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Carolina Journal Radio No. 821: Candidates make early jump into 2020 races

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Truth Network Radio
February 11, 2019 12:00 am

Carolina Journal Radio No. 821: Candidates make early jump into 2020 races

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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February 11, 2019 12:00 am

Candidates are already lining up for the 2020 elections in North Carolina. It’s not unusual to see candidates jump into a race a year before the election. But some might be throwing their hats into the ring even earlier than normal. That’s because primary elections have been moved up from May to March. Rick Henderson, Carolina Journal editor-in-chief, discusses developments in the upcoming races for governor, U.S. Senate, and other important statewide elected positions. Some governments use sin taxes to nudge people away from behavior that elected officials and bureaucrats dislike. Adam Hoffer, associate professor of economics at the University of Wisconsin at Lacrosse, discusses the problems associated with using taxation to spur behavioral change. His comments are linked to his work from the recent book For Your Own Good. The University of North Carolina at Chapel Hill faced a couple of recent surprises. Chancellor Carol Folt announced her resignation, then decided to remove the pedestal of the controversial Silent Sam Confederate monument in the middle of the night. That move prompted UNC System officials to move up Folt’s departure date. Harry Smith, chairman of the system’s Board of Governors, explains why he and his colleagues took action. The N.C. Supreme Court recently celebrated its 200th anniversary. Speaking less than three weeks before he announced his resignation, Chief Justice Mark Martin urged colleagues to set aside personal policy preferences to work together in upholding the rule of law. N.C. lawmakers will face pressure this year to expand the state’s Medicaid program. Jordan Roberts, John Locke Foundation health care policy analyst, says Medicaid expansion would create problems for North Carolina, even in a form different from the expansion proposal tied to President Obama’s Affordable Care Act.


From Cherokee to current attack from the largest city to the smallest town and from the statehouse into the schoolhouse Carolina Journal radio your weekly news magazine discussing North Carolina's most public policy events and issues welcome to Carolina Journal, radio, luggage, coca during the next hour, Donna Martinez and I will explore some major issues affecting our state. Some governments like to use syntaxes to nudge people away from behavior that government officials dislike will chat with an economist who labels this bad public policy.

The University of North Carolina's governing board reacted recently when the Chapel Hill campus, Chancellor abruptly resigned and had the remnants of the controversial silent Sam Memorial removed in the middle of the night to learn details North Carolina's Supreme Court recently celebrated its 200th anniversary courts Chief Justice use the occasion to remind his colleagues about the importance of the rule of law and will discuss the prospects this year for Medicaid expansion of North Carolina. Why is expansion a good idea or a bad idea. Those topics are just ahead. First, Donna Martinez joins us with the Carolina Journal headline.

The calendar says 2019 and but for those seeking elective office in North Carolina 2020 is clearly already underway were starting to hear official announcements of people who want to be the next governor, Lieut. Gov. or US senator representing North Carolina Carolina Journal is following all of these races. Editor-in-chief Rick Henderson joins me now with an update.

Welcome back. Thank you. So I think this is maybe the first time that you and I are chatting about 2020 in earnest here yes because it is really not that far off, as evidenced by these announcements. Let's start first with the impending race to be the next governor of North Carolina we have a Republican says he's in charge to enforce Lieut. Gov. so we completing his second term and term limited to, the governor has formed an exploratory committee, which means he can raise money and is pretty much the signal he's going to run these put out a newsletter for video and the like, and he's going to challenge the Democratic incumbent Roy Cooper almost certainly and Cooper probably is not going to face any primary opposition to the question is will be a forest face serious primary opposition. He probably will have some but how will be more the token opposition was a chance at the riverbed yeah that's on the big questions on the Republican side. I know at least in the past there's been some polling that would show that that you would be quite a race in a primary between Pat McCrory and Danforth. That's right yes and and the the issues there was a fairly recent poll by the Democratic Republic policy polling which still shows that they enforce doesn't really have a lot of name recognition that the about close to two thirds with generally no opinion about whatsoever is plus minus is about even as far as favorable or unfavorable's value, but very low numbers of Pat McCrory has slightly ugly, slightly positive, favorable versus unfavorable, but there are still about 1/4 the voters don't have an opinion about him so that it's it will be interesting to see Dan Forrest has been an effective campaign or a me the question here is going to be who was going to get money behind both have been very effective fundraisers and so the big Republican donors choose to pick one or the other. That person certainly would be favored. Do we know for sure that Roy Cooper is going to run for reelection.

