Commentary

Another byproduct of the Medicaid Blockade: Catastrophic medical bills, massive debt for families

There are a lot of terrible problems that North Carolinians have been forced to endure as a result of the Medicaid Blockade that state legislators continue to enforce. Here’s another especially awful one: Every year, an average of 14,776 North Carolina families experience financial distress as the result of catastrophic medical bills. This is the case even though 67 percent of families lacking health coverage have either a full-time or part-time worker in the family.

Happily, in spite of the Blockade, the Affordable Care Act has helped millions of people. Prior to passage of the ACA, 41 percent of adults between ages 19 and 64 years reported having trouble paying medical bills and/or accumulated medical debt. As the ACA has increased Americans’ ability to access more affordable health coverage, however, the number of people reporting difficulty paying their bills fell by 13 million people in the past five years. Unfortunately, the Blockade has prevented these benefits from flowing to hundreds of thousands of other people who need them.

Not surprisingly, there is a strong association between medical debt and lack of health care coverage. And, of course, thanks to the Medicaid Blockade, there are 500,000 North Carolinians in the coverage gap and thus at risk of facing catastrophic medical bills. What’s more, many of these insurmountable medical bills result from one-time events. Take, for example, Jacqueline and Darian. Five years ago, Darian experienced a workplace injury that has left him unable to return to the labor force. Even though Jacqueline still works, she does not have employer-sponsored health insurance. Unfortunately, both are in the coverage gap.

Darian’s workplace injury resulted in a medical bill of close to $20,000. That is a lot of money for most families and completely beyond the means of low-income working families. Luckily, Darian was among a relatively small group of people who are able to obtain charity care. But, while Jacqueline and Darian appreciate the charity care they received, they understand that their fiscal, physical, and emotional health are still at risk in the event of another accident, unforeseen injury or health emergency. What’s more, both also recognize that they are not alone in their financial fragility; they understand that medical debt and its many related impacts are a huge community-wide plague.

The bottom line: People like Jacqueline and Darian understand only too well that even hard working North Carolinians can lose their ability to work and contribute financially to their communities if they lack access to health care and remain uninsured. And thanks to the Medicaid Blockade, this is a huge problem that’s not going away any time soon.

News

Senate moves forward with confirmation hearing despite court order; Larry Hall’s absence criticized by GOP

Larry Hall

Larry Hall

The Senate Committee on Nominations proceeded Wednesday with a confirmation hearing despite a court order that states the advice and consent process can’t begin without Gov. Roy Cooper first formally submitting his nominees to the Senate president.

Cooper has not formally submitted the names of his cabinet appointees and his office has said he will not do so until the March 7 trial in his lawsuit challenging the constitutionality of the hearings. The law states that he has until May 15 to submit his appointees.

Larry Hall, secretary of veterans and military affairs, did not show up for the hearing Wednesday and Sen. Wesley Meredith (R-Cumberland) argued about whether he had been formally nominated already.

Meredith, the Senate Majority Whip and co-chair of the Nominations Committee said Hall was named secretary on Jan. 13, resigned from his position with the General Assembly on Jan.16 and has been serving in the position ever since.

He added that in his opinion, he didn’t think anyone could say with a straight face that Hall hadn’t already been nominated.

The six-page order from the three-judge panel, however, acknowledges that Cooper has not made the formal nominations to the Senate president to trigger the advice and consent process.

“The Advice and Consent Amendment require the Governor to begin the process by first notifying the Senate of the nominee, and the Senate cannot begin the advice and consent process until the Governor submits a nominee,” the document states.

Yesterday, Cooper wrote the chairman of the Nominations Committee, Sen. Bill Rabon (R-Bladen, Brunswick, New Hanover, Pender) informing him that moving forward with the confirmation hearings violates the court order.

The court denied Cooper’s request for a preliminary injunction to stop the hearings, but it did so based on the fact that Cooper had not yet formally submitted his nominees to the Senate, the letter states.

“The Court will decide whether or not the legislature’s actions are constitutional,” said Cooper’s spokesman Ford Porter in a press release yesterday. “Until then, Governor Cooper hopes Senate Republicans will put aside the political theater and work to find common ground on issues that matter to North Carolinians like raising teacher pay, helping communities recover from Hurricane Matthew and repealing HB 2.”

Meredith said at the hearing Wednesday that the Senate has tried to afford Hall every opportunity to show up for the hearing, and will give him one more chance to show up tomorrow.

“As we have said all along, the purpose of the confirmation hearing is to determine whether Gov. Cooper’s cabinet secretaries are capable, qualified and without conflicts of interest and willing to follow the laws of our state and our nation,” he said. “By disrespecting this process, Secretary Hall is openly defying a law that has been backed by the courts and is plainly allowed in the constitution.”

