What do NC House, NC Senate candidates for Asheville, Buncombe say on Medicaid, hotel tax?

ASHEVILLE - Voting is now underway in General Assembly primaries, the legislative body that drives a myriad of statewide and local issues, from health care expansion to county taxes for tourism.

Early voting runs through May 14. The primary is May 17.

Republicans currently hold majorities in both the state House and Senate.

There are two Senate districts and three House districts that include parts of Buncombe — though not all have enough candidates to require primaries.

Below is a list of the races with candidate answers to questions about health care, the problem of jail deaths, hotel tax money distribution and more. Candidates with no answers did not respond to the Citizen Times by the requested deadline.

2022 Election: Voting in Asheville, Buncombe, WNC starts April 28; who's on the ballot? A complete list

The questions:

Medicaid expansion: The Affordable Care Act gives states the choice to expand Medicaid with most costs paid initially by the federal government. The 500,000 North Carolinians who could be covered by this expansion get no ACA subsidies because of a Supreme Court ruling following a challenge to the law. Should the state expand Medicaid as 38 other states have? Why or why not?

Mission and HCA: Was the sale of Mission to HCA a good idea? How can problems cited by patients and nurses, such as decreased staffing and time spent with patients be improved?

More: Mission competition? AdventHealth applying for new Buncombe hospital. HCA close behind.

Deadliest jail: The Buncombe County Detention Facility is the deadliest in the state by detainee population. Detainees recently said they have been held in group cells for up a week and made to sleep on cold concrete floors with no blankets or mattresses. What, as a legislator, would you do to help?

More: State's deadliest jail: Buncombe has worst death rate, Citizen Times investigation shows

Hotel taxes: The Buncombe County Tourism Development Authority is looking to collect $40 million in hotel taxes this coming fiscal year. Of that 75% by state law goes to marketing to draw more tourists while 25% goes to projects that are meant to increase hotel business. Asheville and Buncombe County local elected officials have asked that the General Assembly change the law to allow less money to go to marketing and more to projects, such as greenways and sports fields, which also benefit locals. The TDA has also supported a change as have state legislators representing Buncombe. What do you think should happen with the hotel tax revenue?

Where to spend, where to cut: What in the state budget should receive more money and what should receive less - and why?

N.C. Senate District 46

Republican primary: N.C. Sen. Warren Daniel and Mark Crawford

Mark Crawford, 60, of Black Mountain. Advanced Placement U.S. government and politics teacher; Black Mountain nonprofit medical center administrator. Family includes mother and three siblings who live in the region.

Medicaid expansion:

My first year in the N.C. House of Representatives, we faced an estimated $1.4 billion “shortfall." Despite that, we initially passed a bipartisan budget bill out of both chambers. Before the governor could sign, the U.S. government reneged on its promised reimbursement rates for Medicaid and lowered the amount. This caused the bipartisan budget to fail and required the state to find almost $20 million more. A new budget had to be created, adversely impacting various programs. This is the same threat we will always face from Washington despite its “promises”, and it generally ends up hurting our citizens.

Mission and HCA:

Our local elected leaders, in my opinion, saw the sale as a path to underwrite their reckless spending habits with new tax revenues, regardless of the cost to our citizens in need of good quality medical care. I think that anytime the quality and amount of care for patients are reduced, and staffing needs are not properly addressed, it cannot be a good idea. One simple suggestion: bring back, as a minimum, the number of staff who were present and serving right before the sale, back when ratings were at the peak.

More: Mission nurse on HCA fallout during merger hearing: Shocked and horrified

Deadliest jail:

It astounds me that an entity like the Sheriff’s Office, responsible for running the Detention Facility and funded annually to the tune of millions upon millions upon millions of dollars, cannot even come up with sufficient blankets or mattresses for the inmate population. I suspect, if I am given the opportunity to serve in Raleigh, I will address these issues with the State Bureau of Investigation and ask them to open an investigation into the mismanagement, or even intentional mistreatment of the prisoners.

Hotel taxes:

When I first began in the N.C. House of Representatives, it was never dreamed or envisioned that the amount of the revenue could or would ever reach its current levels. There never seemed to be any complaints early on, only when the revenues grew - then the local Asheville and Buncombe County elected officials started eying it as another “pot of gold” to plunder. I do think, however, that if given the chance to restructure this, it would be worth considering, as long as it is done for public works, and not local politicians’ favorite pork programs.