I mean officially well that we don't know that yet officially we imagine that he is if you were to get into some sort of ethical trouble or something like that. That of course he may decide not to but better producing only governor in the fruit category last two governors are the only ones in the arrow that we've allowed governors to succeed themselves who have not won a second term, and so there but I don't know if Roy Cooper will break that streak or if you will decide not challenge this prequel to see how that goes on at the stated moment first pallets. Let's move to Lieut. Gov., of course, and that is the seat that Dan Forrest currently holds and we haven't heard from Republicans at least officially yet about anyone wanting to get into the race, but several Democrats wanted yet what we already got two fairly high profile names who said they're going to run Terry Van Dyne is State Sen. from Buncombe County.

A very progressive center Cal Cunningham is a former State Sen. businessman whose run for a couple of races in the past larger that you are outside the general assembly not successfully think about Cal Cunningham is very interesting is that he has received the endorsement of Linda Coleman, who was the nominee the nominee for governor in both of the races against Dan Forrest and is very well known in Democratic Party survey will known form of the state Board of Education former member of the White County Board of commissioners. I believe and also was someone who had the full endorsement of State employees Association of North Carolina, both during both of her races and so her weighing in immediately. Just as soon as Cal Cunningham announced his intentions. Within days of the Coleman said this is my guy that may have some impact and probably because Cunningham is not going to be quite as progressive as is Terry Van Dyne I think Democrats kinda sensing a good year in 2020, possibly an a don't want to blow it by nominating somebody who so far left that that which the unpalatable mode here in North Carolina. The standard conventional wisdom is that anyone who is looking to be Lieut. Gov. really wants to be governor right and wants to use that as a steppingstone, could we see maybe a crowded field on both sides of the aisle just for people who are maybe thinking they don't have a chance at enough statewide recognition to actually make it into the office, but it could be that first time to put their name and their image before statewide overdubbing.

That's what possible good to see that sort of issue coming up with the potential special election races for Congress. We may have one of the third District because of Walter Jones's illness where one of the ninth district because of the concerns about the potential of ballot fraud there and so this again will give a larger safe someone would say like a familiar general assembly or someone who's has a fairly limited audience so the race forward to the government provide the same sort of opportunity. You may see several current members of the general assembly.

For instance, decided they will try to step up and run for governor or you may see some former mayors or who want estate will the statewide platform and greater ambition. Step were also get to see a fascinating 2020 race for a seat in the United States Senate. Now Republican Tom Tillis will be up for reelection. First, all do we know at this point if Sen. Tillis is going seek a second term. We have not got an official announcement yet and he left the possibility open that he would not seek a second term doll Trump was elected president because he was very concerned about criminal justice reform. You may recall that the original Atty. Gen. Jeff sessions as opposed to that that we've seen some movements toward that. So Sen. Tillis may decide he will smooth well because he's consider that to be a big issue for him and so that that may have prodded him to consider making a run next time around. He does have about $2 million in the bank. By the way have we heard any rumblings even behind-the-scenes about Republicans who might want to either run for that seat if Tillis decides not to run for reelection or may be given a primary challenge. Well I don't know that Sen. Tillis gets a primary challenge from a serious contender because one thing he won the race very improbably. He was not expected to win that seat in 2016 and so is she certainly shown his acumen as a campaigner to fundraiser but if you were to decide not to run for another term. I give us a plus eat the peppercorn might consider. There are others who may go in there and that if if it if Tillis is out. You may see a very crowded primary field to try to see that the six year term right for U.S. Senate, so I think Tillis was elected in 14 then sees happening outlining what the Democratic side that we've Artie got some people saying that they want a shot at that.

