public health, Trump Administration

Trump budget weakens NC’s ability to respond to public health, workforce needs

President Trump and the GOP want to dismantle the Affordable Care Act and restructure Medicaid, and “American First: A Budget Blueprint to Make America Great Again” provides further evidence that they do not want to invest in a healthy and thriving North Carolina. While many North Carolinians may not feel the impact of the provisions outlined in the budget immediately, there are significant threats to public health, our state’s ability to address their health, and capacity to strengthen our healthcare workforce.

In addition to an 18 percent cut to the U.S. Department of Health and Human Services (HHS), the Trump budget outlines a $5.8 billion cut to the National Institutes of Health (NIH), a 31 percent cut to the Environmental Protection Agency (EPA), and the only mention of the Centers for Disease Control and Prevention (CDC) is in reference to a $500 million block grant to states. These cuts are threats to North Carolina’s public health because the NIH funds research that could help identify innovative cancer treatment, the EPA helps to ensure that rural communities have access to safe drinking water (Note: 80 of North Carolina’s 100 counties are rural), and cuts to the CDC could impact vaccine development for the next epidemic. Read more

Environment, News, public health

Six things to have on your radar this week ahead of Easter

Making it official – Dr. James C. “Jimmie” Williamson, who began his role as the eighth president of the NC Community College system in July, is officially being installed today on the campus of Richmond Community College.

Dr. Williamson has a background steeped in education, business, economic development, workforce development and community service. Most recently, he served two years as the System President and CEO of the South Carolina Technical College system.

Two notable bill’s on the House Calendar – Members of the House reconvene at 4:00 p.m. with two notable bills to watch. Representatives are expected to give final approval to the Agriculture and Forestry Nuisance Remedies bill (HB 467) and the School Calendar Flexibility bill (HB375).

Learn more from Policy Watch’s Lisa Sorg about the troubling rush job on HB467.

Education reporter Billy Ball has a rundown on HB375 and another school calendar bill (HB389) that would impact the school start dates of 20 rural counties.

“Brunch Bill” back before lawmakers –  Tuesday at 9:00 a.m. members of the House Alcoholic Beverage Control committee will consider a bill that would allow liquor sales at restaurants beginning at 10:00 a.m. on Sundays instead of noon.

Members will also consider ABC Omnibus Legislation that would allow North Carolina breweries to self-distribute up to 200,000 barrels per year and would make it easier for small breweries to terminate distribution agreements.

The House Alcoholic Beverage Control meets is Room 1425 of the Legislative Building at 9:00 a.m.

Medicaid expansion – Proponents of Medicaid expansion have repeated this talking point for quite some time: There are currently more than 500,000 uninsured in North Carolina, more than 300,000 of these individuals and families have no affordable options for health insurance.

On Tuesday House Bill 662, entitled “Carolina Cares,” will be introduced creating a healthcare program that addresses the needs of North Carolinians who are ineligible for Medicaid due to income levels but are otherwise unable to afford health insurance.

Primary Bill Sponsor Rep. Donny Lambeth holds an 11:00 a.m. press conference in the legislative press room to discuss the ins and outs of the bill. For now, here’s how the News & Observer’s Lynn Bonner explains the legislation:

Under the bill, adults whose incomes are at or below 133 percent of the federal poverty level – less than $16,000 for a single person – would qualify. They would have to pay annual premiums equal to 2 percent of their household income, with some hardship exemptions. In most cases, adults would have to be working or “engaged in activities that promote employment” to be eligible for the coverage.

Legislation caregivers will want to watch – The House Aging Committee will vote on the Caregiver Relief Act – House Bill 543. This bill would provide support in the workplace under state law for caregivers who provide direct care to certain family members in need of care in instances where such leave would not be afforded to the caregivers under federal law.

The bill would require that employers that comply with the federal Family Medical Leave Act of 1993 with respect to a spouse, son, daughter, or parent of the eligible employee’s sibling, grandparent, grandchild, stepchild, stepparent or parent-in-law.

Why does this matter? Well, bill sponsors note there are 1.7 million family caregivers in North Carolina providing care to an adult with limitations in daily activities at some time during the year.

The Aging Committee meets at 11:00 a.m. in Room 423 LOB.