Where to spend, where to cut:

I have been in classrooms at elementary, secondary and university levels for parts or all of 26 academic years. Therefore, I lean toward increasing education spending. However, I only favor spending which focuses on the education of N.C. students - not on bureaucratic, socio-political or other extraneous programs. What to decrease? Just two years ago, the state’s budget allocated over $800 million for “Reserve and Debt Service." We need to pay down the actual debt, so that we don’t have to spend so much in interest on the debt – funds that could be much better spent elsewhere.

Get to know your candidates:

• What to know about Asheville council candidates: Find out where they stand on top issues

• What to know about Asheville mayoral candidates: Find out where they stand on top issues

N.C. Sen. Warren Daniel, 53, of Morganton. Attorney with Daniel Law Firm. Graduated U.S. Military Academy at West Point and UNC Law School. Married with three adult children. Burkemont Baptist Church, N.C. Sentencing Commission and past member of N.C. Domestic Violence Commission.

Medicaid expansion:

People need affordable options for healthcare. We have citizens that work very hard, but can’t afford health insurance. I would prefer that North Carolina submit a 1115 waiver to the federal government that would allow us to design our own Medicaid program. The simple truth is that no hospital or physicians group wants to open and run exclusively on Medicaid. They simply can’t afford to do business without a mix of government and commercial payors. Medicaid was created in the 1960s. Our world has changed significantly over time, and we need the freedom to design a healthcare solution that meets the needs of North Carolina as it exists today and in the future.

More: Answer Man: Mission Hospital ER wait times too long? What do urgent cares do?

Mission and HCA:

We can look back now and see that this hasn’t worked. A better solution is to have more health care options for our citizens, which brings competition and forces these monopolies to provide better services and lower costs. That’s why I support the repeal of certificate of need laws.

Deadliest jail:

The operation and funding of county detention facilities is a function of county government, but they are inspected regularly by several government agencies, including the Health Department, the Fire Marshal, and N.C. DHHS. At the state level, I have and will continue to support funding for improving the security of our prisons, the safety of our prison detention staff, and the proper treatment of the inmate population. I am certainly willing to look at the inspection reports related to the Buncombe County Detention Facility to see what deficiencies may have been noted, and to talk to local officials about remedies to any deficiencies.

Hotel taxes:

I know that N.C. Sen. Chuck Edwards has been working for months to change this allocation, and the changes seem to be supported by the tourism community, so I would support them.

Who else is running in the primaries?

• Buncombe sheriff primary candidates talk jail, public outreach and supporting employees

• Who's running for Buncombe commission? What to know about 2 facing off in May 17 primary

Where to spend, where to cut:

As a result of sound Republican fiscal policies since 2011, our state has had six consecutive years of hefty budget surpluses. This has enabled us to cut taxes on working people, to provide teacher and state employee raises, and to build needed facilities for our schools, community colleges and universities. If these surpluses continue, we need to continue to cut taxes, but also to put additional funding into our mental health system and our Rainy Day Fund. I would also support additional “Powell Bill” funding to small municipalities for street maintenance and repair.

N.C. Senate District 49

Democratic primary: City Council member Sandra Kilgore, N.C. Sen. Julie Mayfield and Taylon Breeden

City Council member Sandra Kilgore, 69, of West Asheville. Real estate business owner, former flight attendant. Family includes adult son. Southside Advisory Board Asheville Board of Realtors Political Action Committee, Asheville Planning and Zoning Commission.

Medicaid expansion:

I definitely support Medicaid expansion in North Carolina. I see no need to reinvent the wheel. Medicaid expansion is already working in 38 states and helping millions of Americans with their healthcare needs. It is sad to see states not supporting it due to politics. How can we become better as a state, as a county, as a nation, if we have politicians that have so little concern for their own people?

Mission and HCA:

I would say the jury is still out on the sale of Mission. At the onset, it does not appear to have been a good idea. Anytime we move from a non-profit to a for-profit organization there are going to be issues. Their missions are not aligned. However, I have heard many complaints of short-staffed, poor service, etc. We must as a community join forces to address these issues just like the nurse’s union. We must find and support alternative services and let it be known of our discontent. For-profit organizations are responsive to their profit margins.

Deadliest jail:

The prison conditions are reflective of overcrowding and unavailable services. I would seek legislation to release non-violent offenders with electronic bracelets and probation. I would advocate for more rehabilitation programs and workforce training to prepare the inmates to sustain themselves so they do not return to the system. The country is struggling with a workforce shortage so we could be addressing a couple of issues at the same time. Also, the savings to the state could be tremendous. By releasing them, providing employment opportunities, and withholding child support from their earnings we can reduce the need for more prisons, reduced the cost to take care of them and their families, and produced a tax-paying population.

