Pass it, THEN figure out how to pay for it and launch it. A really bad bipartisan habit Raleigh needs to break.

Silly me.  I thought representative government was all about our elected folks getting together to publicly make decisions for the greater good.  Too many big decisions in our capital city — from current times back to the Black-Basnight era and beyond — are made by a handful of folks in a smoke-filled backroom.  *Those not honored to be part of that esteemed “handful” are expected to wait patiently on (1) a finished product to emerge from said smoke-filled room and (2) instructions from party leaders on how to vote. *

The latest examples come from last year’s drawn-out budget drama and the much-celebrated expansion of Medicaid.

The debate, if you want to call it that, on Medicaid expansion featured a lot of elected folks on Jones Street who had been forever bashing welfare and big government in general doing some amazing 180s to suddenly support the expansion of the notoriously fraud-ridden federal / state health care program.

Upon passage, we had Speaker Timmy and Uncle Phil holding hands and singing kumbaya with our ridiculous governor. *The world, we were told, had officially been SAVED. *

Fast forward to now.  We’ve been finding a curious number of county governments now struggling with covering the costs of an expanded Medicaid program.  (We specifically targeted the situation in Mecklenburg.)

We were curious to see how many other counties were finding themselves stuck with surprise bills.  We spoke with a senior county government source in our neck of the woods who told us his county had not yet been hit with any nasty Medicaid surprises:

“We were told to go ahead and get set up like the money is coming.  Hire who you need to hire. The money you need will be coming, Raleigh told us.  We called the bluff.  Like the guy in ‘Jerry McGuire,’  we said “Show me the money.”  Then, we’d talk about whether to add resources.  We sat tight, and thank goodness we did.  We’re not experiencing the money issues that some of these other counties, who believed the original spin from Raleigh, are.”

The honorables on Jones Street tried to pass all kinds of crazy things in last year’s budget bill — casinos, weed, and the like.   One thing that really slid under the radar and ended up in the final document was the creation of a state-level exchange for ObamaCare.  The idea was for people who want to sign up for ObamaCare deal with the NC Department of Insurance, instead of the feds in DC.  

Folks from the governing class who are familiar with this move see it as a great idea.  Some money that would normally be going to DC would instead be kept in Raleigh.  (Yay?)   We were also told that this move would “pay for itself” for many years to follow. 

The ObamaCare exchange was a done deal with the passage of the state budget last year.  But this legislation, introduced by senator Ralph Hise (R), caught our attention.  What’s going on here?

It appears that Hise’s legislation was meant to offer some clarification to what was passed in the budget last year.   Again, we spoke with several folks in Raleigh familiar with discussions on this health care exchange deal. Hise’s bill was introduced on May 1.  As of May 21, the folks at the state Department of Insurance — who are designated to administer this thing — had little to no idea of just how many new employees or resources would be needed to get the exchange of the ground.

(In fact, the word is no one at the legislature could be bothered to huddle with the folks at DOI prior to sticking this idea in the budget. *Why keep the folks who will be charged with running this thing in the loop?*) There was also little idea on where the money to fund the setup would come from.

According to one of my Raleigh insiders, the response from Jones Street to questions about where the money was going to come from was: “Don’t worry about the money. We’ll take care of whatever is needed.”

*Sound familiar?*

A good reference point on this is Georgia’s exchange. 

Our sources tell us Georgia’s state insurance department needed 35 to 40 new employees to set up and start up the exchange.  Setup costs were reportedly estimated to be in the tens of millions.  (Do we have that laying around?)