Ideology holding up budget agreement, not Medicaid

Ideology holding up budget agreement, not Medicaid

- in Fitzsimon File


It turns out that the disagreement between the House and Senate over the cost of Medicaid next year is not the only thing holding up a final state budget that provides a pay raise for teachers and state employees.

Senate President Pro Tem Phil Berger told WRAL-TV that any budget deal must not only include the Senate’s estimates of Medicaid costs but must also reduce the number of people who are covered by the program.

Berger said the Senate wanted “reductions in the welfare spending that is ongoing at the present time.”  Medicaid, the health care safety net for the most vulnerable people in North Carolina, is now welfare in Berger’s far-right view of the world.

The budget the Senate passed earlier this session would kick at least 5,200 aged, blind and disabled people off of Medicaid. More than 1,600 of them have Alzheimer’s or dementia and are in special care units, which to Berger must be a new fancy way of saying welfare.

And the numbers are conservative estimates. They come from a conservative Berger knows well, State Budget Director and Republican Party benefactor Art Pope, who detailed what the Medicaid cuts would mean in a recent appearance before the Senate Appropriations Committee.

The discussion then was about the differences between projected Medicaid costs in the budgets created by the House, Senate and Governor Pat McCrory.  Pope was making the point that Senate projections of Medicaid costs for the fiscal year that began July 1 were far too high and forced the Senate to fire 7,000 teaching assistants in its budget and kick people off of Medicaid.

(It is important to remember that all three of the budgets ignore an obvious way to raise revenue to pay for a teacher pay hike, simply cancel the next round of tax cuts for corporations and the wealthy scheduled to take effect January 1. The top one percent of North Carolina taxpayers received a $10,000 cut on average in last year’s tax package. They don’t need another one.)

Senate leaders responded testily to Pope’s presentation before the budget committee, sticking by their exaggerated Medicaid cost projections.  Berger mentioned them in the WRAL interview too, repeating an earlier assertion that Pope’s Medicaid numbers are not accurate.

But now it’s clear that the budget dispute is about more than numbers. It is about Medicaid itself.

Pope’s almost emotional explanation about the vulnerable seniors who would lose coverage under the Senate cost projections was widely seen as a powerful  response to the suggestion by Senate leaders that their inflated cost projections were a responsible way to put the budget together.

But it’s not so effective if one of the goals of Senate leaders is to kick 5,200 aged, blind and disabled people off Medicaid.

They are not worried that their cost projections will force them to kick people off the program because they want to kick people off the program.  It’s welfare after all.

That’s what it has come to in this budget dispute between hard core conservatives and tea party conservatives. One reason there’s no budget deal is that Senate leaders don’t want to give teachers a raise unless they can cut off care for 1,600 seniors with Alzheimer’s and dementia to help pay for it.

And to think we used to be a reasonably compassionate state.