- [Narrator] Legislative leaders promise they'll redraw congressional districts to add at least one Republican majority US House District, and Republican lawmakers ask why the Stein administration would not delay Medicaid cuts.

This is "State Lines."

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[uplifting music] ♪ - Welcome back to "State Lines."

I'm Kelly McCullen.

Pull up a chair for the next half hour, because joining me today, a great group of friends and very smart people about North Carolina politics and policy.

Skye David is to my right from New Frame and the "Do Politics Better" podcast.

Check it out.

Campbell Law School's Rick Glasier to her right.

Rick, good to see you again.

- Good to see you, Kelly.

- [Kelly] Donna King, the editor in chief of Carolina Journal.

Good to see you, Donna.

- Hi.

Thank you.

- [Kelly] Former Justice Bob Orr, current attorney, does a lot of things.

Still good to have you on, judge.

- Still good to be here.

- Good for us to see you as well and a good week for you to be on.

Let's start out.

Donna, you'll kick this one off for us.

Let's talk about the House and Senate Republican leaders who say they will lead efforts next week to redraw North Carolina's congressional districts.

State lawmakers will convene in Raleigh, where the GOP promises they'll follow President Trump's agenda to give him the mandate to rule.

It's expected the first congressional district, which is currently held by Democratic representative Don Davis, that it will be redrawn into a Republican majority district, giving the GOP an 11-4 advantage in US House seats, and Governor Stein, Donna, can't veto congressional redistricting, so here comes the train.

- Sure.

Oh, it's gonna be a big week next week, certainly.

This is already scheduled to be hitting the ground running on Monday morning.

There's a draft map up on the ncleg.gov website, so you can take a look yourself if you want to.

What it looks like this draft map does is expands Congressional District 1, currently represented by Don Davis, as you described, and kind of switches it a little bit with Congressional District 3 in some areas, which is currently represented by Greg Murphy.

If you look at the population shift in some of those other documents, it comes down to individual voters, one person in many cases, to make sure that that population balance, but what this really does is it makes that CD1 a little more Republican, makes CD3 a little more competitive.

What we really could be looking at is, if there's a really sweep for Democrats, if they have a really big year, this could actually end up hurting Republicans potentially, because, you know, we may see that that CD1 be a little more competitive for Democrats, but what we are seeing is that this is a move by the state legislature that will likely end in some, you know, likely draw some litigation, particularly if they, you know, split some communities in racial or along racial lines, but in all the documentation, it looks like they're doing it straight by population, and the courts have already said that they're not gonna step into partisan gerrymandering.

So, you know, it's going to be a big week, but it is something that the leaders of both chambers say that they're going to really try and cement representation for Republicans in Congress.

- So, Rick, Republicans are being removed from Congressman Murphy out there to go into this district for Don Davis, who says he's going to explore all options.

He may continue, he's likely to continue this fight.

He is the sitting incumbent.

- Well, I think that's right.

I think there's two points to make on it, and Donna really accurately summarizes this.

First, let's be candid.

This is unadulterated political gerrymandering at its height and it's being done ostensibly, it appears at least, to appease the president of the United States and his desires in a process that sadly is sweeping the country where Texas started it, California's done it for the Democratic side, Missouri's done it for the Republican side.

And it is wrong on so many levels.

And the question becomes, right?

Is it in the people's interest?

Are the new districts truly compact, contiguous, representing communities of interest?

But I think there's a second point to have here.

And the second point is, look, the legislature is coming back and spending an inordinate amount of time doing this.

The one primary task they're handed is to form a budget and to pass a budget for the people of the state.

And they haven't done it.

So they're gonna come back for political and control purposes, but they're not gonna spend time on passing a budget.

And that just makes no sense from a priority point of view about what the legislature should be doing.

- Skye, that's a good point.

They're there, they can do lots of things.

They're going to redistrict.

- That's right.

And that seems like it might be one of the only things they're gonna do next week.

I've heard that there might be some local omnibus bills that are passing, but it doesn't seem like there's gonna be a Medicaid deal or a budget deal or even a mini budget deal that's coming across.

- From the lobbyist perspective when redistricting comes rolling through.

I mean, it's a busy job there in Raleigh.

I've seen people in and out of offices.

Is it just a, is everyone join in the gallery and watch something that doesn't affect all these interest groups out there?

Is it just, are you spectators?

How does it work?

- Personally, you won't see me there.

