- [Kelly] North Carolina's Senate hears public feedback on medical marijuana legislation.

The governor and legislative leaders weigh in on a positive 2023 state budget forecast.

This is "Sate Lines."

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[upbeat orchestral music] ♪ [upbeat orchestral music continues] - Hello again, I'm Kelly McCullen, this is "State Lines."

On the panel this week: Anna Beavon Gravely of NCFREE; Nick Crag, making the trip up from "Wilmington's Morning News;" a political consultant, an "N.C.

Spin" graduate, I would say, Brad Crone.

Welcome to the news show on PBS NC Brad.

- Thank you.

- And Joe Stewart, longtime political analyst for us.

Thank you Joe for chairing seat four for us.

The official North Carolina budget analysts have released a joint report this week.

They're forecasting a state revenue increase and a state budget surplus.

The Office of State Budget and Management, and the General Assembly's Fiscal Research Division believe our state could, or will enjoy a 10.7% revenue increase, looking in the immediate months ahead.

Translates into a $3.25 billion surplus, or over-collection, as fiscal conservatives would label it.

Governor Roy Cooper released a press release, might see it there.

He says, "These increased funds are needed desperately to pay our teachers more, fund our schools, provide quality childcare for our parents, and our workforce, and pay for those tax cuts our working families that we put in place last week."

Over in the Senate, Republican leader, Phil Berger's press release calls it, a one-time $3.25 billion surplus.

He says, quote, "We must continue to prioritize responsible spending, addressing our state's workforce needs, and providing tax relief for our citizens."

Ah, Anna Beavon.

- Kelly.

[all laughing] - Oh boy!

- First question to you, everybody's gonna claim credit for a nice budget surplus, $3.25 billion.

- Yeah.

- Are you impressed as someone who works in Raleigh and follows politicians and issues?

- I think the impressive part is that this is, this is not new for North Carolina, we have had a lot of surpluses and I think that that really just speaks to the legislation and the work that the General Assembly has done really on both sides of the aisle.

'Cause ultimately we have to, in order to have a budget, we gotta have people agree to the budget and I think this is something that we should really feel comfortable and feel proud of overall.

- Nick.

- I would say that Tillis gets a lot of credit for that, and Art Pope does too.

When the Republicans took over the General Assembly in 2011, and then Art coming in as Budget Director under Governor McCrory- - Oh yeah.

- And the fiscal approach that they took was very conservative.

We have have the best ballot sheet the state has seen since I've been following politics, going all the way back to 1980, so that's a real positive thing.

For the Democrats I don't see the Republican legislature having any appetite to throw a large amount of money of the surplus back into public education without changing outcome data and looking at how the teachers are performing and how the schools are performing.

- Nick, you hear directly from the people every morning.

- Yes.

[Anna laughing] - What do you, well I can't say, have you talked about this on the air?

- Oh yeah, absolutely.

- What are they telling you?

- So, I mean, let's be perfectly clear about it.

Government doesn't have money they take money from us and then they can reallocate it and spend it.

When you're talking about a 10% budget surplus, that's a lot of money, but I think North Carolina is kind of setting the standard nationwide for fiscal conservatism in the state.

Taxes are continuing to go down.

There's plans in place right now for corporate taxes to go down over the next maybe two or three years, those are gonna progressively go down, and the state's still generating money.

So you can cut taxes, get more money back to the taxpayers, and still spend more on education which is what the last couple budgets have looked like.

- Joe, your turn, you've seen a lot of budgets too.

Did you go back to 1980 looking at budgets though?

- Well, not quite that far back, but I still think it's an impressive thing and Nick makes a good point.

We often forget that government itself is a non-profit organization, it just has a very sophisticated fundraising strategy.

If you don't make a contribution you go to prison.

And so that money- [all laughing] Really is intended to be invested in things that is gonna redouble those benefits to the private sector economy that the money government has borrowed is used for.

The thing that's interesting here is, the Republicans do deserve a lot of the credit for fiscal policies that have led to this point, and Senator Berger's right to say that maybe some of this needs to be held aside.

We do have the propensity to have hurricane damage come that we need those sorts of resources for.

Some speculation we're still in line for a recession, so money would be needed for that, but I think ultimately the good news is, for the legislative session, this makes more money available for pet projects back in districts, sort of the teaspoon of sugar helping the medicine go down as they negotiate a lot of different issues during this legislative session to bring votes along that are needed to pass a budget, to pass redistricting, those sorts of things.

- Anna Beavon do you think having more money than expected makes things, makes issues more easier to handle when you're in Raleigh 'cause I think you may literally meet every candidate when they're running and see a lot of them once they're elected.

