Why GOP leaders are pushing pot and Medicaid, abortion limits and guns

The 2023 legislative session is only a month in, but already it’s shaping up to be one of the most meaningful in years.

In part it’s because of the state’s booming economy opening up new options in the budget negotiations that will start this spring. Another factor is the new level of Republican political power — which has allowed GOP leaders to resurrect controversial bills that failed in the past, but which they can push again this year with greater chances of becoming law.

At an expected $33 billion, the upcoming state budget will be not only the largest in history, but also a full 10% bigger than what fiscal analysts were expecting. The extra billions will give lawmakers more options in the budget for potentially balancing tax cuts, state worker raises, road construction and numerous other projects.

Beyond the budget, huge policy changes — Medicaid expansion, medical marijuana and a slew of pro-gun bills — are also looking increasingly likely to become law.

All those issues have varying levels of support in both political parties. In some cases, like with guns, Republicans long ago passed all their main policy goals and are now getting around to more fringe positions, like a bill filed Thursday by an influential House leader to let anyone carry a concealed gun in public, without having to first prove they can handle it.
In other cases, like with medical marijuana and Medicaid expansion, Democrats have pushed those issues for years. Now Republicans are starting to seriously consider them, acknowledging public polling that’s overwhelmingly in favor of both.

Since Republicans flipped a number of seats in the 2022 midterms, they’ve also now resurrected a number of hot-button culture-war issues that failed in the past but could pass into law this time around. Those include controversial bills on immigration, LGBTQ rights, public schools and political protests.

Republicans have a veto-proof supermajority in the state Senate for the first time in five years, and are just one seat short of a supermajority in the House — meaning that the legislature can override Cooper’s vetoes if not all House Democrats show up to vote one day, or if even just one Democrat bucks the party and sides with the GOP on a vote.

And while there’s already a long list of high-interest bills to watch, some of the biggest issues haven’t even surfaced yet.

  • A sports betting bill failed to pass last year by a single vote in the state House, and is widely expected to be filed again this year. Gov. Roy Cooper (a huge Carolina Hurricanes fan) is in favor, and a new version this year is rumored to be almost ready to go public.
  • A handful of election-related bills have been filed, such as proposals to significantly shrink the state’s early voting period and ban counties from getting grants to help run elections. But other expected GOP-backed changes to election laws in advance of the 2024 elections — like cutting down on mail-in voting, or a new voter ID law to replace the 2018 law that was recently ruled unconstitutional for racial discrimination — have not yet been filed.
  • Redistricting is also unlikely to happen until this summer or fall. With the GOP newly in control of the state Supreme Court, Republican lawmakers are expected to have free rein to redraw the state’s political maps to all but guarantee Republicans will win several more seats in the U.S. House of Representatives. The main question is which current Democratic representatives will be targeted.
  • A proposal Republicans call the Parents Bill of Rights, one of the first bills the Senate passed this year, is part of a national conservative push targeting transgender K-12 students. It failed to pass last year but has better odds now. Still yet to resurface this year is another do-over bill — to ban trans girls from playing girls’ sports. Last session in 2021, the bill’s sponsors gathered supporters for a press conference on March 24, the fifth anniversary of HB2, which required people to use restrooms matching the gender assigned at birth. Opponents viewed it as discriminatory against transgender people.
Republicans are also expected to introduce legislation further restricting abortion. North Carolina law currently bans abortions after 20 weeks, with no exceptions except to save the life of the mother. Republican leaders have said they likely won’t push a full ban on abortion, but they do want to make the law stricter than it is now.

The politics are tough for conservative leaders to navigate on any proposal to further limit abortion access. If they want a bill that could actually become law, they’ll need to find a solution that can still win support from more moderate Republicans and, crucially, at least one Democrat in the House.

At the same time, barely any Republican lawmakers represent politically competitive districts. Most legislators face their biggest political challenges in the party primary, not the general election. So will Republican legislators support an abortion bill that’s not as strict as the party base wants, if it means potentially losing a primary in 2024?