I am not involved in redistricting at all.

And I'm not gonna go watch that, no.

- Well, can you judge anyone?

Judge, can you judge anyone for not wanting to go sit and watch redistricting come through?

What do you make of this mid-decade redistricting to give Trump his mandate to answer California, which answers Texas, which answers the complaint about Massachusetts and Illinois also being extreme democratic gerrymanders for political purposes?

I can go on and on.

- Yeah.

Well, we're missing the core question.

This is an election for a congressional seat, number one in C1 and the government, the legislature is manipulating the voting pool in such a way as to in essence, rig the election.

I mean, and that's not a political statement, that's a practical statement based upon the data that they're using on each of the precincts.

And so they're moving counties, they're moving precincts around for the exclusive purpose of putting their thumb on the scale when it comes to the election.

And I think the people of the state and the courts of this state have got to answer the question, do we have any constitutional right to a fair election?

I mean, the whole premise of democracy is that you elect your representatives, but if the government is going to go ahead and preordain who's gonna win, then you have completely cut the legs out from under our Democratic system.

And so I think we talk about geography, we talk about maps, but it's manipulating election results.

And frankly, I think it's unconstitutional.

- Donna, would this be possible without the advent of computers to make this easier?

I've been around a long time, but I haven't been around long enough to watch 'em in a smoke field room drawing it out by hand.

- Right.

- Like on a checkerboard or a map of some sort.

- Sure.

- How do you think this, is technology making this possible?

- Oh, I think it's certainly playing a role in it, of course, but I think, in many cases, like for example, CD3 becomes a little more competitive.

Some of the areas around Wake County become a little more competitive.

And the ones that have changed, Trump won 10 points are more in some of what we're talking about.

So certainly it's going to lean a little more Republican.

But we are seeing some of these districts become more competitive.

So it could be, even though it is a strategic move, it could be risky.

- Rick, you were there when Republicans took over the legislature back in, what was it, 2010.

- 2010, 2011.

- And you can redistrict and the census came out that year if you're Don Davis, what do you do when your former colleagues, if they were across the aisle, just redraw the map and take you from having to fight for reelection to, you're probably going to lose if you run?

- Well, I mean, he's got obviously decisions to make on a personal level, but I have to agree with Justice Orr.

I mean, this, what is happening is pyramid political manipulation.

And the public has not asked for this.

This isn't necessary.

It doesn't serve the public's interest.

It serves specific power interest by specific people.

And that is fundamentally wrong for the government.

Don Davis is gonna be the newest, but not the only victim in this process that has been going on for a number of years.

And you have to fight.

I think he will, but in the end, he doesn't control what the legislature's gonna do by the other party.

His reality is gonna be what's passed next week and how he goes from there.

Now, I do believe there should be and will be litigation over it, but I think the bigger issue is what Justice Orr raises and that is the public consciousness of why this is being done and what the result is and is that really what we want as a society?

And I think number one, we're better than that.

And number two, the Constitution suggests that shouldn't be happening.

- To Donna's point though, that CD3 becomes more competitive and now Don Davis actually resides in that district.

So will he run against Representative Murphy, or will he stay in district one and run there?

Which he doesn't have to live in his district.

So he could do either or say I'm done with this.

- Yeah, well I was just gonna say that the Supreme Court said in 2019 that this is not something, that political gerrymandering is not the place of the courts to decide.

So I think that that's one thing that may shift the idea of litigation coming down.

- You did say political, you said it was a political move, not a racial move or any other... - I think the distinction, the Rucho case, the Harper 3 case, were challenges to the map, seeking proportionality, an even number of Democrats, even number of Republicans.

What I'm saying is this is a discreet election.

And I had a political consultant tell me that he has 2000 data points on every voter in the state.

So the people in that back room, drawing those maps have the ability, they know whether you're a member of the NAACP or the NRA, they know what church you go to, what primaries you voted in, what income you have, and you manipulate that data in such a way that you are going to have guaranteed or as close to guaranteed wins as possible.

Look at what happened to Kathy Manning's seat, Wiley Nichol's seat, Jeff Jackson's seat.

And so, you know, it is a fundamental question for our state and our nation 'cause this is going on all across the country.

And that is, if you allow government to manipulate the election for Congress and the legislature, I mean, you've done away with democracy.

- Don, I wanna ask one question.

They put out this release, it's done to support President Donald Trump.

