- Just ahead on Black Issues Forum, finally, Medicaid expansion for North Carolinians is on the way, but at what cost?

Talk of a government shutdown once again as Congress contemplates the debt ceiling.

And UNC students take concerns about gun violence to the nation's capitol.

In the past two decades more children have died of gun violence than on duty police officers and active military combined.

We'll talk all about it with our political analysts next on Black Issues Forum.

Stay with us.

- [Narrator] Black Issues Forum is a production of PBS North Carolina with support from the Z. Smith Reynolds Foundation.

Quality public television is made possible through the financial contributions of viewers like you, who invite you to join them in supporting PBS NC.

[upbeat music] ♪ - Welcome to Black Issues Forum.

I'm Kenia Thompson.

State or Nation, it's all about the economy.

North Carolina Senators pass a $30 million budget but Governor Cooper does not plan to sign it.

However, even without his signature it will still become law.

One of the most highly debated and sought after line items in this bill, Medicaid expansion.

Let's talk about the costs and what it will be worth.

I wanna welcome to the show Senator Natalie Murdock and political analyst Steve Rao.

Senator, this kind of feels like it's been a tug of wars, this push and pull.

Last time you and I had this very same conversation asking where things were going and things are still little uncertain at that time, but, so let's update us now and tell us where we are in this decision of expansion and what does that mean for North Carolinians?

- Yes, after much, much delay, we will finally, finally be providing Medicaid expansion to over some 600,000 North Carolinians that have been waiting.

And I have to highlight, we can't just focus on the fact that we finally expanded Medicaid while we were going through having Medicaid in limbo for months, to be clear.

We could have moved forward with Medicaid expansion in January, February if we wanted to.

So we have been holding or my colleagues, the majority, has been holding Medicaid expansion hostage in the budget saying that they would not move forward with expansion without a full on budget.

As we did that, some 9,000 folks a month were impacted.

And that resulted in around 18,000 people that lost their coverage before we finally expanded.

And it's a big part of, as we'll talk about later why the Governor is gonna have to move forward with the budget.

It will allow us to finally have a go-live date of December 1st.

Had we continue to drag that out, we would've been looking at January, February to finally begin Medicaid expansion.

And it's not easy.

It's gonna take a lot of work to get those 600,000 folks signed up for Medicaid expansion.

But we finally will no longer be one of, I think a dozen or so states that is still failed to expand Medicaid after we federally pass expansion of healthcare.

- Yeah.

Which is great news, right?

I mean there are some issues that we'll probably have to flesh out.

Steve, money is obviously a huge determining factor here and $30 million is no joke.

What impact does this decision have on our financial positioning as a state?

- Well, I think first of all it's just a great win for North Carolina.

I mean, we're getting about 1.63 billion in North Carolina, the 41st state to join, as the Senator said.

And many of the states who didn't aren't getting that money.

There's $60 billion of the 10 states remaining that didn't.

So what it means for, you know, North Carolina financially is, you know, number one, tremendously reducing medical debt for North Carolinians because, you know, now they can get access to healthcare.

Investing those dollars in rural communities, so that hospitals can stay open.

Addressing mental health and substance abuse disorder.

You know, 55% of North Carolinians that have mental health haven't been able to get the care they need because of the costs.

Helping working families access healthcare.

I like that idea of helping about 12,000 veterans, which is great.

People who serve our nation.

So all in all this money is gonna be invested very well to North Carolina.

So I'm so glad that it's going in effect.

It's a little disappointing it took them so long.

And with that being said, you know, I spoke to Treasurer Folwell this week and he, you know, he had a good point that, you know, there's the revenue side of it, but there's also the cost side of it.

And so we've seen healthcare costs continue to rise particularly for those under the State Health Employee Plan.

And you know, he's concerned that, you know, hospital costs, he's got the medical transparency bill.

Is the Medicaid expansion bringing these people on the rolls going to increase the cost?

But I still believe that this is the right thing to do, but it's not a panacea.

We have to look at how we're gonna address costs.

The other thing, the final thing I'll mention is that 70% of Medicaid patients are only taken by medical providers where 90% of patients are taken that are covered by, or 90% of physicians cover those that are under private insurance.

Only 70% cover those under Medicaid.

What that could mean is potentially longer lines, poor service, right?

So these are things I think we have to keep an eye on, but I really want to commend the Senator and her colleagues for what I think is the right thing.

