Commentary, Trump Administration

Comments due Monday on Trump’s scheme to bring back health plan bars to pre-existing conditions

While last year’s legislative repeal-and-replace proposals were rejected resoundingly by the American public and by a slim majority in the Senate, the Trump administration has been moving on its own to implement changes to the current health care landscape. The latest proposal from the administration would enable insurers to sell “short-term” health insurance policies that last up to 364 days—hardly a short term under any reasonable interpretation when traditional health insurance policies last 365 days. While these plans are currently on the market, they can last no more than three months under rules put in place by the Obama administration.

The Trump administration touts these plans as a solution to the country’s high health care costs. But these plans have cheap premiums because they can cherry pick whom they will cover. Upon closer examination, these plans look an awful lot like those that left millions uninsured and drowned others in medical debt before the passage of the Affordable Care Act. Here are some excerpts from a policy currently sold here in North Carolina by Golden Rule Insurance Company, which is a UnitedHealthcare company:

Preexisting conditions, and complications resulting from a preexisting condition, will not be covered under the policy.

Preexisting condition means those conditions for which medical advice, diagnosis, care or treatment was received or recommended, or a condition that had manifested itself, within the one-year period immediately preceding the effective date of a person’s coverage; or a pregnancy existing on the effective date of coverage.

Another reason that premiums are low for these plans is that you get what you pay for. These policies cover so few benefits and pay out so little in claims that insurance companies selling them actually reap much greater profits than on traditional plans. Short term plans routinely exclude benefits not just for coverage of pre-existing conditions, but also for essential services like prescription drugs, mental health and substance use disorder treatment, pregnancy care, and preventive care, among a host of others.

Even for the few services that are covered, enrollees will be stuck with large out-of-pocket bills. Some Golden Rule policies on the market have deductibles of up to $12,500 for a policy that lasts only three months, and some of these policies also impose dollar limits on what they’ll pay out in benefits over an enrollee’s lifetime or policy period. One Golden Rule policy in NC includes a $250,000 lifetime limit.

And that’s the trend: insurers make bank off of these policies while enrollees attracted by the low premium find themselves without adequate coverage and face-to-face with crushing medical debt once they need care.

These plans are dangerous to those who enroll in them. But they also undermine the ACA and those who benefit from comprehensive coverage there. Through their discriminatory premiums and benefit designs, short-term plans are designed to pull young and healthy folks out of the ACA coverage market, leaving the remaining risk pool older, sicker, and more expensive. This puts comprehensive coverage out of reach, especially for North Carolinians who make too much to qualify for premium subsidies under the law.

Unlike last year when the GOP-controlled Congress failed to revive these discriminatory plans through legislation, the Trump administration is proposing to do this through administrative rulemaking, meaning that members of the public can weigh in by submitting comments until the deadline on Monday, April 23. Click here to submit your own comment.

Environment

Before state Supreme Court, Duke Energy lawyer calls NC WARN’s solar agreement with church “almost exploitative”

NC WARN installed a 5.25-kilowatt solar system on the roof of Faith Community Church in Greensboro. Duke Energy filed an opinion against the project at the NCUC, alleging NC WARN is acting as a public utility. The case is now before the state Supreme Court. (Photo: NC WARN)

The sun has risen and set nearly 1,100 times since NC WARN installed a small solar power system on the roof of Faith Community Church in Greensboro. And since that time in May 2015, the Durham-based environmental nonprofit has been fined $60,000 by the NC Utilities Commission — the penalty was later rescinded — and has taken its case to the Court of Appeals, which ruled 2–1 against NC WARN. The group appealed and today argued before the state’s highest court that it should be allowed to provide solar energy to the church.

Typical of high-level legal battles, the oral arguments dove deep into the semantical weeds: What defines “public”?

Is NC WARN “selling” the electricity — verboten under North Carolina law? Is it  legally “leasing” the system, or operating in regulatory limbo under a “unique” finance agreement?

Three years ago, NC WARN installed the 5.25-kilowatt system as part of a power purchase agreement in which the church pays 5 cents a kilowatt hour for solar-generated electricity. NC WARN has discontinued the agreement and has provided no power until the court case is settled.

All along, NC WARN has contended that this is a finance agreement, a private contract that should not be meddled with by the utilities commission. “This case is about overregulation,” said Matthew Quinn, attorney for NC WARN. “Is the function of  [this agreement] to sell power or to help Faith Community Church put a solar system on its roof?”

NC WARN contends it’s the latter. Judge Robin Hudson seemed unconvinced. Reading from the Power Purchase Agreement, she noted that the church “will purchase electricity” from NC WARN. “Are we supposed to read this as not selling electricity?” she asked Quinn.

“Yes,” Quinn replied, adding that a previous court ruling considered the “function” of an overall agreement.

For their part, Duke Energy, Dominion Energy and the public staff of the NC Utilities Commission have countered that NC WARN is essentially acting as a utility and must be regulated as such. If private entities go rogue and sell electricity, they argue, it would upend the state’s entire regulatory scheme: In exchange for a near-monopoly, Duke Energy agrees to have its rates set by the utilities commission.

“This is not altruistic,” said Dwight Allen, attorney for Duke Energy. “NC WARN is trying to be a utility.” The agreement with the church, he added, “is almost exploitative.”

Judge Sam Ervin IV served on the utilities commission from 1999 – 2008, and as such, is well-versed in relevant law. He asked Quinn about NC WARN’s view that this is a “test case,” which could push the boundaries of the state’s energy law. “You want this case to be a model for other nonprofits,” Ervin told Quinn. “That it would cover not only this contract but that you will enter into other contracts.”

“It’s our position that it would be unfair to hold NC WARN to contracts that may or not happen,” Quinn replied.