That's right that we don't have a high profile contenders, yet the highest profile contender is a century, Sen. Erica Smith of Northampton County but we have a couple of lesser known candidates. Trevor Fuller from Mecklenburg County Eva Lee from Raleigh. The pressure is going to be on trying to attract candid, high profile candidates who conceivably could raise money and compete with Tillis and the names that are coming out are a Deborah Ross who barely lost to Richard Burbach in 2016 that also. Atty. Gen. Josh Stein and former Charlotte Mayor former housing secretary Anthony Fox, the dynamics of the 2020. Once again, will be fascinatingly know North Carolina will be a battleground in the presidential race could presidential race dynamics impact who decides to get in. For example, if Democrats think it'll be a Democratic year the presidency will we see more jump in and conversely Republicans as well. We sure will that's that's quite possible to force the Republican national convention is going to be in Charlotte so that's a another opportunity for people to get on the big stage and so it's it's going to be this would be very fascinating year 2020, already underway, and of course Carolina journal will be reporting on all of these key races in the monthly print edition as well as Carolina leave in talking with Rick Henderson as editor-in-chief. Thank you stay with us much more Carolina journal radio to come in just a moment government plays a key role in your life affecting your paycheck the way you educate your kids the way you do business.

How can you tell if government is doing a good job making the right choices. Spending tax dollars wisely. Carolina tackles those questions every day. The John Locke foundation publishes Carolina journal in print each month and on the web each you'll find exclusive investigative reports on topics. No one else is covering what else a rundown of the best new stories, editorials and opinion columns in North Carolina. John Hood's daily Journal new stories and important public event set Carolina and the voices of the newsmakers themselves at Carolina journal radio in print on the air and on the web. You can find the information you look back to Carolina journal radio I Mitch okay.

Many governments assess so-called sin taxes on items such as alcohol and tobacco. Do these taxes represent good public policy. A recent panel discussion tackled that topic.

The event was cohosted by the John Locke foundation Western Carolina University's center for the study of free enterprise and the Federalist Society were interviewing panelists to get their take in this segment we welcome Dr. Adam Hoffert. He is associate professor at the University of Wisconsin at La Crosse and coeditor of a book on this topic, titled for your own good taxes, paternalism and fiscal discrimination in the 21st century. Welcome to the program. Thanks Romeo so first of all, syntaxes or these specialized taxes targeting specific groups are the good public policy.

When we look at syntaxes as a whole. They do not represent good public policy syntaxes are remarkably effective at doing one thing and that is raising revenue. However, one of the things that we try to emphasize in the book is to remind our readers that government tax revenue comes from the pockets of the consumers that are buying the goods in the stores that are selling the goods. So what syntaxes do well raise revenue. We can't count is a very good thing, because it's money that's coming from the pockets of our taxpayers are our friends and our families, and the idea that I think is expressed at some point in this book as well is that sometimes you are really taxing those you think you are tax yeah. So that's exactly the case. So often times we think that's the goal of this taxes to get heavy people to stop dragging soda. For example, here we go we seen an increase in the number of soda taxes that are are are being put in place across the country, but a lot of people drink soda. It's only those that might need to lose weight.

It's a lot of people right so these taxes are really blunt policy tools that don't do a very good job of accomplishing the stated outcome if we think about everything that obesity is a real public health issue needs to be addressed. Syntaxes are a really poor tool to try to address that goal and why is that bench, that's blunt, but it also doesn't really address the real goal right and so we know if we make something more expensive. People are going to buy less of it right so we put a tax on soda. People will buy less soda but that does not guarantee that they're going to say consume fewer calories, or exercise more, in effect, when we look at the research on the topic. We have zero empirical evidence that caloric consumption falls when we put a soda tax in place. Why does that happen.

