Interested in health care? Join the Coalition for Health Care of NC and Health Care for All NC in Durham on Sunday, April 7, 3-5pm, for a NC Health Care & Medicaid Transformation Legislative Forum at Eno River UU Fellowship, 4907 Garrett Rd in Durham. We'll focus on the Medicaid expansion bills filed at the NC General Assembly (NCGA) and the updated national Medicare for All bill recently introduced in Congress. Our panel includes Wendell Potter, a former health insurance executive who now campaigns for single payer health care; Senator Woodard and Representatives Black, Hawkins, Insko, Morey, and Reives from Durham & Orange Counties; Gina Upchurch, RPh, MPH, Executive Director of Senior Pharmassist; and Nicole Dozier, director of the Health Advocacy Project at the NC Justice Center. Bring a friend!

The major health policy issue on the table in NC is Medicaid expansion. We wrote about that in early February. Updates to that post:

  • Moms Rising is hosting another Medicaid expansion advocacy day at the NCGA on April 16. Check the event page for more info; they plan to release a toolkit of actions you can take from home if you can't make it to Raleigh!
  • The NC Justice Center's Health Advocacy Project continues to release excellent resources on Medicaid expansion, ranging from simple one-page fact sheets to in-depth policy analyses. Find links here.
  • NC Health News just released a special report on what's happened in other states after expanding Medicaid (spoiler alert: good things happen).
  • It appears that last year's Republican-sponsored Carolina Cares bill will be reintroduced next week. We can't comment on it until we see it, but we expect that it will fall short of what is proposed in HB 5, Close the Medicaid Coverage Gap, introduced by Democrats at the beginning of this session.

Here are some of the other health care bills that have been filed at the NCGA:

  • SB 387, Medicaid Work and Community Engagement Opp., would subject some current Medicaid beneficiaries — parents with children over the age of one — to work reporting requirements as a condition of their eligibility for coverage. This is a terrible idea that has failed in other states AND was struck down in Arkansas and Kentucky by a federal judge just after this bill was filed. Read more about it from NC Justice Center and NC Health News. This gets a thumbs down. In Senate Rules.
  • HB 464, Small Business Health Care Act, would follow Trump administration rule changes designed to undermine the Affordable Care Act by loosening restrictions on Association Health Plans, among other things. Many of these changes are being challenged in court. Association Health Plans can offer skimpier benefits and vary rates based on age, gender, and occupation in an effort to siphon young and healthy risk from the ACA-compliant risk pools. The bill has some bipartisan support in Raleigh, though most health policy experts see these plans as often promising more than they deliver in terms of coverage. HB 464 has been referred to the House Insurance Committee. A similar bill with the same name, SB 86, has already passed the Senate and been referred to House Rules. Here's why we give these bills a thumbs down.
  • SB 361, Health Care Expansion Act of 2019, does nothing to expand health insurance coverage. It modestly expands the Innovations Waiver, a program for people with intellectual and developmental disabilities to get in-home care and services, to cover 2,000 more people (it currently covers 12,000, with a seven-year waitlist). That's a good thing, but the bill's sponsors claim this is an either/or choice with Medicaid expansion, which pits these individuals against the needs of those eligible for Medicaid expansion in a political attempt to prioritize the “most vulnerable.” Read more from WRAL. Another thumbs down." In Senate Rules.

Ready for some thumbs up bills?

  • SB 386, Greater Transparency in Health Care Billing, would keep patients from receiving surprise bills from providers who are out of their insurance network even when the hospital they're in is in-network. Instead, the hospital would have to disclose if a patient may be seen by an out-of-network provider and inform them that they’re not legally obligated to pay the additional fees. The bill also tightens rules that prevent hospitals from charging “out of network” rates on emergency services or services the patient is unable to get from in-network providers. This bill's sponsors are all Republicans, which makes me nervous, but it seems to be a reasonable consumer-protection bill. In Senate Rules.
  • HB 516, Mental Health Protection Act, would protect LGBTQ minors and disabled adults from “conversion therapy." A recent NC poll showed that 80% of all polled respondents immediately stated that they think “conversion therapy” purporting to change a person’s sexual orientation or gender identity should be illegal on children under 18. Of the remainder who initially disagreed or had no opinion, more than half changed their mind after better understanding what the practice of “conversion therapy” entails. Read more from Born Perfect NC. Referred to House Health.
  • Three school-related health bills deserve support:
    • HB 482, School Psychologist Compensation and Recruitment, would increase salaries for school psychologists, and the State Board of Education would establish a retention and recruitment program that would provide signing and retention bonuses to retain high-quality school psychologists. Referred to House Education K-12.
    • HB 524, Additional Funds for School Nurses, would do what it says. Referred to House Education K-12.
    • SB 424, Fully Fund School Psychologists and Counselors, would increase funding to and be maintained at $262 million by FY 2021-22. By FY 2021-22, school counselors would reach the nationally recommended SISP (Specialized Instructional Support Personnel) to student ratio of 1:250 and school psychologists 1:700. In Senate Rules.

WHEW! Let's take a cleansing breath...


What are we to do about this mixed bag of bills? You know the drill by now:

  • CONTACT YOUR LEGISLATORS to let them know what you support and oppose, especially if they're on one of the committees considering any of the above bills. Don't give up if you're represented by Republicans - they know health care is a top issue for voters and they saw what happened in 2018, so they may be more receptive to constituent input (especially when you remind them of those two facts). Include a personal story about family, friends, or clients/patients who would be affected by the bill whenever possible.
  • Write a letter to the editor of your local or regional newspaper! This works and it's easier than you imagine. I'm 3/3 getting published, and I'm no Emily Dickinson; I just write about my experience as a health care professional. Tips from the League of Women Voters.

Now it's time for some self-care, that's part of health, too!


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