Now that the Supreme Court has ruled — again — that the structure of the Affordable Care Act is constitutional, it is time to move forward with making the law work better in our state.

The first, and most important, step is accepting federal funds to extend the benefits of affordable health insurance coverage to 500,000 more people in our state. Gov. McCrory said last year that his staff was assembling options to expand coverage and that he would make an announcement about his recommendation after the Supreme Court ruled in King v. Burwell. The ruling has arrived.

When asked about expansion today McCrory was sort of squishy and said he wants a North Carolina plan. We all do. But first we need the Governor to draft and release such a plan. Conservative Governors in Ohio, Indiana, Utah, Michigan, Tennessee and other states have either closed the coverage gap or assembled a strategy to accomplish a coverage expansion. There’s no reason our Governor can’t do the same.

Legislators are still critical of expansion. Sen. Ralph Hise says that he doesn’t think the federal government will be flexible enough to allow a state option. His wish list includes wanting to expand using private insurance and imposing co-pays on recipients above the federal poverty level.

Of course, the federal government has approved even more conservative measures than Hise mentions. Several states including Arkansas, Iowa, and Michigan do use private insurance to expand coverage. Some states are charging co-pays and premiums even on enrollees earning less than the federal poverty level. The federal government has shown a degree of flexibility that makes many advocates uncomfortable. The idea that our hands are tied is, to quote Justice Scalia, pure applesauce.

Recently released data from the National Health Interview Survey show the dramatic impact of expanding coverage. In Kentucky the adult uninsured rate dropped from 24.1 percent in 2013 to 15.6 percent in 2014. In Arkansas the rate went from 27.5 percent to 15.6 percent. And, most stunningly, in West Virginia the adult uninsured rate went from 28.8 percent in 2013 to 12.2 percent in 2014. These numbers reflect only the first year of expansion and states nearly cut their adult uninsured rates in half. In North Carolina the adult uninsured rate moved from 25.6 percent to 22.5 percent.

A majority of states are expanding coverage while reforming their Medicaid programs. More states will join their ranks now the Supreme Court has ruled that the Affordable Care Act is here to stay. The Governor must show leadership on this issue and ensure that all of our citizens have access to comprehensive, affordable health insurance.

NC Budget and Tax Center

What’s the deal in Kansas these days? That’s a question Governor McCrory and North Carolina’s state leaders should be asking themselves.

After passing huge tax cuts in recent years, the subsequent unimpressive economic performance and continued disinvestment in core public investments in Kansas serve as a cautionary tale for North Carolina.

A recently released report by the Center on Budget and Policy Priorities (CBPP) highlights how Kansas’ economic performance has failed to live up to the promises made by Governor Brownback and his legislative allies. Kansas passed huge income tax cuts in 2012 that reduced annual revenue for public investments by more than $800 million for FY 2014. Proponents claimed the tax cuts would boost the state’s economy.

Last year North Carolina followed Kansas’ lead when state leaders passed and Governor McCrory signed into law a tax plan that includes huge income tax rate cuts and reduces annual revenue by more than $650 million once all tax changes take effect. Here too, the governor and proponents claimed that cutting taxes will boost North Carolina’s economy.

So how is Kansas faring these days?

Kansas hasn’t experienced anything close to an economic surge in the wake of the huge tax cuts. Massive revenue loss has meant continued state funding cuts to core public investments – public schools, colleges and universities, and healthcare services, for example. Read More

NC Budget and Tax Center, Poverty and Policy Matters

This school year, approximately 56 percent of all students in North Carolina public schools come from families with incomes low enough to qualify for free and reduced lunch (up from 48 percent in 2008). Many students within this new majority require extra learning supports, as they lag their peers in core learning areas such as reading, math, and English.

The budget signed by Governor McCrory cuts funding in many areas that help boost student achievement. For the 2013-14 school year, these funding cuts have meant fewer classroom teachers, teacher assistants, instructional support, and instructional supplies. This raises concerns about what the failure to invest in public education means for future student performance. Read More


It looks like Governor McCrory’s role in the big tax cut debate between House and Senate leaders might be merely to market what the legislative leaders come up with.

Here’s what House Speaker Thom Tillis told the News & Observer about McCrory’s role in the discussion about a tax deal.

We need the governor fully on board so he can communicate it and get people to understand it.

That’s a bit of an odd take from Tillis. He didn’t say they need to work with the governor because he is running the state or because he is the top elected official of their own political party or heaven forbid, because he might have some policy ideas and strongly held views of his own about taxes.

No, they need the governor on board only to sell the package that Berger and Tillis decide on. It is pretty clear legislative leaders believe they are in charge in Raleigh these days. McCrory? He is their PR guy.


The following four charts demonstrate why NC Medicaid, far from being “broken” or worthy as a scapegoat for every unpopular budget decision made by the NC General Assembly, is containing costs better than any Medicaid program in the country while helping create better health for North Carolinians.  The letter reproduced after the charts shows how disingenuous the “Medicaid is over budget” claim is by Governor McCrory and legislators.

1.  NC Medicaid cost growth is very low.  Just plotting some simple data from the Kaiser Family Foundation shows that the average annual growth in NC’s Medicaid program has declined for the last twenty years and the program is now growing more slowly than the national average.  Current annual cost growth for Medicaid in NC is actually the lowest in the nation and much lower than the national average:

medicaid growth chart

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