- Yeah, I think it's a mixed bag.

I think there's a moment of, hey, look what we did, this is great, our policies are working, let's continue in this trend, we've seen the pattern of performance, and then there's also like, but we have a lot of money.

It's like when we have money in our own budget, we're like I'm gonna buy that really nice bag that I've been trying to buy.

- Are you?

- Yes, yes I am because we're wondering.

[all laughing] But more it's we have to be really careful about how we spend this money and this is something that was addressed in your voiceover, but we need it to be on one time, one-time uses and not recurring funds and that's always a challenge that we see.

- Brad, I did not get a press release from Art Pope or Pat McCrory taking credit for a budget in, or budget outlook in 2023, how in the world do you go back that far and give them credit for something that a current governor, and a current sitting president, pro tem, and Tim Moore, I should say, I just didn't include his press release, say, hey, this is part of our work?

- Yeah, no I think the foundation that they laid is critically important because it was a totally different attitude.

When the Democrats were in power they would put a budget surplus back into recurring expenses, not into capital, or a one-time outlay.

And so there was additional pressure, every budget year, to meet those numbers whether you were in good times or bad times.

So clearly, Nelson Dollar, there are numerous Republicans who set that stage that citizens of North Carolina are benefiting from today.

- Last word to you, Joe, when it comes to setting projections, and you've worked in the treasurer's office among other agencies, is the goal of these analysts to nail this bullseye accurate that they really believe they're gonna collect 30 billion dollars, or do they undershoot it in order to create the perception of surplus to make us feel good about our elected leaders and ourselves?

- Well, you know, to some extent I think it it is a perspective that they're trying to bring to what they think is likely to happen.

It is always about the future.

And so they're in effect trying to protect the future.

We have as a state because we borrow money, the people that we're borrowing the money from, the bond buyers, are looking at our balance sheet and they want to know do we have the resources to repay these bonds?

But significantly important too is are we making investments in the type of infrastructure that will continue the economic prosperity that we've enjoyed?

We're a growing state because people want to come here and there are jobs for them to do here but those investments are needed to make sure that economic landscape remains robust.

- And that's great about having a weekly show because they change anything at all, gives us five more minutes of show we can discuss every issue there is.

Up next, the Senate Judiciary Committee heard public comments this week on legislation that would legalize cannabis or marijuana use for diagnosed medical conditions.

The Judiciary Committee says it will continue hearings on medical marijuana next week and that includes an expected debate on possible amendments to the current bill.

The current proposal defines the medical diagnoses that would allow your doctor to prescribe medical cannabis use.

Proponents came to the hearing and told senators that you should allow prescriptions for chronic pain relief and consider conditions that's not in the current bill as it's written.

- Let your physician decide whether you need to continue to keep taking opioids for something.

If you do not want to continue taking opioids then you should be allowed to have medicinal cannabis be one of the solutions that you can look at with your physician.

So let's stop calling it chronic pain and start calling it opioid reduction therapy.

- States are essentially legalizing recreational marijuana but forcing physicians to act as gatekeepers for those who wish to obtain it.

Smoked marijuana is not medicine.

This fundamentally speaking is an in run around the practice and the standards of modern healthcare and medicine.

- You know, regardless, Nick, of what you think about any issue, some people are always there for their causes.

And I, Reverend Creech is always there.

Now the spin is on, Opioid Reduction Act.

Marijuana use has benefits.

Conservatives driving the bill.

I love asking conservatives about marijuana.

- Sure.

- And so I'll ask you.

- I think if you look at the national trend, you would assume that North Carolina is the only holdout for medical marijuana.

But when you look at all of our neighbors besides Virginia which where it's at this point, recreationally legal, South Carolina, Tennessee, and 10 South Carolina, Tennessee and Kentucky, all, it's still illegal for medical use in all of those states.

So we're not on an island by ourselves with this.

I think do think North Carolina's gonna push forward with it.

We saw some appetite last general assembly with it being led by Senator Bill Rabon down in Brunswick County.

He's got a personal connection to this, dealing with some cancer in the past and some treatments there.

So I do think there's an appetite for it.

And I think, as you know, we look at younger voters getting involved in being engaged this is becoming less and less of a tentpole issue for younger conservatives and younger Republicans.

- All right, Brad.

- Last time I was in Charlotte a couple weeks ago in uptown there was no shortage of marijuana on the street.

So the folks who are using it in Mecklenburg County aren't waiting on the state legislature to decide whether or not we're gonna have medical marijuana or whether it's gonna be recreational use.

Now a lot of that's due to the fact that the city council and the prosecutors aren't necessarily going to arrest you for having a blunt, but it is a proper discussion.