More primary races:

• GOP WNC House debate: Cawthorn's absence panned, split on Medicaid expansion, 'big oil'

• Buncombe DA Candidates debate violence, homelessness and justice reform at CIBO meeting

• WNC Democratic House candidates: $24 minimum wage, hack Chinese fentanyl sites, free pre-K

Hotel taxes:

There presently is legislation in the General Assembly to amend Session Law 2015-128 to direct a more equitable distribution of funds collected and to expand the allowable uses. It presently asks for a 33%/67% split, which is an improvement from where we are now. However, I would be supportive of a 50% /50% split, which I feel would have a more positive impact on the community economically as well as improve the relationship between the tourism industry and residents.

Where to spend, where to cut:

North Carolina spends a much lower percentage of its annual gross domestic product on education than most states. It spends 2.3% compared to the national average of 3.4% annually which is reflected in the state’s overall low ranking in all educational categories. Increased funding to provide education from the cradle to career is needed, to prepare our N.C. residents for the 21st Century. As the state work on encouraging economic growth, we must also fund our workforce training programs to ensure job opportunities are filled by our local residents.

N.C. Sen. Julie Mayfield, 55, of West Asheville. Co-director of environmental nonprofit Mountain True, attorney and former City Council member.

Medicaid expansion:

Yes. In addition to covering 500,000 people (and likely more), expanding Medicaid would mean an economic benefit to North Carolina by way of $100 million in budget savings and providing new revenue to hospitals for the $1 billion in care that is currently uncompensated. Given that the federal government will pay over 90% of the cost of expansion, there is no excuse not to provide coverage to these individuals. When and if that federal subsidy ends, we can still afford it by not granting more tax cuts to corporations and high wealth individuals.

Mission and HCA:

The sale of Mission was, at least in part, a byproduct of NC’s failure to expand Medicaid. The sale has been a disaster in terms of quality of care, charity care, quality of workplace, the departure of dozens and dozens of long-time physicians and community confidence in our hospital. The nurses union has helped, but HCA needs to change its bottom-line approach and begin re-investing rather than continuing to cut. We can also give the attorney general more authority over future hospital conversions to spare other communities what we have experienced.

Deadliest jail:

We need to ensure our jails have sufficient resources to meet state requirements for inmates and are being inspected sufficiently to identify and address these failures. Local governments are mainly responsible for jails, but the state could supplement in places that struggle with these issues. The state could also provide more resources to address the significant physical and mental health and drug addiction issues people are bringing into jails. Creating special medical units within jails that provide higher levels of care, as proposed by Sheriff Quentin Miller, are an excellent idea and could be funded in part by the state.

Hotel taxes:

What we expect will happen this year is legislation to change the allocation to the more standard 66%/33%, expand uses for the non-advertising dollars, and expand the TDA board. There is local agreement on these points and they are not likely to see opposition at the state level. What should happen in the future, however, is that the split should be at least 50-50 and the revenue should primarily fund local government capital projects, transit and affordable housing. Most importantly, communities — not state interests — should determine the percentage split and spending priorities.

Where to spend, where to cut:

So much more money to the things that set people up for success and help lift them out of poverty: public education, health care, public transportation, workforce training, affordable housing. Also more funding for local government infrastructure like roads, water and sewer projects that many local governments struggle to afford. More funding for environmental protection, land conservation and to help ensure a just transition to a clean energy future. No funding for education vouchers for private schools that do not meet state standards, no funding for “pregnancy centers” that masquerade as health care facilities, no more tax cuts.

Taylon Breeden, 30, of Asheville. Owner of hemp extraction lab Simply Extract, owner of mushroom cafe the Pot Stirred. Former executive director of local branch of National Organization for the Reform of Marijuana Laws

Medicaid expansion:

Yes, I think expanding Medicaid is essential to help our most vulnerable communities in the state. It helps Protect families from medical debt and bankruptcy. As someone who has a sister with a mental illness, I understand how much this is needed for families. We must help our rural hospitals that are struggling to keep up with providing care for uninsured people. Expanding Medicaid also creates jobs and stimulates economic activity, especially in the health care industry. We are losing so many nurses, and I’m hoping this can also help with maintaining our healthcare staff. People should not get a death sentence because they are poor and get sick.

Mission and HCA:

I think HCA is a prime example of how we need to stop treating our healthcare system like a business. We sold a 133-year-old nonprofit to the nation’s largest for-profit hospital chain, for an estimated $1.5 billion. What did we think was going to happen? The quicker we elect politicians that will fight corporate takeover, the quicker we can start caring for our people. I will be bold in the legislature against selling the people of Buncombe out. We need to not be a “right to work state.” This would allow us to have stronger nurses unions and give our healthcare staff the opportunity to finally be treated with respect and be paid what they are worth.