We know the consumers are going to change their behavior. While some consumers in a change their behavior, but for those who do change their behavior. It's difficult to predict what they are going to switch to. So, for example, we do have strong empirical evidence that suggests if we place a tax on soda and soda becomes more expensive. Adults consume more alcohol when it comes to children, we we have evidence that if we have a soda ban in schools. For example, children consume whole fat chocolate milk more, and so on net when it comes to total caloric consumption would not see any effect of soda taxes. We are chatting with Dr. Adam Hoffert.

He is associate professor at the University Wisconsin at La Crosse also coeditor of this book titled for your own good taxes, paternalism and fiscal discrimination in the 21st-century. One of the issues involved with the syntaxes seems to be tied into this whole idea of behavioral economics before we get to the links. Just give us a quick reminder. What behavioral economics sure so it became sort of a national spotlight when when an economist by the name of Dick Thaler one Nobel Prize in economics for his work in behavioral economics last year, we focus specifically on these things called nudges, which can be tools to try to affect behavior, but importantly, as does Dr. Thaler summarizes nudges can change behavior, but they still leave options intact. The exact same options as before, the nudge for consumers to make their choices to have the syntaxes fit in with the soul like so the great idea behind nudges is that we can we can get better outcomes without affecting choices that consumers have right so perhaps the best example of this is a default system where people opt into retirement savings accounts that their employers may match what sex but they still have the option of opting out of that account. And so the choices are still the same, but it just becomes a little easier for people to save for retirement. While this same idea has been corrupted by some policymakers who are trying to take a little heavier handed approach, forcing consumers to say eat healthier or make decisions that are more considered, publicly correct or or more in line with whatever the politician wants people to do with her life so they often put in these syntaxes and call them nudges right because the make and say look forward to strengthening nudge people say to consume less soda or less fatty foods or pork smokeless or or or drink less right so look at an economist won the Nobel Prize in the economist think this is a great thing that these nudges will the syntaxes are not nudges, and so one of things we try to do in this book is. His heart stopped to that line of thinking of these are not nudges because we put a tax on something you make it more expensive and so by defaults. Consumers are no longer able to consume the same amount that they were before. Because we all only have so much money to spend. So the idea that syntax could be another judge you're saying no, don't think of these please don't think of these taxes is nudges and different reporters and girls of a followed up with with Dr. Thaler and Dr. Sun Steen, who wrote this book to make explicitly say a please don't think of taxes or outright bans on products is nudges because nudges keep the choice what they call choice architecture, but they keep the ability for consumers to make these choices intact, but perhaps maybe putting front that I level and chips down at your feet, you can see by the chips.

If you want them, but you gotta bend on the right and so that's a lot different than us a banning potato chips altogether. In the brief amount of time that we have left.

Why should a typical North Carolina radio listener setting to us. Why should they care about these issues while I think there are a lot of reasons why a typical listener or or a readership should care about these issues all summer, all help. Stick to one point here also the becomes a very slippery slope, and so forth.

In my life when I started researching this. The focus was on cigarette taxes, cigarette taxes and a little more emphasis on alcohol and now all of a sudden work were going down this slippery slope of soda taxes, bacon bands that I don't know what going to be next but I'm worried that at some point it's going to be something that I really do want to can want to consume and I don't want to have government bureaucrat telling me that I'm not allowed to because they don't think it's healthy enough for me was a very interesting topic.

If you want to learn much more.

The title of the book is for your own good taxes, paternalism and fiscal discrimination in the 21st-century.

It's coeditors Dr. Adam Hoffert. He is associate professor at the University of Wisconsin at La Crosse, like so much for joining us think your friend will have more on Carolina Journal radio just a moment. If you have freedom we got great news to share with you now. You can find the latest news, views, and research from conservative groups across North Carolina all in one place North Carolina it's one stop shopping.