Funding a solution to NC’s food desert– Finally, Tuesday at noon the House Ag. Committee will discuss the Corner Store Initiative. House Bill 387 would establish a source of funding and assistance for small food retailers in both urban and rural areas to increase the availability and sales of fresh fruits, vegetables, and other nutrient dense foods at affordable prices to local residents.

The  goal is to improve the diet and health of residents in food desert zones. The Agriculture committee meets in Room 643 of the Legislative Office Building.

Commentary, public health, Trump Administration

Congress sneaking in last-minute change to make Trumpcare even worse

Ahead of a floor vote scheduled for later today, Republican leadership in the House has realized that they do not have enough votes right now to pass the American Health Care Act (AHCA), the Trump-Ryan proposal to repeal and replace the Affordable Care Act (ACA). As a result, Trump and others are trying to sneak in disastrous last-minute changes to an already terrible bill to win over conservative votes at the expense of millions of lives.

One such change that they are proposing is repealing the requirement that health insurance plans cover a core set of essential health benefits. This guarantees that plans provide coverage for core services, such as hospitalizations, maternity care, prescription drugs, as well as mental health and substance use disorder treatment.

If this provision is repealed, insurers could offer bare-bones plans that don’t cover services that North Carolinians need, meaning only the most expensive, premium plans would cover services like treatment for opioid addition, for example.

What’s more, other key consumer protections would fall apart. While the AHCA does not repeal the ACA’s prohibition on lifetime limits and annual caps on services, that protection is useless without the essential health benefits requirement. Current law only applies these protections to services considered essential health benefits. If this provision is repealed, insurers may be free once again to arbitrarily cut off coverage for patients because their treatment is too expensive.

The haste with which Congress and Trump are moving to repeal our health care is telling; why rush to change one-sixth of the U.S. economy and millions of lives unless you don’t want the public to see what you’re doing? After all, we still haven’t seen the bill language that the House will vote on today. It seems like the Republicans may have to pass the bill to find out what’s in it.

News, public health

What you need to know about the Republican plan for replacing the Affordable Care Act (Audio)

If you missed it over the weekend, be sure to check out Chris Fitzsimon’s radio interview with health policy analyst Brendan Riley of the NC Justice Center. Riley discusses the Republican plan for replacing the Affordable Care Act, what subsidies could look like, and how many people could lose coverage under the new Republican proposal.

Also take time to read Health Advocacy Project analyst Ciara Zachary’s take on the replacement plan for the ACA over on Policy Watch’s main site.

Environment, public health

Former DHHS deputy Randall Williams nominated to head Missouri health department

Missouri Gov. Eric Greitens (left) has nominated Randall Williams, former NC Deputy Secretary of DHHS, to lead Missouri’s health department. (Photo: Gov. Geitens’s Facebook page)

Randall Williams, among the state officials entangled in the coal ash and drinking water controversy, could be the next leader of the Missouri health and senior services department. The story was reported today by The Kansas City Star.

Williams, who served as the deputy secretary of the the NC Health and Human Services, was nominated by Missouri Gov. Eric Greitens, a Republican. The Missouri Senate still must confirm Williams.

In a Facebook post, Gov. Greitens wrote, “Our new Director of the Department of Health and Senior Services, Dr. Randall Williams, is an exceptional leader who will put the people of Missouri first.”

The post continued:

As the State Health Director and Deputy Secretary for Health Services in North Carolina, Dr. Williams helped lead a 17,000 member agency with a 20 billion dollar budget. But even as he helped lead such a large organization, he never forgot that he was there to serve the people. He visited all 100 counties in North Carolina to understand and listen to the needs of their rural, underserved patients. And after each visit, he took action. And he got results. He’s committed to doing the same here in Missouri. … Now, he’ll serve the people of Missouri with the same commitment and compassion. Together, I know that we can create a health system that ensures that everyone has access to quality care, and nobody is forgotten.”

Williams became central to the coal ash scandal for his role in reversing the do not drink orders to households whose wells may have been contaminated by discharge from Duke Energy coal ash basins. Those letters, which rescinded previous “do not drink” advisories, downplayed the health risks of hexavalent chromium in drinking water.

Shortly before leaving office, Gov. Pat McCrory appointed Williams to the state’s oil and gas commission. Obviously, Williams must resign that position to take the Missouri job. Fun fact: Greitens, a former Navy SEAL and amateur boxer, graduated from Duke University in 1996.