Some Republicans feeling vindicated

This year’s bills for medical marijuana and Medicaid expansion have allowed conservative lawmakers who had long privately advocated for those changes to now step into the spotlight, no longer needing to keep their advocacy hidden behind closed doors.

In a recent interview about Medicaid expansion, Republican Rep. Donny Lambeth got up from his office desk and walked over to where some poster boards were stacked in a corner. He turned them over, unveiling charts, numbers and some slightly outdated cartoon graphics: It was a presentation Lambeth said he gave to fellow Republicans eight or nine years ago on the benefits of expanding Medicaid.

The graphics might have aged, but Lambeth’s arguments haven’t. Leaders in his party weren’t swayed back then, but they’ve now come around to his way of thinking.

Lambeth, who went into politics after retiring as a hospital executive in Winston-Salem, recalled a conversation he had after one of those early presentations with a top GOP legislator who told him, “Timing’s probably not right. But there will be a point that North Carolina will pass expansion.”

Nearly a decade later, it appears the timing is now right. Rural conservative lawmakers have watched as numerous rural hospitals shut down in the last few years, or only stopped from shutting down because the state government stepped in to save them. Lambeth has also risen to a more powerful position: chair of the Health committee and a top state budget writer.

And while the House and Senate disagree on the details, he predicted that 2023 is the year Medicaid expansion will finally happen. It’s just a question of how long it takes to wrap the negotiations.

“I am very encouraged that before we leave here — if we leave here in June, or if we leave here in November — we will have a comprehensive health plan,” he said.

It’s a similar story on medical marijuana for Sen. Bill Rabon, arguably one of the most powerful people in the state as chairman of the Senate Rules Committee. He’s also a cancer survivor, which led him to research the arguments for marijuana replacing painkillers and other prescription drugs.

He spent years talking to fellow Republicans about medical marijuana in private, before shocking many political observers in the state by sponsoring a bill for it last year, making himself the face of an idea that can be controversial in conservative political circles.

“Timing is everything in politics, and I’m not sure North Carolina was quite ready to do it, until other states did it,” Rabon said in a recent interview, when asked why he waited so many years to publicly support the idea he had pushed in private. “We saw some states that didn’t do so well; we saw some that did it well. And we tried to take from the ones that did it well.”

Polling shows a majority of North Carolinians support fully legalizing marijuana, and nearly four in every five people support medical pot. Rabon said that fact helped him build support among fellow Republicans, before going public with his bill.

“They said 80% of people can’t be wrong,” he said.

Medicaid details

Medicaid expansion may be the weightiest issue of the session, and the House has already passed its version of the bill, which Lambeth wrote.

But that bill was dead on arrival in the state Senate because it includes Medicaid expansion and nothing else. Senate leaders want to combine expansion with major rollbacks to the state’s hospital regulations. Lobbyists for hospitals and doctors oppose those changes but supporters say they would improve health care costs and access, in urban and rural areas.

The Senate hasn’t yet filed its own proposal this year, although whenever it does happen it’s likely to be similar to what the Senate passed last year. Berger said last week that GOP leaders don’t have a timetable to file it.

And there were unanticipated benefits to waiting so many years: Because experts believe expanding Medicaid would have such broad benefits for the nation, from better health outcomes to fewer people going into debt when they get sick or injured, the federal government is now offering signing bonuses to the final few holdout states such as North Carolina.

In North Carolina’s case, that would mean an extra $1.8 billion to use however the state legislature sees fit.

The delays at the legislature, caused by the disagreements between House and Senate leaders, come even as the clock ticks on that $1.8 billion federal payment — plus a looming deadline that might end up dropping people from the state’s Medicaid rolls, only to return some of them once expansion happens.

Cooper has called for speed, saying that in addition to these issues the state forgoes more than $500 million in federal expansion money that could be paying for health insurance for hundreds of thousands of people, many of them the working poor.

WRAL state government reporter Travis Fain contributed.

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