolina, people who fall into a gap between traditional Medicaid for the poor, and Obamacare coverage for regular workers who lack workplace coverage, otherwise, and who must pay a small premium. Medicaid expansion fills that gap, and covers the working poor, previously uninsured, for no premium.
Enacting Medicaid expansion in North Carolina arrives now after 10 years of delays, due to resistance from some sectors of the Republican party in the state. Medicaid expansion has long been a policy goal of Democratic Governor Roy Cooper.
Republicans in North Carolina deserve credit, however, for changing their minds and delivering on Medicaid expansion this year. It will come with the enactment of the state budget, which Medicaid expansion was tied to when it passed, separately, last Spring.
This Medicaid expansion represents a policy achievement in North Carolina this year, after a decade’s worth of effort, I would argue. Governor Cooper noted the timeline while criticizing the legislature for not acting sooner (News and Observer, Raleigh, NC, 9/22/2023, website article, newsobserver.com).
Republican state legislative leaders are rightly proud of their work this year. “…I think that’s an indication that this budget is a solid budget, something that’s good for the state of North Carolina,” said NC Senate leader Phil Berger, Republican, on Friday, following the budget’s passage in his chamber, as quoted in the News and Observer (Raleigh, NC, 9/23/2023, digital edition). Berger cited the $2 billion of funds for water and sewer projects statewide, as well as tax reductions and Medicaid expansion, all included in the budget, according to Dawn Baumgartner Vaughan, reporting for the News and Observer (Raleigh, NC, 9/23/2023, digital edition).
While the budget was working its way through final passage, another Republican representative praised it this way: “This budget is built on key investments in our state’s infrastructure, meeting our needs in health care, education, transportation, manufacturing, and tourism, just to name a few,” Rep. Donny Lambeth, Republican, was quoted as saying in the News and Observer (Raleigh, NC, 9/22/2023, digital edition).
The budget includes, also, an average of 7% raises for teachers, over two years, and raises for most state employees, as reported by Luciana Perez Uribe and Avi Bajpai in the News and Observer (Raleigh, NC, 9/22/2023, digital edition). In addition, the budget moves more appointment powers, for state boards and the judiciary, to the legislature, and away from Governor Cooper, in the executive branch, as reported on Spectrum News 1 (Raleigh, NC, 9/23/2023, Spectrum cable television news channel, 1 pm broadcast).
Governor Cooper has said that, despite the raises for teachers, the budget “shortchanges our schools… and prioritizes power grabs.” He warned that “many of its provisions will face legal action,” he was quoted as saying in the News and Observer (Raleigh, NC, 9/23/2023, digital edition).
Expanding casino gambling was not included in the budget, which spends roughly $30 billion of taxpayer money, according to the News and Observer (Raleigh, NC, 9/23/2023, digital edition; 9/20/2023, digital edition). Too many people, and their representatives in the state legislature, believed that casinos, even with the extra jobs in rural areas and extra revenue coming to state government; too many people felt that casinos were fundamentally inconsistent with their vision of a good, wholesome Southern culture.
That vision of an almost utopian Southern culture was laid out in the final chapter of William Faulkner’s classic Southern novel, The Sound and the Fury (1929). This chapter involved a Sunday service in a fictional Southern Protestant church. Needless to say, this vision did not include casino gambling.
I would point out, however, that video lottery terminals have long been a fixture of Southern cities in North Carolina. These are currently illegal and are continually being shut down. In addition to casinos, these would have been made legal, as well, according to the News and Observer (Raleigh, NC, 9/20/2023, digital edition).
Coming back to reality today in the South in North Carolina, there are currently two options available already, now, for North Carolinians to gamble, today. These casinos include slot machines, which work on-site via video. One option is the Cherokee casino in Cherokee, North Carolina, in the mountains in Western North Carolina. The second option is right across the state line in Danville, Virginia, in Southern Virginia. This second option is a Caesars casino that is already open and which serves many customer-gamblers driving from North Carolina across state lines to Danville, Virginia, according to a recent report on WRAL news (Raleigh, NC, reported from Danville, VA, NBC, Chan. 3 on Spectrum Cable television, Raleigh).
This NC budget merely failed to legalize and expand casino gambling beyond these two options, which already exist. I am in favor of legalizing casino gambling, since I believe it is a rewarding form of entertainment, mainly, for the casino customers. The house (casino) provides a thrill, which is the chance to win money for your bets, in exchange for your money, which are your losses to the house, in the main, predominant instance. Personally, I see nothing intrinsically wrong with this form of entertainment, primarily, except when customer-gamblers spend and/or lose too much money. That is called gambling irresponsibly. There should be telephone help lines available for all gamblers to teach responsible gaming, and to fight any gambling addiction. These lines should be open and available, from the state regulating authority, at all hours during casino open hours. This way, a potentially addicted gambler can call the state gambling help line, instead of betting and losing all of their money in an irresponsible bet. I am serious about this. Not everyone is taught how to gamble responsibly, and limit their losses, and some gamble irresponsibly, and harm themselves, financially, in the process. Along with legalization, regulation, and taxation, there should be support and education for how to gamble responsibly. This is called responsible gaming. It can be fun, although one usually does lose some money, in the process.
In any case, expanding gambling in North Carolina is not happening, at this time. I support expanding gambling options, beyond what already exist, although with requisite support and education to foster responsible gaming and to fight any kind of gambling addiction. In addition, I do not have a problem with leaving the gambling to the Native Americans in what amounts to a gambling monopoly inside the state. Glutting the market is not necessarily good business sense, especially when it comes to gambling.
On balance, I give credit to Republican legislative leaders in North Carolina, including House Speaker Tim Moore, Republican, and Senate leader Phil Berger, also a Republican, for enacting a new NC state budget, and for finally expanding Medicaid in North Carolina. The business of state government has been taken care of in North Carolina, although largely along Republican lines and vision.
Enacting Medicaid expansion in North Carolina represents the achievement of a longer-term policy goal of mostly Democrats, however, I would point out. Governor Roy Cooper, Democrat, deserves credit for allowing this achievement to take effect.
Although I would have preferred a new NC state budget that followed more of a Democratic vision, as expressed by Governor Cooper, Democrat, I applaud all state leaders in North Carolina, Democrat and Republican, for finishing the job, finally, and for taking care of the people’s business. Republican legislative leaders and the Democratic governor proved able to pass a new NC state budget, and more to the point, to expand Medicaid, finally.
For this, they deserve credit.
—Nicholas Patti
Wake Forest, NC
USA
Additional Sources:
This blog: post, 4/1/2023; post, 10/17/2022. Address: nickpattifeatures.com.
News and Observer, Raleigh, NC: 9/23/2023, digital edition; 9/22/2023, digital edition; 9/22/2023, website article, newsobserver.com; 9/20/2023, digital edition.
Spectrum News 1, Raleigh, NC, 9/23/2023, Channels 1, 14, Spectrum cable television.
WRAL news, WRAL, Raleigh, NC, 9/22/2023, NBC, Channel 3, Spectrum cable television.
WUNC, 91.5 FM, Chapel Hill, NC, 9/22/2023, NPR-affiliate, radio, broadcast and internet.
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