Hi there, 

With the election fast approaching, we have more election-themed research coming your way!

This week, we’re delving into how North Carolinians will know if official vote totals, as reported by the State Board of Elections (SBE), are accurate.

One way is to audit the results. 

And there are a few ways the SBE can audit results. One is called “hand-to-eye count," which determines if the ballots in election officials’ possession were counted accurately.

However, the selection process of which ballots are audited in this system seems random at first glance. The SBE randomly selects two sample groups of ballots for each county to count by hand. The SBE then informs the counties of their sample groups of ballots, which contest on the ballots to count. 

However, which specific groups of ballots are chosen is not so random, as they are required to produce a statistically significant result, which means that some ballots are more likely to be chosen than others. 

So… what can be found to make sure that the audit is more fair and representative, and to avoid sampling errors?

The first change is to make sure that hand-to-eye counts are done by units (i.e. voting sites, precincts and all absentee ballots), such as all the ballots at an early voting site which were counted and reported together. This would equalize the change of units, particularly absentee ballots in larger counties, being included in the audit. 

Another way to address the problem would be to fairly apportion the number of units in the sample hand-to-eye count to the total number of units in a county, so that more populous counties would audit more units. 

A longer term solution would be “risk-limiting audits” (RLAs). RLAs are a hand-to-eye recount of a random selection of all ballots in an election contest to provide strong statistical evidence that machine-counted results are correct. 

This would mean that every type of ballot is audited in every county after each election. 

But transitioning to RLAs requires a change in the law. This change to let us move away from “unit-based” audits, requires a transition from ballot marking devices (BMDs) to hand-marked paper ballots in all counties. 

Having paper ballots is particularly important, because auditors can better determine voter intent with hand-marked paper ballots (which are not currently available in all NC counties). 

There are better ways to conduct post-election sample audits, and you can read more about them here, here and here. 


Esse quam videri,

Brooke Medina

See Our New Video

More from Locke

1) 📈📈📈 Where do NC’s legislative candidates sit financially

• As early voting begins, I’m sure you’ve been inundated with political ads and media coverage about the top of the ticket
• But it’s equally important to pay attention to down-ballot races that could determine who controls the state legislature
• While Republicans are likely to keep a majority in 2025, the question is if they can keep their supermajority in both chambers
  • According to the Civitas Partisan Index, there are 10 toss-up and lean seats in the Senate
    • Here you can find the current financial standing for all toss-up and lean Senate seats
  • And there are 26 toss-up and lean seats in the House
    • And here is the financial data for the toss-up and lean House sets

You can find all the relevant data here. 


2) 🍔🍔🍔NC Medicaid expands to cover weight-loss drugs in the ‘Barbeque Belt Buckle’

• On August 1, 2024, North Carolina Medicaid launched coverage for GLP-1 drugs (this Ozempic) for weight loss
  • This is despite the State Health Plan (SHP) ending coverage on April 1, due to the budget strain on the nearly insolvent SHP
    • Before halting coverage, the SHP was projected to spend $170 million on weight loss drugs in 2024
• So… why is it a big deal that NC Medicaid decided to cover weight-loss drugs?
  • GLP-1 drugs can be used not only for weight loss purposes, but to treat Type 2 Diabetes as well
  • This could lead to substantial demand for GLP-1 drugs under NC Medicaid
    • Particularly due to the obesity epidemic occurring across the U.S.
  • As of 2023, 39 state Medicaid programs offered unrestricted coverage for at least 1 GLP-1 drug to treat Type 2 Diabetes
    • This led to ballooning healthcare spending for state governments
      • For example, Virginia Medicaid’s gross spending on GLP-1s for weight loss increased from $3.9 million per quarter to $15.63 million since 2023
      • And for treating Type 2 Diabetes, from $27 million to $42.04 million per quarter
  • And on a national level, the U.S. Senate Committee released a report show that if 50% of obese adults are prescribed a GLP-1 drug, the annual net cost to Medicare and Medicaid would be $166 billion
• In July, NC Medicaid released an estimated annual cost to NC taxpayers’ for coverage of GLP-1s for weight loss
  • For Fiscal Year 2024 - 2025 = $21,604,072
  • And for Fiscal Year 2025 - 2026 = $15,763,390
  • But, according to our expert’s estimate, if only 5% of NC Medicaid recipients with a BMI > 30 qualify for GLP-1 coverage, then it would cost taxpayers approximately $86.26 million a year
    • He also recommends:
      • Requiring the DHHS to provide quarterly reports to the public detailing the costs of GLP-1 under NC Medicaid
      • Increasing the baseline for coverage to BMI > 40 (severely obese), so that GLP-1 coverage is prioritized for those who need it the most

You can read more here. 


3) 🌴🌴🌴What North Carolina could learn from California about school finance

• While California may not spring to mind as a model for sound education policy, North Carolina could actually learn from California’s school finance reforms
  • California funds public districts and charter schools with a student-based funding formula, giving each district a set amount of money per student, supplemented with additional funds for students with above-average needs
  • Meanwhile, North Carolina continues to use an antiquated, byzantine system which doesn’t prioritize student needs and outcomes
• So, how exactly does California’s school finance system work?
  • California actually used to have a school finance system similar to North Carolina’s
  • Now, they use a Local Control Funding Formula (LCFF), which allocates dollars via 3 funding streams:
    • Base grants - a set amount of funding per student that varies by student’s grade level
    • Supplemental weights - Additional money, worth 20% of base grant, allocated for each student classified as an English language learner, low-income or a foster youth
    • Concentration weights - worth 65% of base grants, given to districts with high-needs students are greater than 55% of the student population
  • North Carolina should also give school district leaders greater autonomy in deciding how to spend education dollars based on student needs
  • North Carolina can also learn from California on balancing funding fairness between high-wealth and low-wealth districts
• On the flip side, North Carolina should avoid repeating California’s mistakes
  • First, base grant funding should not based on student attendance over the prior 3 years, regardless of whether districts are still serving those students
  • Second, categorical grants outside of the LCFF would be eliminated, to streamline financing even more
  • Third, school-level financial data should be accessible and transparent to hold public district accountable for spending and results
  • And finally, accountability measures should be implemented more effectively, and not just become another round of paperwork for compliance
• By learning from both the successes and shortcomings of California’s reforms, North Carolina can implement a fairer, more flexible and more transparent school funding system

You can get the full picture here.