A group of Democratic North Carolina senators is calling on the chairs of the conference committee that is negotiating the final state budget bill  to protect the health are of hundreds of thousands of North Carolinians who could be harmed if Congress makes good on its threat to repeal the Affordable Care Act. In a letter delivered late last week to Senator Harry Brown and Representative Nelson Dollar , the senators propose an amendment to the Appropriations Act of 2017 that would “maintain key provisions of the Affordable Care Act.” This is from the letter:
“We are writing to urge you to include the enclosed language in Senate Bill 257 (‘the Appropriations Act of 2017’) that protects health care benefits of North Carolinians. We believe the passage of the federal American Health Care Act will put the health and well-being of countless North Carolinians at risk. Therefore, we strongly urge you as conferees to include a provision that reflects this General Assembly’s intent to maintain key provisions of the Affordable Care Act, including prohibiting denial of benefits for pre-existing conditions.
As you know, last month, the United States House of Representatives passed the American Health Care Act in an effort to repeal and replace the Affordable Care Act. Under the American Health Care Act, states could opt out of key provisions of the Affordable Care Act such as requiring insurance companies to provide a minimum set of benefits and prohibiting insurance companies from charging higher premiums based on a person’s health status.
The impact of the American Health Care Act would likely result in millions of American losing their health care coverage. Under this bill, the nonpartisan Congressional Budget Office estimates that 14 million people would be uninsured in 2018.2 By 2026, the Congressional Budget Office projects that number would reach 23 million.
The American Health Care Act would also roll back coverage for millions of North Carolinians. According to the Department of Health and Human Sen-ices, 4.1 million North Carolinians have a pre-existing condition.4 The Brooking Institute estimates that 3.4 million North Carolinians have insurance plans with lifetime limits.5 ·without the Affordable Care Act’s protection, these North Carolinians could be denied coverage or charged unaffordable prices.
As members of the General Assembly, we have a duty to ensure these North Carolinians don’t lose affordable health care coverage. That’s why we urge conferees to insert language in Senate Bill 257 that maintains key provisions of the Affordable Care Act including:
- requiring insurance companies to provide essential health benefits, including ambulatory patient services, emergency services, hospitalizations, maternity and newborn care, mental health behavioral health, and substance use disorder treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services, chronic disease management and pediatric services that include oral and vision care;
- prohibiting insurance companies from discriminating based on an individual’s preexisting condition or health care status;
- requiring insurance companies to use adjusted community rating, allowing for premium rates to vary based only on the following factors: (a) family size; (b) geography; ( c) age; and ( d) tobacco use;
- extending coverage of dependent coverage for children up to age 26;
- requiring insurance companies to provide cost-free preventive services, including services recommended by the United States Preventive Services Task Force, the Advisory Committee on Immunization Practices, preventative care and screenings for infants, children, and adolescents, and women’s preventative services;
- prohibiting insurance companies from imposing an annual and lifetime limit on the dollar amount of essential health benefits.
The letter goes onto suggest specific language that could be added to the budget bill to make these protections a reality. It is signed by Senators Angela Bryant, Jay Chauduri, Ben Clark, Joel Ford, Valerie Foushee, Jeff Jackson, Paul Lowe, Floyd McKissick, Gladys Robinson, Erica Smith-Ingram, Terry Van Duyn, Mike Woodard and Joyce Waddell. Obviously, the request has little chance of being granted in the near term, but it does help to further clarify the stakes in the current healthcare debate and the stark differences between the two sides. Kudos to the senators for speaking up.