I support medical marijuana, I support recreational marijuana, but I also support regulation and taxation on it and make sure that if we are going to do medical marijuana that it is physician driven and it's medically necessary.

- This is probably one of those issues where nobody's wrong.

I mean, everybody has a particular perspective about whether or not this should be available either for medical purposes or for recreational purposes.

There are perils, societal perils to allowing a drug to be more widely available that has historically been restricted by law.

But there are plenty of reports and studies that show there is a beneficial aspect of this.

And you saw one of the elements of the testimony provided in the committee meeting this week was to talk about how marijuana can replace opioids.

And we know the considerable opioid crisis that we faced in this nation.

I think this, this is why legislators get the big bucks.

They're gonna have, they're gonna have to decide this very difficult issue where there's not really a right or wrong answer.

It's just what's the direction the state wants to take with regard to this one particular issue that has strong feelings on both sides.

- And yeah, Ana Bevin.

- Yeah, I think in concept what we're all talking about makes a lot of sense.

I think this legislation does a really interesting and may potentially be a harmful way of teetering both sides of the aisle.

Meaning not political aisle but more concept of trying to appeal to those that are not in favor of marijuana at all and those that see an opportunity for us to grow our economy.

'Cause there are 39 other states that have medical marijuana legalization and 21 that have overall recreational.

And so, and by including, they're like, Hey we're gonna do this thing that you guys want over here on the economy side, but we're gonna have it have the the greatest restrictions and control of any other regulation or any other bill in the country.

And so, and by doing that they're finding ways to grow the government and grow the government's involvement in the economic side of this.

And so can they have both?

I don't really know.

And I think that's one of the bigger challenges with this legislation.

- Nick, what happened in the conservative household that the kids could say I'm a Republican, I wanna vote Republican all the way but I want marijuana, whether it's medical or recreational versus mom and dad who are gonna vote the same way.

And you've made mama mad talking about that 'cause that's a drug.

- Yeah, I guess I think it's when you look at what's going on, you know, in, you know, generationally for conservatives.

There are just bigger issues going on right now.

Like the current status of the economy and everything else than marijuana.

I'll mention this real quick.

One group that hasn't gotten a lot of mention in all of this is there's a large veteran advocacy group pushing for this too.

PTSD and some of the victims of that are some of the largest advocates of medical marijuana because they've been struck not only with the effects of war, but then the opioid crisis at an unbelievable rate.

- Brad, this issue, if say everyone could vote their conscience and bills weren't bottled up for personal reasons and chair members don't like the bill and they don't, if this were to go to a vote in the house and the senate what do you think happens to marijuana, not just medical but marijuana policy in general?

Would it be banned?

Would it be legalized or would we find medical right there in the middle?

- I think that's going to be a real big question.

I wouldn't.

- Put odds on a vote from the legislature on this issue, at any given time.

I will say this, we need to look at it.

We need to look at steps.

We need to get rid of the black market.

We need to tax it and regulate it.

- Yeah and I think the challenge for the proponents, of this legislation are probably seeing, their greatest obstacle of the house side.

I think it will probably get out of the Senate.

Bill Rabin, the rules chairman on the Senate side and has a very compelling personal story, to tell about this issue.

I think he can get the bill out of the Senate.

The votes in the house are, I think, are less certain.

- And he's downplaying the idea.

This is a small family farm crop.

You're gonna have to have big money and probably corporate backing, to get into the marijuana business in North Carolina.

We'll see what happens.

- Well just to add one more thing.

This legislation, just like the 2022 version, has 10 dispensaries, licensed dispensaries, which will essentially create a cartel and millionaires overnight.

So there will be a ton of money.

- Easy on that cartel language, that makes you think of other things.

- Sorry.

- Cartel.

- Apologies.

- The State House easily approved its version, of a Medicaid expansion plan this week.

The bill passed 96, 23.

This version of Medicaid expansion, would extend health coverage to families, earning up to 133% of the poverty level.

Bill sponsors are promising their tapping federal funding, for at least 90% of that expansion cost and they would roll back expanded coverage, if the quote feds would reduce funding under 90%.

Brad, is this a deal across the board?

96, 23.

Can I look at that and go home and say the people have spoken?

- Well, it's bipartisan support, clearly, there's 600,000 patients in North Carolina, who are dependent on this legislation and it is a good compromise Bill.

It'll be interesting to see how Senator Berger and the Republicans in the state senate approach it.

In the past, the big sticking point, has been certificate of need, regulatory components on utilization of equipment, for hospitals and for doctors.

So one of the key provisions of this legislation, is the healthcare access and stabilization program, HAS, which is going to provide billions of dollars, that's going to cover the difference for the doctors and the hospitals on the state tax.