It's a higher calling.

Trump voters are loyal and they're gonna stick with their President over any state Senator or House speaker.

What do you say to that?

That this could be at the state level a mess legally, but it's a better purpose across America.

This is for the good fight.

- The leadership in both chambers has said in their press release that this is, a call from the President to solidify, to counteract what was happening in California, where they are going to abandon their independent redistricting commission temporarily in favor of redrawing these maps that would carry through 2030.

And so Trump said, "Hey, I need help from Republican legislatures."

And you know, they're saying, "Yeah, we're here, we're gonna do that."

- I mean, this is a classic the ends justify the means philosophy.

And that has never been a good result in almost any aspect of life.

And that's exactly what's going on here.

- But I think it should be noted, California was in response to Texas, you know, so you know who's responsible for it.

I mean, candidly, the president started it by calling on Texas initially to create new seats.

- But do most Republican voters rank and file, you know, Doug and Diane Tarheel out there, they support the president if they voted for 'em, and they don't mind that we're redistricting.

And no matter what the former justice says.

- I think there's been a recent poll that 80% of North Carolinians are opposed to political gerrymandering, including 70% of registered Republicans.

So I think they're not doing anything for the good of the country or the public.

They're doing it to consolidate power for their own political party no matter what state or what party.

- We'll pivot this show towards medical debt where Governor Josh Stein announced.

- This week over $6 billion in personal medical debt has been extinguished right here in North Carolina.

The Cooper administration had worked a deal a year or so back with federal officials to give North Carolina hospitals those billions.

The hospitals would then need to agree to release debt claims in exchange for the cash.

2 million people saw their debt relief with this one time funding an average of 2,600 bucks per person, and rural hospitals could receive higher Medicaid reimbursements for offering debt relief as well.

About 100 hospitals out there, every single one of them, Rick took this deal.

- Politicians say they helped out the common man with medical debt, but really this is federal money infusing into struggling hospitals, right?

- Yes.

In part, yes.

This is really a good news issue, right?

As opposed to some of the controversial stuff.

This is a first in the Nation program and Governor Cooper and Governor Stein and their administrations deserve a lot of credit for putting this together, but it really is gonna help in immense ways.

Now it looks like it'll impact about 2.5 million people.

It'll be, as you suggested, $2,600 at a minimum per person.

But this covers essentially all Medicaid enrollees as of July 1st, 2025, and their debt going back to January 1st, 2024.

It also helps people who are not Medicaid recipients, but have income threshold at below 350% of the federal poverty level.

And also those who don't even meet that category, who have an extraordinarily high medical debt to their income.

It is life changing, life altering, and it's not just money that's coming in right now, this is also going into the future because it includes a number of other provisions that the hospitals had to agree to, to reduce medical debt and to reduce it in the future, which includes less aggressive tactics and going after medical debt, lower interest rates on the debt that exists.

It includes essentially not reporting medical debt to credit reporting agencies.

I mean, there are a lot of consumer protections in this bill, and the amount that we're talking about is about $6 billion in reduced debt directly to patients and as well by hospitals indirectly having to reduce those costs.

The last thing to note is what you pointed out, and that is it also really, particularly for rural hospitals, which have been struggling, creates a federal stream of money, no state tax money involved that supports rural hospitals, keeps them from closing, which improves healthcare access, healthcare quality.

This is a win-win, win all the way around.

- Skye, what strikes me, I remember when this deal was announced last year before Roy Cook were left office as governor, Republicans were silent on it.

And I also must say from everyone that's been on state lines, Republican or Democrat, everyone supports rural hospitals.

So I did notice there was quiet positivity with this breakthrough, not only this week, but last year.

- Yeah.

I think to Rick's point, it is a win.

I personally have dealt with this on a case by case basis.

When a rape survivor goes to a hospital.

Your rape kit's paid for, but everything else that might happen is not.

- You're kidding.

- And you have a 17 or 18- - Wait, victims are getting billed?

- Yes, 17 or 18-year-old, and maybe they work at the Starbucks and you have to submit their pay stubs to the hospital to try to get charity care.

And so I think this is a win all the way around, just as you said.

- And it really does increase the requirements on local hospitals to increase access to charity care.

- Donna, what do you make of this issue?

I mean, the money's now here, it's one time, but people will- - Right.

- Still fall back into debt, I presume, in the future.

- Well, and that's the question, right?