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North Carolina is changing not just day-to-day but outward to our minute to minute and 2nd to 2nd, how can you keep up with the changes, especially the ones that affect you, your family, your home, your job, make the John Locke foundation and Carolina Journal part of your social media diet on Facebook like the John Locke foundation like Carolina Journal. Follow us on Twitter at John Locke in the sea and at Carolina. Journal news, insights and analysis you'll find nowhere else. Thanks to the experts at the John Locke foundation and thanks to the first-class investigative reporting of Carolina Journal. Don't wait for the morning newspaper. Don't wait for the evening news. It's happening now it's happening here the John Locke foundation and Carolina Journal have you covered with up to the second information like us on Facebook the John Locke foundation and Carolina Journal. Follow us on Twitter at John Locke NC and at Carolina. Journal did you know you can now advance freedom and free markets just by shopping with Amazon it's true online shopping is now a great way to support the John Locke foundation just shot using the Amazon smile program and designate as the work foundation to receive a portion of your purchase amount that's right you shop and Amazon donates money to ask the John Locke foundation. So here's how it works. Log on to Amazon smile.

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Don't forget log on to today by something nice and help defend freedom. Support the John Locke foundation will come back Carolina Journal radio on Muskoka UNC Chapel Hill encountered a couple of recent surprises.

First Chancellor Carol Fuld decided to resign after six years on the job. Second, she had the base of the controversial silence and Confederate monument removed from the campus in the middle of the night. That action prompted University Board of Governors chairman Harry Smith and his colleagues to move up the timetable for. Archer of January and also allow you so necessary motion is.

That vote met full time to leave her job at least three months earlier than she had planned after the vote, Smith explain our focus is on the institution and so you know, nothing to chance or took a very bold action there and so from that perspective we take a look at what we think is the very best for the institution. You know we we feel strongly that this is probably in the best interest to go ahead and allow a change in leadership so we can move to a healing process and so you know it's our goal to treat cancer. Follow grace and dignity in and and work with her Is not punitive in any way shape or fashion. What I will say is if we follow a healthy process. We normally get great results and so I will tell you we have were very tirelessly with you initially all of their leadership atrocities.

We just work on the March night and we had a good good path forward.

We got members us and so you know we had a really really healthy process. I will tell you we would've loved to have had the conversation about this action and we would welcome this conversation sent from my perspective, we never gave you initially a reason to do this and so you know I believe strongly that is this public service we have an opportunity that we have an obligation offering total transparency and we work really hard and so was very important that they felt what they had to do it in this manner you had discussions with Chancellor follow and you know what I would've encouraged as this is the action he wanted to kill us talk about is the board of governors still want a permanent plan for silent Sam by March.

Yeah, absolutely.

From our perspective unit within the garage and input. Our team in place, you know, there's no doubt their substring think that's very fair you know you know this is a bit stunning based on how this is going to tell UNC Chapel Hill validated thickness, draconian action. I think that's what is inside.

When you start scheduling trains of my critical stakeholders are involved. Since this is unfortunate. That's Harry Smith, chairman of the University of North Carolina system's board of governors. He's discussing the decision to move up UNC Chapel Hill Chancellor Carol. Archer removed the remnants of the silent Sam Memorial without approval, will return with more Carolina Journal radio would've where doubling down on freedom at Carolina Journal radio were proud to bring you stories that impact your life and your wallet. And now get twice as much freedom when you also listen to our podcast headlock available on iTunes headlock is a little bit different. It's a no holds barred discussion that challenges softheaded ideas from the left and the right, like Carolina Journal radio headlock is smart and timely but with headlock you'll hear more about the culture wars get some more humor as well. We guarantee great information and a good time double down with that's listen to Carolina Journal radio each week and listened Locke to remember, you can listen to head or subscriber download each week iTunes Carolina Journal radio and headlock just what you need to stay informed and stay entertained both brought to you in the name of freedom by the John Locke foundation. Welcome back Carolina Journal radio I Muskoka, North Carolina's Supreme Court recently celebrated its bicentennial Chief Justice Mark Martin use the occasion to discuss the courts important role in state government 200 anniversary is a remarkable achievement in the life of any institution is a cause for celebration is also an opportunity for deep reflection.