He added that Hall is failing the “obey the law” portion of the criteria the Senate will use to confirm Cooper’s nominees, and they will consider this as they decide whether to move his nomination forward.

“If he does not [show up tomorrow], he should bear in mind there are consequences when state officials refuse to follow the law,” Meredith said.

 

Courts & the Law, News

Why strict voting laws like North Carolina’s are discriminatory: An explainer

Yesterday, Gov. Roy Cooper and Attorney General Josh Stein took steps to withdraw the state’s request for the U.S. Supreme Court to review the state’s controversial 2013 voting law that the Fourth Circuit Court of Appeals struck down last July. For those not following the matter closely, here is a brief layperson’s explanation/reminder of what the case is about and why Cooper and Stein acted as they did.

As many will recall, in 2013, the General Assembly passed a bill that made it harder for North Carolinians to vote by imposing strict voter ID requirements and other changes. Critics dubbed it the “Monster Voting Law” and/or the “voter suppression law.” After a series of judicial proceedings, the federal Court of Appeals struck it down after finding that it was discriminatory, sought to “target African Americans with almost surgical precision” and limit access to the polls.

Former Republican Gov. Pat McCrory and the legislature at the time disagreed with the ruling and filed a court document asking the U.S. Supreme Court to step in and review the case and reinstate the law.

Cooper and Stein are now taking steps to reverse that request, in the hope that the law will remain invalidated.

Now, there are some very complicated legal arguments about whether Cooper and Stein can take back the state’s request for review, but that is not what this blog post is about. Instead, this post is an attempt to respond to the large number of people who have asked in recent days how strict voter laws are discriminatory and why they cause such concern for good government advocates.

The Atlantic best addressed this in an article earlier this month about a new study from researchers Zoltan Hajnal, Nazita Lajevardi, and Lindsay Nielson at the University of California, San Diego. The study is one of the first to analyze certified votes across all states after the implementation of voter laws in multiple elections.

Specifically, they found “that strict photo identification laws have a differentially negative impact on the turnout of Hispanics, Blacks, and mixed-race Americans in primaries and general elections.”

The article features a lengthy explanation about the researchers’ methodology but ultimately uses a Washington Post article that summed up the study’s findings to explain what it all means.

By instituting strict voter ID laws, states can alter the electorate and shift outcomes toward those on the right. Where these laws are enacted, the influence of Democrats and liberals wanes and the power of Republicans grows. Unsurprisingly, these strict ID laws are passed almost exclusively by Republican legislatures.

In keeping with the UCSD researchers’ findings, Bob Hall, Executive Director of Democracy North Carolina applauded Cooper and Stein for the move they made to protect voting rights and said the decision would help all North Carolina voters.

The decision will save taxpayers millions of dollars and save millions of voters from needless cuts to early voting and the elimination of safety-net protections (like same-day registration) that improve the elections system for everyone.

The Monster Law (H589) disproportionately hurt African Americans, other voters of color, and youth – but in raw numbers, it actually hurt more white voters, including those who backed the Republican legislators who passed it. For example, research by Democracy North Carolina shows that only one in three (35%) of the voters using same-day registration in 2016 were Democrats. Most were white Republicans and unaffiliated voters, and our research indicates that most of them supported Donald Trump and other Republican candidates.

Ironically, had Republicans prevailed in the US Court of Appeals, there would be no same-day registration in 2016 to help their candidates.

The message is clear: passing laws to make voting more difficult winds up hurting everyone, especially infrequent voters of all political persuasions who may not focus on the changing rules. Laws like H589 lead to an elitist voting system. The better path to achieve a representative democracy is to adopt laws that make the elections system fair, secure and more accessible for all citizens.

NC Policy Watch will be monitoring the Court in the days and weeks ahead as it processes the Cooper/Stein request. Check back frequently in this space for updates.

Commentary, immigration, Trump Administration

Good for Margaret Spellings: Conservative UNC president fights back against Trump on immigration

All over the country for the past month, caring and thinking Americans have been hoping and praying that some conservative Republican, somewhere, would stand up to Emperor-without-clothes Donald Trump with respect to his cruel, destructive and counter-productive immigration policy proposals. Yesterday afternoon, it happened — at least sort of. What’s more, and somewhat surprisingly, the conservative Republican in question comes from North Carolina.

