The cracks in North Carolina’s safety nets are widening under the compounding pressure of a months-long budget stalemate, and that’s putting the state’s most vulnerable residents at risk of falling through.
That was the message delivered to Democratic members of the North Carolina state Senate last Wednesday. The public hearing at the General Assembly featured community advocates, teachers, medical professionals and farmers — all of whom spoke to spotlight the real-world consequences of the legislature’s ongoing failure to pass a state budget.
“Make no mistake, we are in a food insecurity crisis,” Barkley Sample, Raleigh regional director of Catholic Charities, told the Democratic caucus. “As much as we have tried to grow, nonprofits cannot shoulder this burden alone. Our budgets are stretched thin, and donations are not scalable to fill the gaps left by North Carolina not having a state budget.”
The Republican-controlled chambers of the state legislature have failed to agree on a two-year spending plan. The deadlock is driven by disputes over funds earmarked for a new state children’s hospital and over the size and timing of tax cuts. The standoff has left North Carolina as the only state in the U.S. without a full budget; it is operating on a “mini-budget” in the meantime.
That bare-bones mini-budget was a stopgap measure passed by the General Assembly in July. It allots agencies the same level of funding they had the previous year, but it doesn’t include any nonrecurring funding. The slim document also isn’t adjusted for population growth, inflation or other sources of increased need.
Rising prices, lack of funding
The lack of budget leaves food banks and nonprofits that administer food pantry services without additional funding — or knowledge about whether they’ll even be funded for the next fiscal year, which can force them to make operational decisions like staff reductions.
But the need hasn’t gone away, food bank operators say. In fact, it’s risen.
“Life is getting more expensive, and the low income families that we serve are feeling that strain the most,” Sample said. “Grocery prices are rising. Health care costs and coverage are uncertain — including eligibility for Medicaid and the loss of subsidies for Affordable Care Act premiums. Child care has been unaffordable and is frequently unavailable. Rent and utilities continue to increase, while wages remain stagnant.”
He testified that the Catholic Charities of the Diocese of Raleigh’s food distribution has grown 50 percent to keep pace with the increased need. In the four months since the budget period, the organization has seen 33 percent more families served overall; the Tar River region reports a 75 percent surge, while the Cape Fear region tracks a staggering 163 percent increase.
“Low income families are experiencing a loss of vital services that provided that extra boost for families to survive,” Sample added, pointing to shuttering of the Healthy Opportunities Pilot, which ceased operations on July 1.
HOP was a Medicaid program that addressed nonmedical health needs of low-income North Carolinians. Beneficiaries could receive deliveries of food, rides to doctor’s appointments and other services.
Medicaid cuts
The political gridlock over the budget has become more glaring as Medicaid cuts continue. The mini-budget fell $319 million short of the $819 million NC DHHS requested to adjust the Medicaid budget for the current fiscal year, which began on July 1. That shortfall prompted department Sec. Devdutta Sangvai to warn legislative leaders in August that without additional funding, reimbursement cuts would begin Oct. 1.
Both chambers then advanced separate proposals to add $174 million to the Medicaid base funding, enough — everyone agrees — to stretch the program through the rest of the fiscal year, which ends in June 2026.
Neither chamber was able to get the other to agree on their legislative language during the General Assembly’s final scheduled session of the year in late October, leading Gov. Josh Stein to call for a special session on Nov. 17 to break the impasse. House Speaker Destin Hall (R-Granite Falls) and Senate leader Phil Berger (R-Eden) rejected the governor’s call outright, calling it a “trumped-up ‘crisis’” and “unconstitutional” in a joint letter sent on Nov. 13.
“This power was never meant to be used as a platform for political messaging or to circumvent the legislative process to achieve a preferred political outcome,” the letter stated. “To that end, if circumstances surrounding the Medicaid rebase are in fact extraordinary, it is only in the context of your administration’s failure to address them.”
To those affected by the cuts, the politicization of the Medicaid budget is frustrating.
“I feel a lot of fear and worry right now that every cut and great reduction to Medicaid will change my whole life. Having disabilities does not mean I am sick, but it does mean I need consistent treatment and care to stay healthy,” Sloan Meek said at the recent public hearing. Meek has been diagnosed with cerebral palsy, cortical blindness and epilepsy. “I do not want to become sick, I do not want to lose my community. I do not want to lose my voice. I do not want to be forced out of my home to live and receive care from a bunch of strangers. I do not want to die because of a political issue.”
Republicans declined the governor’s call, but neither chamber’s floor was entirely empty on Monday, Nov. 17 — the day Stein had called lawmakers to Raleigh. Several Senate Democrats, House Democratic Leader Robert Reives (D-Goldston) and the House Democratic caucus all appeared. The lack of the majority party’s participation drew sharp criticism from Senate Democratic Leader Sydney Batch (D-Raleigh) in Wednesday’s hearing.
“I wish I could sit here and say that there are a lot of profiles of courage along with some of my Republican colleagues, but what we have seen is that they just have failed to act, and their inaction has hurt every single last person,” Batch said.
The inaction will have ripple effects that could stretch beyond a budget agreement, providers warned.
“This is not just a fiscal challenge, it’s a health equity crisis,” said April Cook, CEO of the NC Association of Free and Charitable Clinics. “The people most affected are those with the fewest alternatives: rural residents, low-income families, communities of color and individuals living with chronic disease. The longer the budget remains unresolved, the more damage accumulates across our workforce, our health care infrastructure and the well-being of the people we serve.”
This article first appeared on North Carolina Health News and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.