Deadliest jail:

We need to open an investigation around these allegations of inmate abuse with the state. We have funding to provide resources to inmates and that is an act of malice. Our country has seemed to have lost care for fellow humans. I want to help reignite that. People can heal and change but that’s not going to happen on a cold floor with no bed being treated like garbage. We are causing so much trauma in our prisons that our community suffers the cost. We are jailing people for being poor and for having a mental illness, and then, when they get out, they can’t get jobs or housing.

Hotel taxes:

Asheville needs to advertise for hotels less, and focus on infrastructure issues and unaffordable housing issues more. I think utilizing these funds to house homeless and rebuild roads, both a result of tourism, is investing in our communities’ future. Tourism supports our local economy, I get that as a downtown business owner, but when our residents can no longer live here because we are catering to rich out of towners, nobody wins. I am the candidate that will always prioritize local people first, and I think utilizing our TDA to fund our people is how we do that. I believe 70% should go to our local community while we better prepare ourselves for our tourist economy.

Where to spend, where to cut:

So many things need funded: housing, transit, medical care, infrastructure both for roads and utilities. We’ve got to fund our public school systems before we lose all of our teachers. We are currently $3,300 below national average on pupil spending. Mental health care and substance abuse funding is one of my top priorities because it helps address a lot of our crime and homeless problems across the state. We need to spend less on private school vouchers that take money from our public school systems.

N.C. House District 115

Republican primary: Pratik Bhakta and Sherry M. Higgins

Pratik Bhakta, 50, of South Asheville. Hotelier. N.C. State University. Married with two children.

Medicaid expansion:

For the last few months, a legislative oversight committee has been discussing the possibility of expanding Medicaid, as well as other reforms to our state’s health care system. I’d be very interested in seeing what this bipartisan group comes up with. I certainly would be willing to discuss solutions and the effect(s) it may have on our state budget to help more low income North Carolinians have access to health coverage.

Mission and HCA:

The sale of Mission to HCA has already occurred, so whether it was a good idea or not is not really within my purview. I am sure the fundamentals of the sale were done in good faith, but the outcome has been less than stellar. As a business owner myself, I would offer that they (as a private company) address patient and staffing complaints expeditiously, to improve their business of providing better healthcare. Feedback from them should be taken very seriously.

Deadliest jail:

It’s very disturbing that inmates in the government detention facilities are subjected this way, some resulting in deaths. There needs to be accountability. Adding to those troubles is a lack of qualified law enforcement personnel. Existing elected leaders have eroded the confidence of law enforcement morale and many have left the occupation because of the toxic atmosphere. We need to restore confidence back into our communities and clean up the city/county for our residents.

Hotel taxes:

While I agree that we should reduce the amount to 66.7% and 33.3%, locally elected leaders want to take control of some of the 33.3% because of their failure to effectively manage and spend their budgets derived predominantly from property taxes. When bonds need to be issued to pay for additional spending, property taxes will go up for everyone, while placing the blame on the hospitality industry that brings in lots of revenues to the area and creates jobs. While some leaders claim visitors “tax the infrastructure," the infrastructure is actually used predominantly by those that work and live here. The businesses pay theirs and the visitors' share by higher valuations in their increased property taxes.

Where to spend, where to cut:

Education is nearly half of the state budget. However, I feel we can continue to do more in education, for our students, parents and our teachers. We need to focus on core curriculums for our students, not political ideologies. We need to bring vocational classes back to our schools while also requiring personal finance management to graduate so our young adults are better equipped to handle their future.

Sherry M. Higgins, 61, of Arden. Certified public accountant. Family includes two sons.

Medicaid expansion:

The question states that "most" costs of expanding Medicaid are paid "initially" by the federal government. I would need to have more information on the costs that aren't paid by the federal government and what the cost would be to the citizens of North Carolina over the long term before I could make a decision on expanding Medicaid.

Mission and HCA:

No response at this time.

Deadliest Jail:

The situation at the Buncombe County Detention Facility is a serious issue that needs to be addressed on the county level. As a legislator, I will listen to what help the county asks for and do what I can to aid in improving the situation.

Hotel taxes:

I will support a higher percentage of hotel tax revenue going to projects that benefit a wide variety of locals as well as tourists to the area.

Where to spend, where to cut:

No response at this time.

Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Got a tip? Contact Burgess at jburgess@citizentimes.com, 828-713-1095 or on Twitter @AVLreporter. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: Asheville, Buncombe primaries voter guide for N.C. Senate, N.C. House