You have to give Republican legislative leaders credit for one thing. They are getting better at avoiding the blame they deserve for the disastrous budget decisions they made this summer. And the Democrats are making it easier for them to get away with it.
The finely honed obfuscation technique was on full display Thursday morning as a key legislative oversight committee discussed a shortfall in the state Medicaid program that could mean an end to many services for adults with a mental illness and prevent seniors on Medicaid from receiving eye glasses or help seeing a dentist.
The Republicans’ priority this year was to cut taxes no matter what, not keep teachers in the classroom or provide help for laid off workers or protect vital services to the most vulnerable people in the state.
That meant massive budget cuts in almost every state program. But the legislators didn’t want people to blame them for the services they were losing, so they wrote a budget full of smoke and mirrors to make it unclear who was behind the painful decisions.
Nowhere was that more true than in Medicaid. The budget slashed state funding for the program by more than $350 million this year, which translates to an actual cut of more than a billion dollars when you take into account that every state dollar is matched 2 to 1 by the federal government.
Part of the cuts were savings built into the Medicaid budget that Republicans knew were impossible to achieve. They knew because Governor Beverly Perdue and other state officials told them. Legislative staff members even pointed out the budget was double counting a reduction in the normal inflationary increase.
But it didn’t matter. The Republicans included the savings in the budget anyway because they needed to find a way to cut taxes to appease their ideological base. They also included in the budget orders for officials with the Department of Health and Human Services to reduce Medicaid services and reimbursements to health care providers if the unrealistic savings were not realized.
Thursday, HHS Deputy Secretary Michael Watson told lawmakers that Medicaid was facing a projected shortfall of $139 million, which had to be one of the least surprising revelations made at the General Assembly in quite a while.
Some of the Medicaid changes made in the budget have not yet been approved by the federal government, just as state officials predicted. The savings from Community Care of North Carolina, a successful managed care Medicaid program, are also falling well short of the Republicans wildly rosy predictions.
Watson told lawmakers the shortfall could mean an 18 percent reduction in rate Medicaid pays medical providers and acknowledged in response to a question that many adult mental health services could end.
The federal government is unlikely to approve the rate reduction, so that would mean slashing even more services for seniors and people with disabilities.
The Republicans couldn’t stand for the truth to stand unchallenged, so they leapt into full obfuscation mode with a two-pronged strategy, blame and mislead.
Representative Nelson Dollar said budget writers had to deal with one-time payments and refunds in Medicaid because of bad decisions made by Democrats in previous years. In essence, it is all the Democrats fault.
True or not, building those payments and refunds into the budget is hardly justification for counting on savings that you know will never materialize.
Dollar and Senator Pete Brunstetter both then repeated the misleading claims they made during the budget debate, that the expected savings were reasonable and they would work with HHS officials to find them.
Neither Dollar nor Brunstetter mentioned the doubly counted cut in the inflationary increase. It’s harder to blame that on somebody else.
Brunstetter said there was some “unfortunate finger pointing” going on about the Medicaid shortfall, apparently referring to comments by Perdue administration officials pointing out the absurdity in the Republicans’ claims.
But the problem wasn’t that finger pointing was going on, the problem was that not enough fingers were being pointed. Watson, the HHS official making the Medicaid presentation, missed several opportunities to make things clear for legislators and the media on hand.
And only Senator Minority Leader Martin Nesbitt asked any tough questions in the face of the Republicans blame-and-mislead dance.
The bottom line is that Republicans passed a budget that will force state officials to cut off vital services to seniors and people with disabilities. And they knew they were doing it.
The public deserves to hear that truth. Governor Perdue and her administration need to plainly speak it.