The Caucus: Medicaid Stalemate

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Medicaid Stalemate

The state House and Senate passed separate bills to provide more funding for the Medicaid rebase, which is the amount of money needed to keep providing current service levels. But neither chamber took up the other side’s bill—talking past each other in a way that Gov. Josh Stein called “crazy.”

State health officials say the legislative impasse will result in cuts to Medicaid services starting October 1.

“Under North Carolina law, the state is required to maintain a balanced budget, meaning we cannot spend money knowing we will run out well before the end of the fiscal year,” Department of Health and Human Services Secretary Dev Sangvai said in a statement. “Without legislative action, health care providers will see reduced payments and North Carolinians will see reduced access to care. It is time to stop delaying and do what is right for the people of North Carolina.”

So who’s at fault? 

Initially, Republican Senate leader Phil Berger blamed the House. The Senate Medicaid bill included new funding for a planned children’s hospital in the Triangle that Berger has championed, and the House version didn’t. Berger said House Republicans were going back on their word from 2023 budget agreements to keep funding the hospital, as well as a rural health partnership between East Carolina University and UNC Health.

“Ask the House why they changed their position on the other matters that are in there,” Berger told reporters. “They have previously agreed to do those things. Why are they opposed to them now?”

House Speaker Destin Hall, who wasn’t speaker in 2023, sees things differently.

“Ask the House about what? … We all know one General Assembly can’t bind another one,” Hall said.

House and Senate Republicans also sought to redirect blame from one another to the state’s Democratic governor, arguing Stein’s administration was exaggerating the shortfall.

In a news conference on Thursday, Stein acknowledged he could push back the October 1 reductions but said doing so would only incentivize continued inaction in the legislature and lead to steeper cuts later.

The forthcoming cuts include an at least 3 percent reduction in provider payment rates and an end to coverage of GLP-1 drugs like Wegovy for people who use them for weight loss.

On Stein’s Desk

It wasn’t entirely unproductive at the General Assembly, however. Several bills are on Stein’s desk after passing both houses.

The one that’s getting the most attention: A crime bill in response to the killing of Ukrainian refugee Iryna Zarutska.

Read more legislative updates here.

— Bryan Anderson

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Thanks for reading The Caucus, a politics newsletter anchored by Bryan Anderson. Reach us with tips or ideas at politics@theassemblync.com.

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Budget Nuggets

Don’t hold your breath for a comprehensive budget any time soon. 

I asked Hall if anything had changed in budget negotiations since talks collapsed in June. He replied: “If anything has changed, both sides are even more clear at this point where the other side stands. And both sides have a sense of the steadfastness, maybe, of the other side. And on the House side, we’re even more aware of the righteousness of our cause.”

If that’s not ominous enough, he added, “I hope that we do have a budget this biennium.” (This biennium goes through the end of 2026.)

Lawmakers return to Raleigh for possible votes the week of October 20.

Post of the Week

The budget dispute is between House and Senate Republicans; state Democrats are on the outside looking in. So Democratic Rep. Vernetta Alston enlisted the help of her five-year-old son, Davis, to try to find a budget. Despite wandering (adorably) around the Capitol checking bushes and grates, they couldn’t find one. 

Davis, if you happen to find a budget, please let us reporters know. The next time I walk across the bridge to get into the back of the Legislative Building, I’ll also be sniffing for the smell of chicken nuggets.

Rumor Has It

CBS17 reported Thursday that Berger would accept an endorsement from President Donald Trump, and in return, get in on the national redistricting wars by redrawing the 1st Congressional District to be more favorable to Republicans. Carolina Forward, a liberal advocacy group, had posted something similar on X earlier in the day.

The Assembly reached out to Berger’s office and political advisers, who either didn’t respond or said they didn’t know anything about it. Multiple GOP senators said they had not been told of any plans to return to Raleigh to redraw congressional boundaries.

Berger responded on X to Carolina Forward’s post, writing, “If we have to draw one more map this year, we will. That said, I’ve never spoken to President Trump about this or an endorsement. The Democrats are spreading lies to hurt President Trump.”

As we’ve reported, North Carolina Republicans have a 10-4 advantage in the U.S. House delegation, with one of the four Democratic seats a tossup—the 1st Congressional District seat held by U.S. Rep. Don Davis. By redrawing Davis’ district, Republicans would risk opening themselves to racial gerrymandering claims and a costly legal battle.

— Bryan Anderson

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Review Date Unknown

A 57-year-old man who’s been incarcerated in state prison for four decades agreed this month to settle a lawsuit he brought against the North Carolina Post Release Supervision and Parole Commission for what he contended is a flawed review process.

Brett Abrams was convicted of second-degree murder in 1984 for the fatal stabbing of a neighbor. Just 14 at the time, Abrams was sentenced to life in prison with an opportunity for parole. But the commission has repeatedly rejected his efforts to get provisional release.

Abrams, who has been in minimum custody for the past 15 years, has also been on work release, employed for 40 hours a week in the community. Because of a 2015 ruling in a different case challenging the parole review process for inmates convicted as minors, commissioners are supposed to consider whether the potential parolee has been rehabilitated.

— Anne Blythe

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Search and Seizure

A federal lawsuit alleges a veteran highway state trooper punched a man having an epileptic seizure after the man hit another car and crashed into a utility pole. Then, the lawsuit says, the trooper charged the man with assault on a government official and resisting arrest. 

The lawsuit also claims witnesses told the trooper that the man was having a seizure.

— Michael Hewlett

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One Year After Helene

Our partners at NOTUS have a behind-the-scenes look at FEMA and the dysfunction that employees say is slowing the flow of funds to Western North Carolina.

Meanwhile, I sat down with Democratic state Rep. Lindsey Prather of Buncombe County to mark the anniversary of Hurricane Helene. She said federal support has been slow to reach the region and that the state should be doing more to provide grants to keep small businesses afloat. She’s also concerned about the pace of debris removal.

So what’s the best thing people can do to support the region? Prather says to come visit. Here’s what she recommends doing:

• Hire a hiking trail guide to support the outdoor recreation industry
• Enjoy a LaZoom Comedy Bus Tour
• In addition to the WNC Farmers Market on Brevard Road in Asheville, visit tailgate markets to support local family farms

— Bryan Anderson

Let us know what’s on your radar at politics@theassemblync.com.

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