To be a utility, electricity has to be sold to the public, Quinn told the court. And NC WARN’s only customer is the church, not multiple customers. In fact, in his dissent, Appellate Court Judge Chris Dillon wrote that NC WARN wasn’t acting as a public utility because one church doesn’t meet the definition of “public.

Allen told the justices that a prior NC Supreme Court ruling determined that one person, and presumably, an entity like a church, can qualify as “the public.”

To complicate matters, since the original court filing, state lawmakers passed House Bill 589, complex in the way only a utility lawyer could love. With extensive input from many interested parties, including Duke Energy, the bill legalized third-party leasing of solar power, with certain restrictions. And it and provided higher monetary rebates for nonprofits that want to install rooftop systems — including churches, like Faith Community.

Education, News

N.C. legislator says children’s blood “will be on our hands” if state doesn’t allow for armed teachers

Rep. Larry Pittman, R-Cabarrus

A North Carolina lawmaker with a lengthy history of gun rights advocacy says the blood of murdered schoolchildren “will be on our hands” if the state doesn’t allow for armed teachers.

Rep. Larry Pittman, a Cabarrus County Republican who sits on the state House education committee, urged his fellow legislators to clear the way for armed school teachers and personnel in a late night email Monday, calling it “the most practical, common sense, and constitutionally sound proposal of all.”

Policy Watch obtained a copy of the email Tuesday morning, which was issued with the subject line “saving innocent lives.” It was sent to all House and Senate members but directed specifically at members of a House select committee on school safety, which was slated to meet Tuesday morning.

From Pittman’s email:

“We need to allow teachers, other school personnel and other citizens, who are willing, to be screened and  to receive tactical training and bring their weapons to school, in cooperation with local law enforcement who would need to be informed as to who is doing this.  We should give them a fighting chance.  Otherwise, when they die, and children die whom they could have defended, their blood will be on our hands.  I cannot accept that.  I hope you will think this through and find that you cannot accept it, either.”

This wouldn’t be the first time Pittman has urged lawmakers to arm teachers, a controversial proposal floated by President Donald Trump and other gun rights activists after a Florida school shooting left 17 dead in February.

Pittman also has a history of inflammatory comments. In February, the Cabarrus County lawmaker apologized after he suggested in a Facebook comment that the Florida shooter was part of a conspiracy to spur more gun control laws. He’s also come under fire for comparing former President Abraham Lincoln to German leader Adolf Hitler.

In his Monday night email, Pittman said so-called “gun free zones” like schools encourage school shooters. He said recent polls indicate between 20 to 30 percent of teachers are willing to “take on this responsibility” of being trained and armed.

He also indicated that he’d spoken with a substitute teacher in Henderson County about a “sizable group of teachers in that county who, along with her, are eager to take on the challenge and responsibility of defending innocent lives in our schools.”

Many school advocates have spoken openly in opposition to any proposal to arm teachers, including the N.C. Association of Educators, which represents K-12 teachers before the General Assembly in Raleigh.

The entirety of Pittman’s email is below:

Read more

NC Budget and Tax Center

Reckless tax cuts stop NC from funding regional support for DSS offices

Do you remember Rylan’s LawThe Family/Child Protection & Accountability Act? Last year, state legislators sought to change how the state administers and delivers social services programs, including child welfare services, food assistance, Medicare, Medicaid, and others.  The effort began with a focus primarily on the child welfare system after federal oversight identified many challenges as caseloads climbed and funding fell short.

The Social Services Regional Supervision and Collaboration Working Group has been working to put together a detailed plan on how the regionalization of DSS offices should be implemented, including maps and staffing structures. The proposal focuses on providing regional support—training, coordination– to DSS offices and maintaining the physical presence of offices in communities.

On Tuesday last week, the working group presented the first of two final reports to the Joint Legislative Oversight Committee.

Although support for the proposed plan was strong, there was a common point of contention: there was no plan for how any of the changes would be paid for. Instead, the co-chair said the group would have to take a “wait and see” approach regarding whether they would consider costs as a part of the plan.

Since 2013, the state has lost billions of dollars in revenue due to tax cuts that primarily benefited high-income North Carolinians and corporations.  Those tax cuts will continue next year when additional tax cuts for corporations and individuals will lose $900 million over the next fiscal year.

Prioritizing children’s well-being and families’ economic security means funding those priorities not more tax cuts.

Our state’s reckless commitment to tax cuts has very real consequences when it comes to making the critical investments we all know we need. It means that even when policy makers are able to agree on what we should be doing, we are unable to do so.

Brian Kennedy II is a Public Policy Fellow for the Budget & Tax Center, a project of the North Carolina Justice Center.

Education

Could smaller schools mean safer schools? One of the nation’s best teachers believes so

As the North Carolina General Assembly House Select Committee on School Safety meets again on Tuesday, one of the the America’s best public school teachers has several suggestions for improving safety.

Gaston County high school English teacher Bobbie Cavnar believes that smaller schools paired with more nurses and psychologists will enhance the safety of our classrooms.

Cavnar, named by the NEA Foundation as the nation’s top educator, recently discussed school shootings and making students feel safer with NC Policy Watch director Rob Schofield:

At today’s legislative hearing, members of the Student Physical Safety Working Group will hear from the:

  • Executive Director of the North Carolina Christian Schools Association
  • Former Chairman of the Governor’s Task Force on Safer Schools Community
  • Development and Training Manager of the Center for Safer Schools
  • Sheriffs of Rockingham County and Carteret County

View the complete agenda here.

And be sure to listen to the full 20-minutes interview with Cavnar below in which he discusses his love of teaching and how he inspires students.