So it covers that 10% gap, which is going to be critically important.

Questions going to be will the Senate, which supports certificate of need, elimination to get rid of that perimeter, for the marketplace?

Whether or not they'll agree to that or not.

And so that's gonna be the big question mark.

- Joe certificate of need, is not something everyday folks often talk about, but there is a bit of a controlled market, in the hospital market certificate of need.

I'll let you explain it.

You're the best at it.

And by the way, before I add, before.

- No pressure.

- Yeah, no pressure.

But let me ask you.

You represent insurance agents of North Cal, independent ones.

- Right.

- Does Medicaid expansion affect your constituents?

- Well, it does to some extent, and the notion would be of course, that this expansion would be, a publicly supported healthcare system.

I think what the republicans, particularly on the house side have said, is tying in a work component, is really intended to make this not a final destination, for people in terms of their healthcare.

If they get job skills, if they get training, while they're on Medicaid, having had it expanded, to the qualify them that makes it possible for them, to get employment and potentially get healthcare, through the private market as a result of being employed, by someone that provides healthcare, as a benefit, that is a very noble goal.

Now, we do know this, ultimately what's true about all lines of insurance, is the better a risk is as a pool, everybody in the United States was healthy, health insurance would be very inexpensive.

And in some part, the reason why people, are not as healthy as they might be, is that they don't have access, to the kind of preventative care, that might make them healthier.

I think part of the sensitivity is, if we could get more people in the pool getting treatment, the overall health of America would be better.

- If I have a job and I have private insurance, why do I care either way about Medicaid expansion, as an economic discussion?

- Well the principle, the economic principle, is more people in the overall health insurance pool, including those expanded into Medicaid, would in effect help bring down the cost of healthcare, because people would be getting preventative care and not needing more expensive responsive care.

- And of course, the cost of uninsured care.

- Yeah.

- And uncompensated care for your docs and for your hospitals.

- The theoretically those indigent patients, that show up who simply have no means to pay for their care, would now have the ability to have that care paid for.

- Well, AB I know, I know two guys, that have some insight on this.

I've noticed you're asking, two different major state departments to work together, on workforce development.

He said it's a noble goal.

Is that what it is?

Is it a goal?

Can we get there and help people get jobs and stay on Medicaid?

- Yeah, this conversation that we're having right now, we could like copy paste on last year, the year before the conflict that exists and in wanting work requirements and having the Biden administration saying, no, well, that's not gonna work.

But then building in.

But if they'd allow it, we will too.

And then having the conversation with the senate, being their hard line on certificate of need.

And that's really a conversation about access to care.

Not necessarily lowering the cost, but increasing access.

And right now they're in conflict and whether or not we like this is a conversation, that is sort of like will they or won't they, are we shipping this?

Like, is this gonna happen?

And I think we're at the same place and it's really gonna depend on, the other pieces of legislation that happen this cycle.

- Well the work requirement is very interesting.

I saw a press press release earlier this week, that Sarah Huckabee Sanders, the governor of Arkansas, another state that hasn't expanded, said, you know, we're in, but you're gonna have to make the, there's gonna have to be a work requirement for it.

But I think to kind of broaden this out just a little bit, you know, for how many budgets were not signed, in North Carolina because Republicans, were not interested in Medicaid expansion.

- Right.

- And now all of a sudden it started last session, late last session, now all of a sudden, every Republican seemingly in the state is in, and I don't know what the public polling, on Medicaid expansion is, at least compared to years past where it was the, you'll plant the flag in the ground on this issue.

Now seemingly it's just gone.

It's very interesting as just a Republican model.

- Well I think there are a couple measures pushing that.

They're very worried.

The policymakers and lawmakers are very worried, about the stability of our rural healthcare delivery system, for our hospitals as well as our doctors.

In the Medicaid expansion bill, they've included legislation to bring docs, into underserved areas, which is a great step forward.

And then you've gotta look too, at the ability for the hospitals and the doctors, to pay that 10% tax that is gonna be a part of it.

So having the HAS money there, is going to help address that too.

- Well and the fact that this has been discussed and debated for so long as Anna points to, we actually are now the beneficiaries, of other innovative other states, in their approach in this expansion.

Arkansas, for example, offers as part of their program, a voucher so that if somebody is poor, but they're working, they can take the voucher, from Medicaid and take it to their employer and pay for the healthcare, that's being provided through their employer as a really beneficial way to keep them in the private markets.

- I don't recall there being a work requirement in the state bills, a requirement to partner to create workforce development options.

So you're talking about other states.

- Right.