Expanding Medicaid providing this investment to the state of North Carolina.

And I'm proud of Governor Cooper for standing by his commit to do this for the state.

- Yeah, Senator, you mentioned that there are a good number of recipients that did not get covered in that lost coverage and we're in that gap yet again.

Is there gonna be some sort of retroactive coverage for that time period?

Or how are they going to handle that?

- Yes, it's my understanding from the Secretary of Health and Human Services also have to give them a shout out.

Now, CDC director at the federal level, Dr. Mandy Cohen, as well as Secretary Kody Kinsley, they have been working around the clock since they didn't know when they could finally start that process.

But it's my understanding that a lot of that work will be official December one.

So on December one is my understanding, half of that 600,000, 300,000 people will immediately be enrolled.

And they've already begun the process of folks that may qualify for other federal programs are more than likely eligible for Medicaid expansion.

But can't stress enough, they could not start that work until we knew what was gonna happen with a budget.

At one point we thought go-live would be October, then November, but we are looking at December as far as when they will officially start the process of enrolling all those folks and getting them the Medicaid coverage they desperately need, those cancer screenings, those surgeries, all of that will finally start now.

- Very necessary.

So I wanna ask you this question piggyback on that.

I know I had the question when I heard that the governor didn't plan to sign the budget, what does that mean?

Like explain that and then how does the budget still go into law even without his signature?

- Yes, I totally understand the Governor's position.

There are a lot of bad items that were in the budget.

But we all know that Medicaid expansion has really defined his term as governor.

It is why we had a standstill with the budget for some years before I became a legislator.

And as we just mentioned, we cannot have Medicaid expansion if this budget doesn't go into effect.

And essentially, with him not signing it, it's him acknowledging that there's a lot wrong with the budget, but he's not going to veto it to prevent it from becoming law.

If he were to veto it, since we're now not technically having regular session, we're having something called skeletal session.

Had he vetoed it last week we really wouldn't know when we would come back to session to address the budget and that would've further delayed expansion of Medicaid.

So he was the adult in the room and said that he will give those 600,000 North Carolinians the healthcare that they need.

And so he's gonna simply allow it to become law while he's still outlining all of the issues that were in the budget.

Which is why in the Senate, in my chamber, all the Democrats had vote against the budget.

- Gotcha.

Thank you for that clarification.

'Cause I was a little confused on that- - Yes.

- And I'm sure some viewers were as well.

- I understand.

- So Steve, you know, as, as Senator mentioned there's many other things within this budget.

Let's talk about what this budget covers and what are some of those trouble areas?

- Well, the first thing that I would bring to point is that you know, the increase in teacher pay three to 4% teacher pay increases 11% by 2025.

I still don't think that's enough.

I mean, we still pay teachers below the national average I think, and we don't have enough teachers.

You know, we have a shortage of teachers, classes are crowded.

I know that that's the case in Wake County.

Kids can't get the classes they need.

So I think we have to do a better job there.

The other concern I have, I mean, their budget does a lot of things, you know, billions of dollars, $2 billion in sewer investments, 2.5 million to increase education for voter ID, which I don't really think is necessary.

So that's a cost.

And there's a number of things it does, but the concern that I have is the Opportunity Scholarship program.

I mean, now providing this to wealthy families is actually gonna drain our educational system by up to $500 million.

It's already in draining about 133 million.

And Governor Cooper is really concerned about that.

And so, you know, I think by helping wealthier families get, use this program, all we're doing is taking away money from our public education system.

And, you know, the Republicans got a lot of things in this budget.

We could be here a very long time.

I wanna start with the fact that part of I40 is gonna be named after the elevator Queen, Cherie Berry.

The court retirement age is gonna increase from 72 to 76.

Ironic, you know, Justice Newby probably will be able to run again because of that.

You know, and just different things that you see in this budget that came in in the last minute.

There's just so many of them.

And you know, I think that's a concern because, you know if we could have taken that money that we invested, that you know, that's we're draining from education and invest that in the teacher pay.

- Right - Right.

- Or training programs.

- Right.

- But anyway, but that's what the budget is.

I mean, it's a, it at least they saw, you know, it's law, investments being made in our state.

But I think it'd have been, could've been a better budget.

- Thank you, Steve.

Well, let's move on to the national picture and current concern over a possible government shutdown.

Come October 1st, if Congress has not passed a budget thousands of federal employees including people in our military, will be furloughed and unable to meet their financial obligations.