How did they get here in the first place?

We have highest healthcare costs in the country, higher than California, higher than New York.

Why do we have the highest healthcare costs in the country?

That's the big question.

How are they getting in this debt in the first place?

And this is creating this kind of shell game, house of cards of money where you get higher reimbursements, which triggers more federal money.

In the end, it's still churning at this very high cost of healthcare that just needs fundamental reform.

- Will, Bob, Rural hospitals live to fight another day or another year with this much money coming in?

Will lawmakers you think seize the opportunity to take a good look at Medicaid?

Right now there is a state funding shortfall.

What happens with this good news?

- Well, we celebrate for the minute and then all of the problems down the road are gonna hit.

- [Donna] Right.

- We don't have a budget in Washington.

Actually, the government is shut down.

We've got Medicaid issues here in the state and nobody's really addressing what's the long-term solution to getting and reducing healthcare costs in the country.

I mean, it's really tough on these families out there and this is a great one time event, but there's a lot more to be done.

- Well, and I do think that it's important to note that this isn't just for this year.

I mean, there is at least a couple year cycle this is gonna stay with, so which you have to have to get it at not recurring.

I think the consumer protection provisions are important provisions as well.

But, Justice Orr and Don are absolutely correct.

I mean, healthcare costs have been staggering for a long time.

Obviously the Affordable Care Act was a serious attempt nationally to get at trying to reduce healthcare costs nationwide at the same time of creating access for millions who didn't have it.

But there are so many issues that are involved in the increasing healthcare costs and the federal and state governments really in a bipartisan way, this is an issue that really has to be bipartisan consensus on, have to start approaching those long-term solutions.

- I think they can do that bipartisan.

I think this could be one.

- You would hope.

- Well, let's hope so.

Yeah, state education officials here in North Carolina report, there are nearly 100,000 opportunities, scholarships or school vouchers being paid out this year.

Overall voucher growth is about 20% higher than last school year.

And that's from new students signing up.

About 15,000 families, Judge, drop school vouchers for '25, '26.

There's a group out there called EdNC, they study our public schools.

They say public schools have protected their market share this school year.

They are still teaching about 84% of all students in North Carolina.

How about this for a public education debate when education advocates are now talking about market share, Mo Green's talking about market share, and guess what?

The public schools have stemmed a lot of it.

They're hanging in there.

- Frankly, I'm not enamored with referring to this as market shares.

I mean, one of the real problems in the voucher system is when the general assembly expanded it to everybody in the state.

No matter the income levels, rich people are getting vouchers just like poor people.

And frankly, what's transpired to my mind is that the original purpose of vouchers, which was to help poor families escape struggling public schools and be able to go to a private school.

Now, most of the money, I think 80% are children that were already in private schools, and this includes well to do families, And the average cost I saw, I think in our area for private schools is 10 to 30,000 and the voucher is 7,400.

So low income and moderate income families might get a little help, but there's still a big chunk.

And so we're seeing money go where it really doesn't need to go, as opposed to what was the original scheme or plan for a low income.

- Don, Don, I wanna go to you and then to Rick.

- Sure.

- But they are using the word market share now.

It feels like a competition and it feels like the public schools stymied what the fear was, there'd be just a funnel of children out of, maybe, maybe public schools are full.

I don't know what critics and supporters would say.

What do you think?

- Well, I mean, hitting that a hundred thousand milestone is huge for these programs.

But I think churn, they used the word churn in this article.

I don't think that's a bad thing.

I think what we're seeing is the evolution of a market that's much freer than it used to be.

And there's a couple of things.

One, it's not universally that you get it, you're universally able to apply for it.

And 80% of the people being, having already been in private school isn't necessarily true.

80% of the kids were already on the program to begin with.

So it's not that it's 80% of wealthy kids are getting the money.

That's just not the case.

So I think what we're really seeing is the market is opening back up.

People are choosing for whatever reason, to take advantage of school choice options, whether it's charter schools or whether it's something like the opportunities scholarship program should they qualify to get funding toward it.

But I think a freer market is what we're seeing.

And the majority of folks will almost always send their kids to public school.

And this, these programs are just providing an option for those who don't see it as a good fit for their kids.

- So I'm gonna start my few comments with agreeing with Justice Soer.

He is a more gentleman than I, so I am gonna use, I'm gonna use a little bit more direct language.

We have one of the worst, if not the worst, flawed model of voucher schools in of any state in this country.

