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Cooper vetoes Medicaid transition bill, signs pay measures

August 30, 2019

RALEIGH, N.C. (AP) — Democratic Gov. Roy Cooper responded to Republicans passing piecemeal legislation to break their budget impasse by signing four employee pay bills on Friday. But he vetoed a funding measure needed to stand up North Carolina’s forthcoming Medicaid managed-care system his administration will operate.

Cooper signed measures that gave most state employees and state law enforcement officers 2.5% annual raises this year and next. Top state executive and judicial branch officials also got similar raises, although Cooper said he donated his included annual salary increase of about $3,700 to a group that helps teachers buy classroom supplies.

The vetoed measure would provide hundreds of millions of dollars to run the Medicaid program for the next two years with the transition to managed-care treatment that’s been expected to go online in 27 counties on Nov. 1. Meeting that deadline already was highly unlikely even before Friday’s veto, a key Republican legislator said this week.

Cooper’s health and human services department has been working to bring managed care to 1.6 million Medicaid enrollees statewide, and needs the changes and funding identified in the bill to get the massive project over the finish line. Like the pay raises, most of the Medicaid bill provisions were in the two-year state budget measure Cooper vetoed June 28.

Cooper defended Friday’s veto by saying health care policy should be done broadly — a likely reference to his budget demand that GOP lawmakers come to the negotiating table and talk about expanding Medicaid enrollment to hundreds of thousands of low-income, working adults. Republicans insist there aren’t the votes to approve expansion now, but they also currently lack the votes to override the budget veto.

“Passing mini-funding bills that simply divvy up the vetoed Republican budget is a tactic to avoid a comprehensive budget that provides for health care and other important needs like education,” Cooper said in his veto message. “Health care is an area where North Carolina needs us to do more, and to do it comprehensively.”

Still, Cooper couldn’t pass up signing popular stand-alone employee pay measures, which received unanimous House and Senate support. Pay increases, retroactive to July 1, also will go to troopers, state investigatory agents and correctional officers.

GOP leaders are taking out pieces of the vetoed budget and running them separately with a goal of winning points with the public and reducing leverage Cooper could have in negotiations. Republican lawmakers said they would pass other stand-alone measures from the budget in September addressing school safety, disaster relief and sexual assault evidence kits.

Republican legislators knew Cooper would likely veto the Medicaid managed-care measure given the largely party-line votes during floor debate this week. Still, Senate Republicans said Friday a Cooper veto on the bill modernizing Medicaid shows he’s not serious about caring for current Medicaid enrollees.

“On one hand he signs four mini-funding bills related to law enforcement and state employee salaries, but then he vetoes a bill years in the making to streamline the state’s Medicaid system because he says that he doesn’t like these mini-funding bills,” Sen. Ralph Hise of Mitchell County said in a news release.

Health and Human Services Secretary Mandy Cohen wrote senators on Thursday that the Medicaid overhaul can’t go live with the base funding Medicaid is running on during the stalemate. “It is my hope the General Assembly will negotiate a comprehensive budget solution” with Cooper, she said.

The Medicaid overhaul process began with a law in 2015, during Republican Gov. Pat McCrory’s administration. Medicaid is moving from traditional fee-for-service coverage to flat monthly allotments to health insurance companies and a physicians’ group awarded contracts to treat each patient covered. DHHS didn’t respond to a request this week for an update on the process.

Rep. Donny Lambeth, a Forsyth County Republican, said this week it was unlikely the Nov. 1 start for recipients in the 27 counties would happen even if Cooper signed the bill because the bill language should have been passed months ago. Lambeth said managed-care now likely won’t begin until early next year.

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