There have only been four government shutdowns in the past twice under President Clinton, once under President Obama and the longest one under President Trump.

Senator, when we talk about economy being in jeopardy, why is it in jeopardy this time around?

- Yes, I think this is not the time to have, you know, to put all of our federal employees through this angst, through this frustration.

We nationally have some other economic factors in play that I think can be exacerbated by a government shutdown.

Mortgage applications are at a 20 year low.

We already have a number of interest rate hikes that honestly may be delayed as a result of this shutdown.

Some interesting news I heard recently was if there's not enough data, if government is shut down, it may be difficult for the feds to justify another interest rate increase.

But I think that this just is not the time to have these thousands, millions of employees across the entire nation to not know when they're gonna get their next check.

And I have to highlight, we don't talk enough about the fact that the average American lives paycheck to paycheck.

The average American does not have three to six months in savings.

They really are waiting on that check to come every two weeks or at least every month.

So it will have a huge, huge financial impact on employees.

Our service members, we know so many of them are right here in North Carolina.

We have a huge military population and also in private industry.

I think people forget how many private contractors, how many of these big consulting firms, Department of Defense, they contract a lot of that work out.

So you'll have a lot of private sector folks that really depend on that funding to come in, let alone there's no reason for this.

It is bipartisan, it is political partisanship at its height.

It is restrained Republicans that are holding the speaker Kevin McCarthy hostage and he needs to be the adult in the room.

The Senate has proposed a continuing resolution just to continue funding for the next few months.

And we need to do that.

We need Kevin McCarthy to step up to the plate and say that he will not be held hostage from a very small group of extreme Republicans in this conference.

- Hmm.

Steve, we know that in addition to the national debt, there's also a federal deficit.

So let's clarify what's the difference between the two and then how do they impact one another if there is an impact?

- Well, by definition the national debt is basically all the federal debt plus state and local government debt.

That's about $33 billion.

And the federal debt is what we owe as the federal government, which is right now about 1.52 trillion.

At the end of the day, it's all the same.

It's debt, you know, the national debt, the federal debt and you know, it, it's just a real concern.

I mean, you know, like the golf analogies we're playing a good short game, but not a good long game.

Right?

I mean, we are, you know, sacrificing services on healthcare, 1.2 million active duty troops, our military.

But at the end of the day, the biggest concern is that if we continue, we can print more money and keep having these government shutdowns.

Like the senator said, it's the circumstances of the extreme polarization we're seeing in the government.

It's really quite amazing that our government is close to coming down to a shutdown because they can't come together on this.

But, you know, I think from an economic competitiveness, you've gotta worry about the social safety net.

You gotta worry about the increasing gap between rich and poor, particularly doing AI and automation.

More and more people, you know, we've got workers strike right now with the UAW.

Yeah, interest rates could continue to stay high which makes it harder to borrow money to buy a home.

Helps, stifles innovation.

Instead of spending money on training programs to put those workers back whose jobs are being displaced, instead of investing in our people, we're paying, you know, $1.8 billion on interest payments, right?

- Right.

- So the more and more we do that, I think you're just gonna see this gap, you know, working families being hit and it's gonna, I think we could head to a fiscal crisis but it seems like we can just keep saying, well, let's negotiate at the end of the day for a shutdown.

But this time it's scary that it could happen and you know, it's gonna hurt essential services that people need.

- Big time.

And, you know, knowing that, there really isn't a cap to this debt ceiling, right?

It can continue to increase.

Senator, if we had another shutdown, could we even handle that?

I mean, we saw from the last time during the pandemic, we had unemployment benefits but people are being asked to pay those back, people are asked being paid back loans.

I mean, can we actually handle another shutdown?

Yes, I think another reason that a shutdown at this time makes absolutely no sense is things have stabilized.

We have unemployment claims have gone down, our unemployment rate is low under the phenomenal leadership of our executive branch.

And we need to keep that success going.

We don't need to push ourselves into a recession that is manmade.

We have all the elements for our economy to continue to bounce back and to be roaring.

And also on a highlight, we're coming on the holidays.

October, that's a huge time for retail when folks start shopping for the holidays.

And so, the timing of it is also really, really horrible.

And I just don't think Americans finances can take it.

We have record levels of student loan debt.

Those repayments will start up again on October 1st.

We also have a record amount of credit card debt that average Americans are facing.