In an op-ed in the Washington Post, (“Mr. President, don’t break America’s promise to ‘dreamers'”) the President of the University of North Carolina, Margaret Spellings, issued an impassioned plea to Trump to preserve President Obama’s stop-gap Deferred Action on Childhood Arrivals program (DACA) in which many young people who arrived in the U.S. as children have been spared from deportation. Last week, Trump threatened to do away with the program. Here’s the conclusion to Spellings’ op-ed:

“[The threat to DACA] has a profound impact not only on immigrant communities, but also on university campuses across the United States. Thousands of DACA students are working toward degrees, striving to become the teachers, nurses, business owners and good neighbors our country needs. They pay tuition without the help of state or federal financial aid and, depending on where they live, they often must pay much higher out-of-state tuition rates.

Now, with immigration policy thrown into disarray, these students are paralyzed, uncertain whether they can safely continue their studies. This month, I spoke with a young woman who was brought here at age 6. She earned her way into college, and she wants nothing more in the world than to finish her degree and go to work improving public health in her home state. The unsettling rhetoric emanating from Washington is making that goal tougher for her and thousands like her.

The lives and dreams of these students were never meant to be a political statement — they just want the chance to live honestly in the only home they’ve ever known. It’s a basic principle of law and good sense that we don’t hold children accountable for the actions of their parents. We shouldn’t violate that principle to punish blameless students.

Their stories deepen my pride in the United States and my awe at what this country represents. We have always welcomed the energy and ambition of those yearning to build and contribute, and that’s exactly what I see in these young people. Offering them the opportunity to keep learning and working, to become contributing adults with the ability to support their families and strengthen their communities, is good for them and good for our country.

My whole career, I’ve advocated for education as a civil right, the bedrock that underpins our promise that this is a land of opportunity for all. Keeping that promise has been the work of generations, and DACA students are now a part of that story.

These are our children, raised in our cities and towns and taught in our public schools. They share our hopes and dreams for a better America. Their faith in this country is a blessing, if we have the grace to accept it.”

Let’s hope Spellings’ effort is the beginning of a flood of such common sense appeals.

Courts & the Law, News

House Republicans pass committee hurdle to make last judicial elections partisan again

District and Superior Court judicial races could soon be partisan again.

House Bill 100 passed the Elections and Ethics Law Committee after debate Tuesday about whether judges should be identified by their political affiliation.

There were efforts in the late 1990’s, early 2000’s to hide judges’ party labels on the ballot to keep judicial races nonpartisan.

“I believe this has caused confusion and allowed judicial candidates to win really for no reason other than their placement on the ballot or a catchy name,” said Rep. Justin Burr (R-Montgomery, Stanly), a sponsor of the bill.

He said labeling judges will give voters the critical information they seek and give them “at least an idea” of each candidate’s political ideology.

Representatives Jason Saine (R-Lincoln), Dana Bumgardner (R-Gaston) and Cody Henson (R-Henderson, Polk, Transylvania) are also sponsors of the bill and spoke out about why labels should be added back into judicial elections.

“This issue is the number one unequivocally asked question [at the polls],” said Bumgardner, adding that he’s worked a lot of elections. “[Voters] don’t know who they’re voting for — they’re just picking a name on the ballot.”

Saine said “voters are hungry” for party labels.

Democrats disagreed. Rep. Grier Martin (D-Wake) said he agrees with the premise of the bill that voters aren’t well informed about judicial candidates but said his solution differs from Republican’s.

He said more relevant information to judges should be available on the ballot, like where they went to law school and how many years and what type of law they’d practiced.

“One thing both parties can agree on is that we don’t want activist judges,” Martin said. “If the only information you’re giving voters is partisan, you’re creating a system that almost guarantees partisan activism [among judges].”

Rep. Darren Jackson (D-Wake) said that adding party labels might help the Republican party in rural areas but would hurt them in bigger areas where well-respected Republican judges currently sit in Democratic-voting counties and would certainly lose, possibly to a less qualified candidate, if labeled on the ballot.

Kim Crouch, Director of Governmental Affairs for the North Carolina Bar Association, spoke out against the bill during the public comment portion of the committee meeting. She said the Bar Association in general opposes the election of judges and encouraged an appointment or selection process to recruit impartial judges.

Rep. Henry Michaux Jr. (D-Durham) agreed that the General Assembly should be looking at ways to free judges from the weight of political affiliation and that elections in general may not be the best way to do that.

Republicans continued to argue that voters should be given party label information, and that just because a judge was elected on ideology didn’t mean they had to rule along politic lines.

GOP lawmakers already added party labels back into Supreme Court judicial elections during a special session in December despite protests from Democrats, attorneys and members of the public. District and Superior Court are the last judicial races without party labels.

Partisan judicial elections are not recognized as a best practice, and North Carolina joins only seven other states that use party labels to identify judges on the ballot.