- But it could easily get there with just one amendment.

- Probably 80% of the patients, though, already are working.

- Yeah.

- They are not able to pay or buy private insurance and they don't qualify for Medicaid because they make too much.

- And, Joe, I'll leave just the last 15, 20 seconds.

If you're on one side of the issue especially an opponent of Medicaid, your party for all this year said no Medicaid expansion and you're working class and now you got a shot at it and now Republicans say it's good policy.

What about the so-called cognitive dissonance there, The person who represented me that said this was bad now goes, "We want it."

- Yeah.

I think the arguments that have been made principally by Republican leaders who say this is important to rural hospitals, that they're losing so much money from the indigent care, that they've got to have this population be able to provide for the care in some way.

I think the argument that can be made for people that maybe felt this expansion of a federally supported healthcare program can make the argument, you know what, we're already seeing other states take this money.

North Carolina should take this money too.

Because ultimately we think the benefit to the overall health insurance marketplace will be good.

- All right.

The Senate approved substantial changes to pistol permitting laws this week.

The changes would allow handgun buyers to bypass the need to get a pistol purchase permit from their county sheriff's office.

Supporters say private gun sales are already a fraction of the overall market and gun stores are already running potential gun buyers through the national criminal background check system.

Democrats say removing sheriffs from this equation and gun permitting could increase violence.

The North Carolina Sheriff's Association supports the bill, Joe.

- It's very hard for legislators to go against something that's so functionally about criminal justice where the significant law enforcement association, the Sheriff's Association, has said they're fine with the repeal.

Not every sheriff agrees with the position that the association has taken, though.

And I think the opponents to this legislation try to make the case that the permitting which doesn't seemingly cause too much of a problem.

There were a little bit of a backlog in some counties during COVID as a result of that dynamic.

But the idea is that you're trying to keep people who should not have a weapon from getting a weapon and that the permitting process, even if it's a very small number of applicants, it does keep guns out of the hands of people that should not have them.

Now, gun issues are the third rail of American politics and people have strong, strong passions about this.

The fact that there have been a number of high profile shootings around the country recently probably makes this a little bit more of a poignant emotional issue for some legislators.

But at the end of the day if it's the sheriff saying they don't think this is needed, I think it's very hard for legislators to say they're smarter than the law enforcement agency responsible for the process.

- Anna Beavon, working at that state level, how does it work when the local leader says I like, I'm a sheriff and I want permitting but the state organization is there every day telling their local senator representative, get rid of it.

How does that work in practice at Raleigh?

- Oh, gosh, that's complicated.

[guest laughing] But I think looking at this overall process, the thing that was fascinating to me is I don't, when was the last time we had like some significant gun regulation like make it to the forefront?

- Right.

- I think it was 2021 with this exact legislation.

- Yeah.

- Right.

- And so we've heard so much national conversation about gun regulations with school shootings and then we look at this where this process is really just eliminating a redundancy.

And that's always good when we can eliminate redundancies but not lose the spirit of the background check to try to protect people.

But North Carolina has just been able to stay out of that overall gun conversation in a way that I think is super fascinating.

- Nick, what about the local power play?

Put power in the hands of locally elected leaders.

This one takes one away.

- Well, as somebody that went through the process during COVID which was a big deal.

It is a bureaucratical process.

And I do think, you know, listening to the testimony in the judiciary committee, there's just a lot of misinformation and from people that have never gone through the process.

And when you go through the process, you very clearly see how it goes, how it's supposed to run.

And there have been active, there are active lawsuits right now against sheriffs in multiple urban counties because they've essentially completely shut down the pistol purchase permit process.

So this law is here to get rid of that.

There's still federal background checks through the NICS system.

There's not gonna be any dramatic changes there.

I haven't seen anybody prove a point as to how these laws that we have right now will have made anybody safer or better off in the state of North Carolina.

It is redundant.

I have to agree.

- Brad, our last 45 second, urban sheriffs, rural sheriffs.

- Yeah, that's a real quandary that the sheriff's association's having to address and I think they're legitimate concerns that some of your metropolitan sheriffs may have, but I think the duplicity is also a hindrance, a barrier for sure.

- There you go.

The last word for Mr. Cornyn.

Welcome back to PBS North Carolina AirWave, sir.

Good to have you AB, Nick.

Joe, always good to see you.

- Good to be here.

- You brighten my day.

That's our show for this week.

Thanks to this crowd for appearing on the show this week adding their insight.

Email us at statelines@pbsnc.org and share your thoughts on the issues you might have heard here.

We read them all.

I promise you that.

Thank you for watching as you've been doing all winter long.

I'll see you next time on "State Lines."

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