And so our government employees are no different from that.

And just basic services that folks need.

We just cannot afford to not have all of the trains running out of the station.

- But even keeping all of that in mind, you know, the holidays are coming up, like you said, but do you think we'll see a dip in participating in that shopping and what fuels our economy?

Because people, I don't know if they can.

I think we will.

And a lot of it is, perception is reality, right?

If government is shut down, it makes you feel very uneasy about your future, about the status of the economy.

So I think folks may pull back and hold back knowing that we're in the middle of a shutdown, and it will depend on how long it goes.

I'm hopeful that it's just a negotiating tactic, one that I don't agree with.

But let's say over the weekend we figure something out because the shutdown will become official starting October 1st.

So we may have a bare bones agreement behind the scenes.

But if it's something that drags out for 1-2 months, then we are in some serious, serious trouble.

- Yeah.

Steve, if the shutdown doesn't happen, does that mean that we are okay?

Or are we just avoiding a larger situation later on?

- I think we're avoiding a larger situation on, and I think that we owe it to the American people to you know, have a government that's working, that's nimble and innovative and doing things the right way rather than just keep kicking the can down the road because of political reasons.

I mean, one of the issues that's holding up the house debate is, the billions of dollars of assistance to Ukraine.

But not agreeing on that, you know, what good does it do to our country?

I mean, you know, you know, India landed a spacecraft in the moon a month ago and I know there's controversies right now going on with the Canadian assassination.

But at the end of the day, you know, a country that was so poor, their government is moving to invest in infrastructure and get things done.

We're the United States of America.

We should be doing that.

And so, I think that, yeah, we can continue to go into these shutdowns, but I think long term, it hurts our country, it hurts our stance, our positioning in the world, people are looking at us, and we should expect more of our leaders in Congress to do the right thing for the United States of America.

- And also quickly, I wanna add too, if I think a lot of federal employees are gonna say, enough is enough.

I think COVID, that pandemic unexpectedly showed people that there are other employment options out there.

And I definitely think that folks are underestimating the resiliency of some of these employees.

I think some of them will say, I can't afford to have this uncertainty and they may find other employment and not come back.

- Absolutely.

- Very good point.

- Yeah.

- Well, it seems like many of these issues today that we're talking about are conversations that we keep having.

This last topic for today's show is no difference.

We're right back to talking about gun violence.

Just after 15 days of an on-campus shooting claimed the life of a professor at UNC North Carolina and students and activists rallied together in an effort to combat gun violence, resurfacing the issue of gun control all over again.

Senator, we have a good number of Republican lawmakers who say that they don't want to support tighter gun laws.

What are your thoughts on why they're doing this?

Yeah, first, again, just want to provide my condolences to the family of Professor Yan with just that tragic, tragic campus shooting.

And I went to UNC for undergrad education.

So really, really hit close to home and also have to highlight the bravery of those students.

They came to the General Assembly, they had a press conference in flooring my colleagues to do something around gun violence.

And we are not saying we're gonna take anyone's guns away.

We're simply saying we want common sense gun legislation.

We want to consider red flag laws.

We want to consider reinstalling that pistol permit that allows your local sheriff to do that additional background check to make sure that you're safe enough to have a gun.

We wanna look at safer stores.

So we're not asking for anything that's extreme but would be remiss if I didn't highlight what's happening at the federal level.

Those same brave, amazing UNC students along with March for Our Lives were invited to the White House when VP Harris and President Biden rolled out a gun violence prevention task force, a full office that March for Our Lives and the survivors of the tragic school shooting in Florida, they've been advocating for that and they were there.

So their advocacy is working, but it's long term.

We have seen that we are making strides in other areas, in other states, particularly those that have changed the balance of control.

But we have a long, long way to go.

And for sure, the low hanger fruit would be a national assault weapon ban.

The numbers are there and it show that mass shootings did decrease when we did that.

So we've got a long way to go.

But particularly here in North Carolina, had the opportunity to speak at a rally with representative Justin Jones who visited from Tennessee.

And we are failing these young people as they come to the General Assembly and say they're in fear of their lives.

They're tired of the lockdowns.

They're tired of the drills, and they want us to do something at the state level about gun violence, and it's time for us to act.

- Definitely time to act.

Steve, the UNC students who participated in the rally were, they were visibly upset, and they even referred to themselves as the lockdown generation, which broke my heart, right?

As a mom thinking my child can't even enjoy their college experience, right?

