Divide & Conquer: NC Speaker of House Tries to Pit Medicaid Beneficiaries Against One Another – Say Ahhh! A Children’s Health Policy Blog

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By Adam Searing, North Carolina Justice Center

Usually the North Carolina Speaker of the House, Thom
Tillis, presents himself as a moderate, business-friendly Republican.  Even as his party has enacted the largest
cuts in the history of NC’s Medicaid program, he’s managed to keep the focus at
local meetings around the state where he has spoken on other topics and
“right-sizing” government.

That all came to an end last week when Tillis, speaking
to a small and very friendly audience, explicitly laid out his plans for people
on public assistance with children. My colleague Chris Fitzsimon broke the story.  At the meeting Tillis complained that there
are people with disabilities who could lose benefits while the state sends
checks to “women who have chosen to have three or four kids out of
wedlock.”  He then continued, “At
some point you need to say first kid, we’ll give you a pass.  Second, third, fourth kid, you’re on
your own.” 

Apparently realizing this might be a controversial
position to take, Tillis pulled out a strategy for quieting public criticism
straight from Caesar and Napoleon – divide and conquer:

“What we have to do is find a way to divide and conquer
the people who are on assistance. We have to show respect for that woman who
has cerebral palsy and had no choice in her condition that needs help and we
should help. And we need to get those folks to look down at these people who choose
to get into a condition that makes them dependent on the government.”

One could hardly imagine a more offensive – or more
revealing – comment for a political leader who forced through huge health care
cuts over even the veto of NC’s Governor.   As the effects of these major cuts to Medicaid has
become more clear, criticism of the politicians who made the cuts has
increased.  It’s an uncomfortable
place to be and sowing dissent among your critics is a classic
counter-strategy.  In fact, it’s
one Tillis used in making other major cuts in North Carolina’s budget.

For example, the budget Tillis praises also ordered that
one of NC’s three schools that serve blind children or deaf children be closed.  Whether a school should close serving
blind kids or a school serving deaf kids wasn’t specified by legislators.  Inevitably there have been agonizing
public hearings about which school should be shuttered.  Unsurprisingly, the politicians who
actually made the decision to close a school have little comment.

But perhaps the most outraged by Tillis’ divide and
conquer budget-cut strategy have been people with disabilities themselves.  As my friend who lives with MS, Alex
, put it,
“I find it egregious for Speaker Tillis to tell me I should blame others who
need government assistance for not being needy enough. He is pitting the
disabled against the elderly, poor, and children? I have heard this argument
before and it is smoke and mirrors.”

The hundreds of thousands of nursing home residents whose
bills are paid for by Medicaid in North Carolina are no doubt also surprised at
the notion that they should resent low-income mothers and children who need
decent health care as well.

In the end, Tillis’s strategy is a losing one.  Medicaid is a popular program in North
Carolina that either directly or indirectly affects every person in the
state.  Attempts to set groups of
North Carolinians against one another will fail because most people realize
taking care of all people who need help is in everyone’s interest.  And the Tillis doctrine of sowing
dissent and resentment will be consigned to the trash bin where it belongs.

(Editor’s Note: The views expressed by guest bloggers do not necessarily reflect the views of CCF.)

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