How did we get here and how should we proceed. Noted American historian David McCullough was reflected that we have to evaluate our fair forebears did for us or not get it taken very seriously and it can slip away. Neither the past success nor the future survival of this court should be taken for granted.

Martin turned to marks issued on the first anniversary of the state Supreme Court back in 1820, then state senator and future justice as this court.

William Gaston reported to the Gen. assembly. The progress of the nation, institution remarked ours is emphatically a government of laws, these are the universal and the only rules of action.

It is indispensable that they be so expounded is that in their control of civil conduct, they shall have a steady and uniform application. There is no model by which the different tribunals of justice in the land held by various persons can be made to incur in the same exposition of the public will other than by establishing one Supreme Court 200 years later, Martin says the North Carolina Supreme Court pursues the same goals of upholding the rule of law right as this institution is sought to remain true justice Gaston's ideal that provide steady, uniform application of the laws of the state.

Women and men who have served in this court have done their best to that solemn obligation to faithfully adhere to precedent to administer justice and to strengthen the rule of law by upholding it in their own time, the great Roman statesman and orator Cicero once wrote that nothing counterfeit has any staying power. Over the past 200 years our state has revised his multitude's Constitution multiple times change the way that members of the quarter selected and witnessed extensive shifts in law and society. Yet, this court has exhibited a remarkable staying power through it all, that we are celebrating bicentennial anniversary is itself a testament to this institutions steadfast commitment to consistency, fairness and justice is also a testament to the justices tireless efforts to earn the public trust and confidence of the people that they serve. X.

North Carolina Supreme Court Chief Justice Mark Mark speaking during a ceremony marking the courts.

200th anniversary, Martin offered his audience what he called a friendly admonition. He said the words are as important now as when Alexander Hamilton wrote them in the Federalist papers in the 1780s in Federalist 78 Alexander Hamilton posited that the judiciary is the least dangerous of the three branches of government. As such, he arrives that the general liberty that people can never be in danger from that. But Hamilton, like any good Lord noted that his thesis came with an important caveat that the judiciary remain truly the state from both the legislature and the executive this morning and mine went on to urge that the courts must declare the sense of the law they should be disposed to exercise well instead of judgment. The consequence with the substitution of their pleasure to that of the legislative body. Martin then reminded courtroom observers that it's not possible to reach unanimous agreement in every case, God is made, each person you so how does that individuality intersect with the objectivity sought in Federalist 78. Each of us as unique individuals and thus is unique jurist may not always administer the principles of Federalist 78 in the same exact way as other judges, but the key is that we strive to do so that we understand that the judicial office is not a political office, the purchaser with a different function in the legislative and executive branches. We understand that judges should defer to the other branches on issues is, on issues of policy as long as constitutional standards are observed that by assuming a seat on this bench we lay down our preferences and opinions in joint pursuit of upholding the rule of law, but if judges do strive in good faith to observe the principles of Federalist 78, and the courts will in fact be the least angry Sprint Martin next tied the Supreme Court's role to the important task of protecting freedom and is often quoted that freedom is a fragile thing and is never more than one generation away from extinction is not ours by inheritance. It must be fought for and defended constantly by each generation our freedoms as Americans are secured by the rule of law by respect for our Constitution and by each of us doing our part to promote and support the public good. The members of this Court of the ultimate guardians of the rule of law in the state, so it is the responsibility of the members of this board now and in the future. Taking Hamilton's charge to decide each case as the law requires.

In so doing, I am confident that this court, my colleagues and our successors will continue to secure the freedoms of North Bradenton.

North Carolina's and to provide justice for all. I am optimistic that our continued fidelity to the rule of law will ensure that North Carolinians had more reason to celebrate this institution years from this work historic day today in a time of deep political divisions. North Carolina's Supreme Court Chief Justice also mentioned the need to work together.

I want to pause and encourage each of us to renew our commitment to be exemplars of civility and professionalism in our community and our state and our nation lets you not in support of the rule of law must promote public trust and confidence in our course.

