Rural vs. Urban Unemployment + Medicaid Cuts + Campaign for Better Care

Nov. 1, 2011

THE MEDICAID HOLE: DHHS struggles with shortfall

The NC Department of Health and Human Services testified last week at a meeting of the Joint Legislative Oversight Committee on Governmental Operations to address how far they’ve come in implementing the $365 million budget cut to North Carolina’s Medicaid program. Earlier this month, DHHS reported that there was a $100 million “hole” in the Medicaid budget. The enormously scaled-back program had been presented with various challenges in terms of cuts – including federal program mandates that proclaimed you can’t cut eligibility for Medicaid under federal law, as well as administrative delays.

Because of these challenges, DHHS projected last week that they’ll be $139 million over budget at the end of this fiscal year. The shortfall could result in the dismantling of critical services for individuals with mental illness and seniors who rely on the Medicaid program.

On top of all of these setbacks, holes and severe cuts, it seems that none of our lawmakers want to admit just how bad and impossible these cuts exactly are. Some senators are still making claims that the expected Medicaid savings are "reasonable," and that it’s within reason for DHHS to find such savings. It’s as if they are actively choosing to ignore the potentially devastating cuts to services, as well as the thousands of North Carolinians that would be directly affected by these budget cuts.

Then again, claiming ignorance is easier than admitting culpability. It's easier than examining the most vulnerable North Carolinians that are hit by Medicaid cuts – individuals such as children, the elderly and disabled, and low-income adults. It's easier than recognizing that 70 percent of all nursing home residents eventually become Medicaid recipients, or that the program paid for more than 50 percent of the state's births last year, ensuring the health and safety of mothers and children across North Carolina. If lawmakers admitted that eliminating critical services in areas such as dental work and hospice care would in fact cost the Medicaid program more in the long run, then they might have to admit they made a mistake by implementing these cuts in the first place.

ROAD TO RECOVERY: Rural areas struggle to create jobs

The road to economic recovery in North Carolina hasn't been easy, but the latest numbers show that it's been harder for some than others, particularly in certain corners of the state.

The Economic Security Commission released its September numbers on Friday, revealing that rural counties across the state have been more immune to economic recovery than their urban counterparts in terms of job creation. The ESC showed that 53 out of North Carolina's 85 rural counties had unemployment rates over 10 percent last month, as opposed to urban counties, where only 5 out of the 15 areas faced similarly high numbers.

Since 2010, rural counties' unemployment rates have also spiked. The average unemployment rate in rural counties in September was at 10.7 percent – a full percentage point higher than the average jobless rate in urban counties. The rural number is up from 9.8 percent in September 2010. Click here to see a map showing the breakdown in each county.

Jobs are needed across the board. Urban areas have a jobs deficit of 111,234 compared to its 2007 numbers. These are striking numbers to be sure, but rural North Carolinians are even greater need of those promised jobs. In fact, more than 165,000 jobs would be needed in order to catch up to pre-recession employment levels.

There are options. A report released by the NC Budget and Tax Center last week found that tax-supported public investments and services are crucial in creating jobs – both now and in the long term. Using state and local tax dollars to pump money into education, transportation, health and public safety all help create jobs and increase household income.

Tax revenue saved or used on imported goods and services do little to benefit local economies. Hiring teachers, emergency responders, health workers and construction workers, on the other hand, put money directly back into the local economy. Investments in these public services could make all the difference in battling the job deficit and moving North Carolina into the next decade as a leading economy once again.

CRUCIAL CONVERSATION: NC Policy Watch events across NC

NC Policy Watch is taking November by storm with four Crucial Conversation events across the state.

The events kick off tomorrow on Nov. 2 in Charlotte. NC Speaker of the House Thom Tillis’ recently remarked that implied his goal was to pit disabled people against poor people as part of a “divide and conquer” strategy. In many ways, his statement seems to be a neat summary of the strategy employed by conservative legislative leaders during the 2011 state legislative session. Join NC Policy Watch on Wednesday, Nov. 2 for a special Crucial Conversation event to find out just how successful this strategy has been. Policy Watch’s own Chris Fitzsimon and Rob Schofield will be leading the discussion.

The event will be held at noon in Harris Hall at the Levine Museum of the New South, located at 200 E. Seventh Street in downtown Charlotte. Click here to register for the event, and contact Rob Schofield at with any questions

On Thursday, Nov. 10, NC Policy Watch will address “fracking,” the name given to the process of hydraulic drilling for natural gas in shale formations. After a blitz of publicity and legislative proposals, fracking is being touted by proponents as some kind of magic bullet for North Carolina’s ailing economy. Others, however, worry that fracking could bring terrible harm to the state’s already fragile environment.

The event will feature Carol French and Carolyn Knapp, dairy farmers from Pennsylvania and founders of the Pennsylvania Landowner Group for Awareness and Solutions (PLGAS), and Grady McCallie, Policy Director of the North Carolina Conservation network. Join NC Policy Watch at the Junior League of Raleigh at 711 Hillsborough Street at noon. Click here to register for the Nov. 10 event.

Mark your calendars for two other, soon-to-be-announced Crucial Conversation events in November, including a gathering in Fayetteville on Nov. 14 and a Raleigh event on Nov. 29 which will address the marriage amendment debate. Details will be unveiled shortly, so keep checking the NC Policy Watch website.

CAMPAIGN FOR BETTER CARE: Lunch for older adults, caregivers

Join the NC Justice Center and AARP NC this Wednesday, November 2 for the next Campaign for Better Care community luncheon and make your voice heard on one of the most important, complex issues in North Carolina today.

The Campaign for Better Care aims to make improvements in the health system for vulnerable, older adults, and build a strong, lasting consumer voice for better health care. Come and share your experiences about what you think needs to be changed in our health system, and take advantage of the expertise offered from the AARP and the Seniors’ Health Insurance Information Program (SHIIP).

The free event will be held from 11:30 a.m.-2:00 p.m. at the Northeast Regional Library in Wilmington. To reserve your space, contact the disAbility Resource Center at 910.815.6618 or Nicole Dozier at or 919-856-2146. For more information, visit the NC Justice website.


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