Because there are triggers and traumas everywhere.

Talk about that long-term damage that this is having on our students, and how may we see that trickle down later on?

- Well, this really hits home for my wife and me and all parents.

I mean, we have a senior at UNC, a freshman that just started at State, and I think that, you know, the gun violence is just, you know, kids can end up getting anxiety, post-traumatic stress disorder.

You know, when I was in college, and I'm sure this is true with Senator Murdock, we didn't worry about whether someone was gonna come in and have a shooting or someone was gonna bring in a gun.

We were focused on studying, interacting with friends, our professors, dreaming big dreams, learning about ourselves, growing, being creative.

And when you have this kind of anxiety, it affects your focus.

You know, how can you concentrate on your studies?

How can you be happy?

And so, I really am just so sad for these kids because, you know, universities should be, they're communities.

They're communities of excellence, and we're so proud in North Carolina to have, you know, our three landmark universities in Duke, UNC, NC State, the HBCUs, the great community colleges, and now they're just, you know, basically places where anybody can come in a gun at any time and shoot.

So we pray for the families, but I just hope that our nation can do what's in the best interest for our national security, which is address the fact that like the senator said, we need gun control laws.

We have 4% of the world's population, but we own 40% of the guns, and we're 250 times more likely to have a gun death here than in Japan or 150 times more than in Britain.

It doesn't mean that we have 250 times more mentally ill people.

We just have too many guns getting in the hands of the wrong people, and we've gotta solve it or we're gonna see more innocent people die.

- Indeed.

- Our children.

- Senator, you know, my speculation is that we may start to even see a dip in college enrollment right?

When we talk about these fears, people take these situations into their own hands.

And do you think that's an option or a possibility that we may see that happening?

- Yeah, it really is horrifying.

As Steve mentioned, you know, when I was at UNC, I was never in fear of my life.

I never thought I could be shot simply by going to class.

And the anxiety that those students are feeling is real.

And I think they're still going through it.

I mean, I would say even those amazing and brave students that had the opportunity to visit the White House, we don't know what they're going through at night.

We don't know if they're able to sleep.

We don't know if they're able to study.

We don't know if they're able to focus.

So I wouldn't be shocked if not only could enrollment potentially go down, but you may have students that have to take a leave, that have to take a semester off.

- Yeah.

- Just because of the anxiety that they are facing since they've been in long-term PTSD.

Because they've gone through it from middle, high school and beyond since, unfortunately this is their reality.

But we have to fight back and will add, they're going to get it right.

I can't stress enough how Gen Z, they are so laser focused on this because it's their lived reality.

And when more of them run for office and become elected officials, we will be there with them since it started with my age group.

I think I was a junior during Columbine.

So I definitely think the combination of Millennials and Gen Z, more of us running for office, we will enact laws that get this right.

- Yeah.

- A little over a minute left in the show, but I wanna bring up, it was disheartening for me to not hear about gun control in the recent Republican debate.

Steve, what are your thoughts on that?

Are they just ignoring the issue?

Do they not wanna talk about it?

You know, what's going on there?

- Yeah, unfortunately it's politics.

I mean, we hear all these, you know, we didn't hear it come up during the debate, which is really concerning in the midst of the worst gun tragedies that we've seen in our nation's history.

But, you know, people are afraid of, you know, voting against their party's base, you know, who are fighting for the nomination and not bringing it up.

And in the past we've heard from, you know, Vice President Pence about, you know, arming personnel, mental health issues.

Let's not forget that Governor DeSantis, as the Governor of Florida, changed laws and made it, you know, you could carry a concealed permit weapon in public.

Meanwhile, you had, you know, just the shooting in Jacksonville.

So, you know, unfortunately, I think it's politics.

You know, you can't bring up an issue that's gonna anger the NRA and your base, but at the end of the day, what's more important?

The safety of the American people.

Anyone running for the President of the United States should be talking about gun violence.

And I want to.

- We gotta wrap it up, Steve.

I'm so sorry.

- No, that's good, yeah.

- I wish we could talk more about this, but thank you both for being on this show.

- I appreciate it.

- Thank you.

- Thank you.

- We invite you to engage with us on Instagram using the hashtag Black Issues Forum.

You can also find our full episodes on pbsnc.org/blackissuesforum and on the PBS video app.

Thank you for watching.

I'm Kenia Thompson.

I'll see you next time.

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