Let's elevate principles over passion. Let's talk to each other and not passed one. Let's genuinely listen to each other and consider different perspectives. Let's be objective when deciding between opposing points of view and disagree, let's do so without the every generation will always have reasonable disagreements over policy, this institution represents an area we can unite together in support of the rule of law that are written Constitution must be upheld and defended as the bedrock of all our liberties that the law should be formally applied in each case, and to each person that we should strive to administer equal justice under law. I am thankful we can come together today to celebrate past successes of this court and what it represents to our society and I sincerely hope we will all actively support its continued success. Well into the future.

That's North Carolina's Supreme Court Chief Justice Mark. Mark delivered these remarks during a ceremony celebrating the 200th anniversary of the state's highest court overturned with more Carolina journal radio development commitment to truth and transparency in government. That is the mission of Carolina journal and we are proud to deliver and now proud to tell you the North Carolina press Association has honored to members of our team with awards for reporting and writing, that's right, we really do deliver award-winning journalism we shine the light on government spending, reveal the truth about boondoggles and dig deep into programs paid for with your tax money. We keep you in the know in a way other media outlets don't enter reach and influence are growing all of our outlets. We reach more than 1 million N. Carolinians each month so make sure you're one of them. Our monthly print edition arrives in your mailbox every month.

Our online daily news site Carolina has fresh stories, opinion pieces, and more. The award-winning Carolina journal team I reporters make government accountable to you. Call 1866 JL FINFO for your free subscription, welcome back to Carolina journal radio I'm Donna Martinez Democrats in the North Carolina House of Representatives have filed a bill to expand Medicaid in North Carolina and that plan would add roughly half a million or more people to this government health insurance program. Many of those 500,000 or so able-bodied working age adults with no kids. Our next guest says that there is a better way to expand access to quality healthcare, and expanding a flawed program that's been plagued by waste and abuse. Jordan Roberts is the healthcare policy analyst, the John lock foundation he joints me now Jordan, welcome back to the show. Thank you, Greta here Jordan. Can you explain for us. First of all how Medicaid works how it's funded and who it's designed for the state runs the Medicaid program and the funding comes a portion from the state and abortion from the federal government that's determined by a percentage and the state largely runs it, and it was supposed to be for you know the most at risk populations.

Those with disabilities and the most low income folks out there.

This is decades upon decades old right and it's it's been this way since 1965.

It's open-ended entitlement. There is no caps are no cost-saving measures to in this program's financing income qualifications are there not I mean it's right to be 87 most vulnerable population ratio not anyone can write to the roles and the state determines that it determines the benefits that these these enrollees get the reason I ask about the funding of Jordan is because one of the key talking points for those who believe that expanding Medicaid is the right thing to do which of course at the John Locke foundation does not believe that Rick talk little bit about what we think is a better way.

But the supporters will say it's essentially a free program to the state or nearly free. What they mean when right so when we talk about Medicaid expansion. This is a part of the affordable care act and the affordable care act, said if you expand your to the states. If you expand your Medicaid program will give you 90% of that funding and you guys stayed south to pick up 10%.

Now a lot of people like to say they were missing out on money by not expanding Medicaid but that's just not true because there are federal tax dollars and there's not up a fund of Medicaid expansion money that were missing out on the were contributing anything to and we talk about the fiscal shape of the federal budget right now $22 trillion in debt. Odds are that this funding percentage will change and the state will be on the hook for a lot more than 10% in years and years to come. So down the road there would need to be additional additional state spending on this program should be expanded, absolutely.

And if you look at other states.

What they found as their projections right now is projection. The state will be on the hook for roughly $340 million, but all the other states that have expanded most of them have seen costs significantly higher than their projections and those that gets paid for by the state.

Jordan, when we talk about a program for the most vulnerable people I think many people will say look, we can understand that this is an appropriate part of our social safety net.

People who are disabled or living on the margins who need some sort of assistance to help right hand up so to speak, but when we talk about expanding Medicaid in North Carolina that population of about half a million people or so it would be added to the rolls.

