Ask Republicans in the General Assembly what they’re most proud of after seven years in control and they’ll tell you they cut taxes and held the line on state spending. It’s a good one-two message to run on, but it has become a reckless formula to run a state on. The reason is showing up in the health and safety of North Carolina’s children, in jails brimming with the addicted and the mentally ill and dangerously understaffed prisons, where five corrections employees have been killed this year and many more assaulted.
Consider first the children. It’s well known that many of the state’s children attend schools that lack sufficient books and supplies and also lack key human resources – teacher assistants and school counselors – as a result of austere state budgets. But an even heavier price is paid by children at risk. The opioid epidemic is intensifying in North Carolina and straining the state’s foster care system.
Opioid overdoses killed 1,360 people in the state in 2016 – a 25 percent increase over 2015. This year is on pace to be even worse, according the state Department of Health and Human Services. Those deaths include parents. And there are more parents in jail or disabled because of addiction. That’s straining the state’s foster care system. The NC Health News reported last week that in 2013 there were 5,198 children in the system. Last year there were 5,721, nearly 40 percent of them there because of parental drug use.
The opioid epidemic combined with scarce funding is also compounding problems with infants. DHHS says there has been a 900 percent increase in the number of babies exposed to opioids. Seven of every 1,000 North Carolina babies die in their first year of life. That’s tied for the seventh worst infant mortality rate in the nation. And it’s a lot worse in poor rural counties. In parts of Eastern North Carolina, the infant mortality rate among African-American babies is on par with that in Malaysia. Meanwhile, in a recent March of Dimes report, North Carolina was downgraded from a C to a D for its increase in preterm births.
Some of the opioid-related problems could be countered if legislative leaders would expand Medicaid. Instead, they’ve chosen to let billions in federal health care dollars go unclaimed. That means less health care for poor women before they become pregnant and less treatment resources for opioid addicts.
The lack of Medicaid expansion money combined with the state’s underfunded mental health system also creates problems for county jails. Whether addicts in trouble go to jail or into treatment often depends on whether they have health insurance. Jails are not suited to safely treat people suffering from withdrawal and mental health problems.
Finally, there are the prisons burdened by high levels of mentally ill inmates and not enough officers. The problem needs to be addressed with more mental health facilities, changes in sentencing and better pay and training for corrections officers. North Carolina could do that, but for the Republicans, cutting corporate taxes takes priority.
Democratic Gov. Roy Cooper has called for an end to Republican tax cuts, more spending on state services and an expansion of Medicaid. Republicans rejected his budget and expansion. Cooper vetoed the Republican budget as too stingy on spending and too costly on tax cuts. Republicans overrode his veto. In a letter to the governor after the override, Senate leader Phil Berger wrote:
“I understand you fundamentally disagree with many legislators about the scope and size of state government. But you cannot deny that Republicans’ philosophy and approach of overall spending discipline and broad tax relief have resulted in consecutive years of balanced budgets and revenue surpluses, while other states that have relied on your tax-and-spend approach, like Illinois, are going bankrupt.”
North Carolina is in no danger of going bankrupt because of a “tax-and-spend approach.” That’s how governments run and how they serve. It’s not about overspending. It’s about meeting the state’s greatest needs. It can be done without damaging the state’s finances. North Carolina established a triple-A bond rating while under the Democrats.
Instead, North Carolina is facing a kind of moral bankruptcy. Only a political change of heart by Republicans to serve the neediest in the face of hardships intensified by the opioid epidemic can prevent that kind of default.
Barnett: 919-829-4512, nbarnett@ newsobserver.com