Hi there, 


I’m Donald Bryson, the CEO and President of the John Locke Foundation, and I’d like to welcome you to my inaugural edition of Locke Notes, as we wish Brooke Medina all the best in her new role. 

Now, let’s get into it!
After holding off for 13 years, North Carolina became the 40th state to expand Medicaid, extending coverage far beyond Medicaid’s original focus and increasing state spending. 

Congress established Medicaid in 1965 to provide health care for society’s most vulnerable groups, such as the disabled, disadvantaged children, and the elderly. It has since expanded into a bloated social welfare program trying to extend coverage to as many groups as possible. 

This created a plethora of issues: including uncontrolled spending, fraudulent payments, unnecessary coverage, overwhelming enrollment, budget shortfalls, and crowding out of traditional enrollees. 

Unfortunately, a $1.6 billion “signing bonus” from Biden’s American Rescue Plan Act, and a federal promise to fund 90% of costs, seduced long-opposed Republicans. 

But the problem is federal funding has only covered 65% of costs traditionally. And with the federal government $36.4 trillion in debt, it's hard to believe this promise. 

North Carolina Medicaid is currently funded by a combination of the federal government, state appropriations, and hospital fees.

In Fiscal Year (FY) 2024, the first year of extended coverage, NC Medicaid expenditures increased by 29.3%, with state-funded expenditures rising 18.7%. Since FY 2010, growth in state Medicaid spending has outpaced total state-supported appropriations, 135.8% to 56.7%
 
North Carolina’s legislation includes a provision to discontinue expansion if federal funding dips below 90%, but enforcing this would require political courage. 

Federal funding cuts for Medicaid expansion in 2025 are unlikely, but some sort of action over the next decade is almost certain. 

Consequently, policymakers will have to follow through on the 90% provision and either cut other funding priorities, raise taxes, or reduce Medicaid expansion. Reducing eligibility would not resolve the budget shortfall, but it could decrease its severity. 

Eliminating or reducing Medicaid expansion would be politically painful. But, if the time comes, North Carolina policymakers will need the courage to restore Medicaid to its original purpose of providing health care to the most vulnerable.

You can read more on the problems facing Medicaid expansion here, here, and here


Esse quam videri,

Donald Bryson
 
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More from Locke
1) 🚜🚜🚜 Defending agriculture from ESG overreach
  • Environmental, Social, and Governance (ESG) policies increasingly harm farmers by restricting their access to financial services, driving up costs, and ultimately jeopardizing food production and affordability 
    • North Carolina has introduced the Farmers Protection Act (HB 62), which aims to protect agricultural producers from ESG-based discrimination in banking
      • The bill would prevent banks from denying services to farmers based on ESG-related factors, such as greenhouse gas emissions, fertilizer use, or fossil-fuel–powered equipment
  • The bill includes enforcement mechanisms such as:
    • Rebuttable presumption - If an ESG-aligned bank restricts services to a farmer, it would be presumed that ESG goals influenced the decision. The bank would need to prove otherwise
    • Annual compliance reports - Banks must annually attest, under penalty of perjury, that they have not discriminated against farmers based on ESG criteria
    • Legal penalties and fines - Violating banks could face civil penalties and fines of up to $10,000 per violation
  • North Carolina is following the lead of other states that have enacted similar laws to counter ESG-driven financial discrimination
    • Those states have prevented banks from excluding the coal, natural gas and oil industries, as well as the agricultural industry
  • Agricultural producers already operate in a complex and unpredictable environment, and ESG-based financial discrimination adds another layer of difficulty 
    • The Farmers Protection Act would ensure that NC’s farmers could continue accessing financial resources without being penalized for employing traditional farming methods…
    • … and preserve food affordability and security for all North Carolinians 
  • In defending the right of farmers to access financial services without ideological interference, North Carolina would be taking a stand for economic freedom and agricultural sustainability

You can read the full report here.

2)💡💡💡 Why North Carolina’s farmland needs nuclear energy
  • North Carolina is striving to achieve carbon neutrality through a cost-effective approach that maintains or improves grid reliability 
    • While environmentalists advocate for solar and wind energy, these solutions pose substantial challenges to the state’s farmland
      • A study by the John Locke Foundation estimates that 7.1 million acres would be needed for solar and wind power to meet current energy needs, nearly 1/5th of the state’s total acreage!
      • This would limit the supply of farmland for food production, raising costs
      • Additionally, solar farms damage soil quality, taking years to repair
  • An alternative solution would be nuclear energy
    • Nuclear energy is equipped to meet these same needs while occupying only 15,000 acres, significantly conserving land
      • Nuclear energy can provide reliable, around-the-clock power without repurposing vast agricultural land
      • In fact, nuclear techniques have shown to increase crop yields, promote water efficiency, enhance soil fertility, prevent desertification, and improve irrigation in other countries
  • Why is nuclear energy the path forward in North Carolina?
    • By prioritizing nuclear energy, North Carolina can preserve valuable farmland while also exploring nuclear-based agricultural developments
    • Research into radiation-induced crop improvements and soil management can help local farmers increase productivity and sustainability
    • Instead of sidelining nuclear energy, North Carolina should integrate it into its strategy to protect both the environment and agriculture, ensuring that clean energy doesn’t come at the cost of food security

Read the full article here.
 
3) 🗳️🗳️🗳️ Bill would reduce early voting period to 6 days 
  • The 2025 legislative session fired an opening salvo over how many days of early voting North Carolina should have
    • House Bill 66 seeks to eliminate Sunday voting and reduce North Carolina's early voting period from 17 days to 6 days. The bill is sponsored by all Republican lawmakers, which is no surprise
      • As Democrats have typically dominated early voting, and few early voting days would help Republicans
  • However, few early voting days doesn’t necessarily mean fewer votes
    • Research shows reducing early voting days does not significantly lower overall turnout; voters shift to other available voting methods (e.g., absentee or election day voting)
    • Still, early voting has benefits beyond turnout
      • It can shorten lines on election day
      • And help election officials identify problems in the process, which they can correct before voting has ended
  • Additionally, more early voting doesn't necessarily help Democrats
    • Early voting has historically favored Democrats, but this trend is shifting
    • In 2024, Republicans outperformed Democrats in early voting due to targeted "bank your vote" campaigns, encouraging supporters to vote early
    • There is an exception to the trend though - Democrats still dominate Sunday voting 
      • Aided by "Souls to the Polls" initiatives and higher Sunday voting availability in left-leaning counties
      • But there is nothing to stop Republicans organizing their own “Souls to the Polls” events with conservative evangelical churches 
  • So, is there an ideal number of early voting days?
    • The big question about how many days of early voting is not about turnout or which party benefits, but election administration.
    • Early voting is costly for counties, requiring personnel and site rentals
    • Reducing early voting days could save resources but may necessitate opening more locations, offsetting savings
    • A possible compromise could be reducing early voting to 7-10 days, while mandating one Sunday voting day statewide
    • This approach balances resource savings with equitable voter access and bipartisan concerns

You can get the full scoop here.  
 
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