The vast majority of them are adults of working age able-bodied not disabled and have no children to support. So there seems to be a disconnect between the goal and the mission of the Medicaid program and now this group of people that the supporters want to add. Tell us about that. So when you expand Medicaid what you're doing is inflating the amount of money that the government spends, and that's the main reason why healthcare costs around the country are so high. Government spends so much money and that moves the goalpost of what healthcare costs so if you keep Medicaid to its traditional populations.

We can do a better job of managing those people and keeping costs down for them. But when you expand it.

We are moving the total amount of money that we are spending on healthcare in the state. If we expanded and added those people to the Medicaid rolls. Jordan, without in any way crowded out people who legitimately qualify as a vulnerable population absolutely nuts main concern here expanding Medicaid.

It does nothing for it only increases the demand for healthcare services. It doesn't do anything for the supply and we find around the state is that there are shortages of physicians and facilities so all expanding Medicaid would do would be to increase the demand where there's not enough facilities to meet the current demand and that that has an adverse effect on the population that Medicaid was supposed to before and and makes those people worse off. So the obvious question is, if not expansion of Medicaid then what because there are people who evidently have no insurance and their concerns of bipartisan concerns about access to care, you say there's a better way and expanding Medicaid right.

I think I think it should be a more high-priority goal to lower the cost of care. All across the state and we can get more people into these private insurance markets and get more people paying into it, rather than just expand government health insurance that many times is not adequate and there's not enough doctors to accept new Medicaid patients, and so it really doesn't address the problems of access and patient affordability.

So if we perform some state-level policies that we can get better facilities, more facilities, cheaper facilities and cheaper access to care than we really would need to expand this program to get more people on the government insurance you have written about a number of barriers in particular one of them is called certificate of need help us understand this government permission slip essentially help us understand how repealing that, or at least pairing it back would increase access to care and help people who really do have a need. So a lot of the center. I think it's a common misconception that in healthcare you need to get care done in hospitals and is the most expensive places to do it and certificate of need largely protects and insulates hospitals and that's where the majority of these new Medicaid patients would go. So if your pill certificate in the law what it would do is open up our Malaga supply reforms and get more facilities into the into the state and a lot of times is a lower cost, facilities compared to hospitals. So if we open up the amount of facilities. The new address the problems of rural access and cheaper care bring down the cost of care. All around the state, and it would address all those problems. You also have written about the issue of shortage of access to medical professionals and doctors and, in particular, are there ways then that we could maybe amend our licensure laws to make sure that people have access to folks who have a high level of knowledge, but maybe aren't actually a medical doctor right so licensure laws prohibit any doctor that's not living in the states administer care to North Carolina patients. Or if you knock down some of those barriers you open up plenty of avenues for people via telemedicine and telehealth to get more access for across the country for physicians that address their needs specifically and largely licensed licensure resumes in the state are the are withholding holding back that access and also access to, for example, nurse practitioners who have a high level of skill but are medical doctors but could take care of some basic needs. That's right so it's all a matter of allowing people to practice something so therefore their full training and license plate reforming licensure resumes would accomplish that. We been talking with Jordan Roberts. He is the healthcare policy analyst for the John Locke foundation all of his writing on this issue. Thank you very much. Thank you. That's all the time we have for the show this week on behalf of Mitch.

Okay I'm Donna Martinez. Join us again next week for another edition of Carolina Journal radio Carolina Journal radio is a program of the job. To learn more about the John Locke foundation donations support programs like Carolina Journal radio send email to development John Locke done or call 66 Jayla 166-553-4636 Carolina Journal radio is the John line foundation airline is maintaining Carolina broadcasting system, Inc. all opinions expressed on this program are so clearly the station formation about the show. Other programs and services of the John line foundation John Locke toll-free at 866 JM would like to thank our wonderful radio affiliates across Carolina and our sponsors. Carolina Journal radio. Thank you for listening. Please join us again next week

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