The future of North Carolina

A year ago the Supreme Court upheld the constitutionality of the individual mandate, while declaring unconstitutional the penalty proscribed in the law if State’s did not expand Medicaid–losing all of their federal Medicaid funding. This provided States with a real choice to expand Medicaid or not. A year ago I said:

Leaving the Medicaid expansion in place, while allowing states to not undertake the expansion without losing all medicaid funding has set up a fascinating test of ideology v. financial self interest for Conservative states. People’s lives are at stake here and I don’t mean to minimize that, but again, elections are important and I suspect what State politicians plan to do about the Medicaid expansions will be a key question in some states this Fall.

As it turned out, there was almost no discussion of the Medicaid expansion in the Gubernatorial election (just ask all the journalists that I was tweeting at about why they weren’t asking the candidates questions about it during debates). Newly elected Governor McCrory said that he would study the issue but announced his opposition to the expansion almost immediately upon taking office, and the Republicans in the General Assembly were uniformly opposed while offering no coherent alternative.

This week the Supreme Court struck down section 4 of the voting rights act (that effectively neuters section 5 that put the onus of burden on certain States to justify voting changes), providing another avenue for States in the South to reassert their freedom to go their own way with actions like voter id and other election law changes that now won’t have to be pre-cleared by the US Justice Department. The past 6 months of total Republican rule in North Carolina have brought about a series of changes in addition to the non-expansion of Medicaid that have caused progressives to cringe:

  • reducing unemployment benefits & eligibility periods to the shortest in the nation beginning July 1
  • repealing the racial justice act, that could swing the death penalty machinery of the State back in gear
  • tax reform that is still to be finalized, but worries abound that the pain is first going to the “least of these”
  • an emerging voter id law that will either be bad or terrible from the standpoint of making it harder for the poor, elderly and minorities to vote

Some say the Dems had their chance, now it is ours. However, the biggest difference between the longstanding one party rule by Democrats in North Carolina and the current one party regime, is that the Democratic Party had profound ideological span, which the Republican Party now lacks, and that is leading to extreme policies.

For example, Democratic Gov. Mike Easley’s (2000-08) political clout emanated in large part from his reputation as a get tough prosecutor and he was proud of having put more people on Death Row than any other DA in North Carolina. I lamented this each time I protested an execution at Central Prison while he was Governor, but I voted for him twice.

Going further back for just one more example, the General Assembly in the 1990s expanded Medicaid and a variety of prenatal care programs to address infant mortality. Two key Democratic Senators at that time were:

  • Howard Lee, the first Black mayor of a majority white Southern City (Chapel Hill), a Civil Rights leader and avowed liberal, and
  • Wendell Murphy, from Rose Hill, who is an entrepeneur who made Murphy Family Farms into the largest Pork Producer in the world that was later bought by Smithfield Foods. I have a lot of admiration for Mr. Murphy because he is such a success story from the part of the world where I grew up, and there aren’t that many. He was also a Democrat, but certainly no liberal.

The current Republican Party in North Carolina has nothing like this ideological span, and it shows in what I believe to be their policy over-stepping.

I have often told outsiders that things were more subtle than they seemed in North Carolina. However, the policy direction of the State now is testing the quiet consensus that has been around since the election of Terry Sanford as Governor of North Carolina in 1960, and the development of what I would call our civic religion of  the past 60 years–“we are not Alabama.” Certainly the Democratic Party that was in power so long atrophied and was wracked with scandals that were embarrassing. And maybe we progressives got lazy and took things for granted, especially in the past decade.

No longer.

About Don Taylor
Professor of Public Policy at Duke University (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute). I am one of the founding faculty of the Margolis Center for Health Policy, and currently serve as Chair of Duke's University Priorities Committee (UPC). My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

2 Responses to The future of North Carolina

  1. Pingback: North Carolina’s Redistricting Mess | freeforall

  2. Pingback: What is happening in North Carolina? | freeforall

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