We now have a hundred thousand students who are getting a voucher.

I was there when it was intended and started as a program for rural areas that didn't have choice capacity for low income kids or for special ed issues where there weren't special ed capacities.

And that was the draw to start it.

That was truly camel's nose under the 10.

And now we've got the full camel and everybody else in there.

- You always get the full camel money.

- Yeah.

Well here's the deal with our charter schools.

Our charter schools now have effectively no income eligibility limitations.

So you could be a $300,000 parent.

- Sure.

- With one kid who is gonna send your kid to the private school.

Now you get $8,000.

Second, our charter, our voucher schools don't have certified teachers for the most part.

Don't have to, they don't have to have criminal background checks for most of their people, which is absurd in this day and time, whereas public schools do for security purposes, they don't have to have anti-discrimination provisions in their handbook.

They don't have any testing or accountability.

We have no dang idea how kids are doing in these accountable charter school models.

- That information is all publicly available.

You have to go look for it.

It's all there.

They have to produce it.

Whether you go look for it or not, that's up to the governor or the executive branch that wants to do it.

- Donna, I respect everything that you are, you are just an incredible professional.

But I disagree with you on that point.

I don't think real testing and accountability measures like we use in the public schools are available.

And I think it's really difficult.

All the other states, most of the other, I don't wanna say all who have voucher schools have these things, we don't.

And then last point to make is, it's one thing to create choice, but public schools do have choice.

And they've had choice for a long time with magnet programs, year-round programs, college success programs, pick it.

It's the areas that don't, that vouchers are trying, should be trying to get.

- I see the emotion.

This is an emotional topic.

I got one more topic I want to get to, but- - Sure.

- This is how it's going to be with public education.

You feel, you feel it.

- Right.

- One way or the other.

- Yeah.

- So.

- Well, I agree with that.

I mean, I have children that have done public and private and we've never been able to get into a charter school and there are great options for North Carolina families.

It's one of the fantastic things about this state.

- All right, Skye, you ready for the final topic, Medicaid?

- Yes.

- Let.

We'll let decompression happen here.

- Yeah, simmer down.

- Speaking of a statement, well, there's no deal on Medicaid either.

A legislative oversight committee held hearings on the Stein administration's decision to implement those Medicaid reimbursement cut to doctors and healthcare facilities that started back on October 1st.

House Republicans pressed Medicaid leaders on that decision.

Instead of shifting state funds to delay those cuts, which they say was possible, some House Republicans are saying they thought they had an agreement to collaborate with the Stein administration to delay those cuts.

Governor Stein says this week, no deal on that.

Legislators need to pass a clean Medicaid funding bill, get this children's hospital debate freed up and he'll find 500 million more dollars in addition to what the legislature ought to be doing.

So he says, what do you say?

- Well, I think Governor Stein's letter to the legislature said, hey, if you're not gonna find the money to do this, I will pull money from the reserve.

- [Kelly] Ah.

- But that's gonna create a bigger problem next year.

So which one would you like to do?

And so I'm interested to see how this is gonna play out.

They were questioning them, saying, what are you doing to reduce costs and why is this something that has never happened before and this year suddenly it's a huge problem?

- Rick, it looks like waste, fraud, and abuse start there, they say, with Medicaid.

I have one minute to get around the horn.

- I mean, I'm getting back to Skye's point.

- [Kelly] Yes.

- I think the governor's sort of left with, if you're not gonna pass a budget, I gotta find a way to make up 300, $350 million.

And rates are part of that, one of the only ways to do that.

So I think the answer to part of this is to the legislature, go do your job and pass the budget.

- Yeah, thanks for the correction on that.

It's a complicated topic.

- Sure.

- I can get in the weeds on this topic.

Will a Medicaid deal happen?

Will Stein be able to bring Republicans here?

- They've got some time to do it.

It's so, Stein was, we had an October 1st deadline that the executive branch set for reimbursements.

But I think that they will get a deal together if they can get a clean agreement.

- Judge, will pressure work?

Very quickly.

Political pressure to make?

- No, but stop punting tough issues down the road.

Let's get 'em resolved, that's what they're elected to do.

- Well if they punt, we have a show every week.

As long as they punt, we have something to talk about.

Email your thoughts and opinions, statelines@pbsnc.org.

I'll read every one.

I'm Kelly McCullen, I'll see you next time.

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