Commentary

North Carolina’s Medicaid reform is missing one transformative component

Dr. Mandy Cohen, Secretary of North Carolina’s Department of Health and Human Services, hosted the fourth and last Medicaid Reform Public hearing last night in Raleigh. Secretary Cohen noted that even though there were hearings last year before the previous administration submitted its plan to move North Carolina’s Medicaid program to a hybrid managed care model, she wanted to hear from providers, Medicaid enrollees, advocates and community members. And like last year’s hearings, approximately half of the comments highlighted the fact that Medicaid reform is not going far enough because the state has not closed the coverage gap.

Mothers, stroke survivors, pediatricians, representatives of health insurers, and members of the faith community all called for North Carolina to extend Medicaid coverage to 500,000 North Carolinians in the coverage gap. Thirty-two states – including Washington D.C. – have successfully extended coverage to veterans, low-wage workers, students, and parents.

One health concern that was raised many times in relation to closing the coverage gap is addressing North Carolina’s opioid crisis. If lawmakers lift the Medicaid blockade, 20 percent of uninsured adults with opioid addiction can finally access the care they need. On top of that, research shows that there are at least 144,000 uninsured North Carolinians with substance use disorders or mental illness that would benefit in lawmakers extend Medicaid coverage. Research also shows that Medicaid coverage increases one’s ability to access both inpatient and outpatient treatment. For example, 37 percent of people with Medicaid coverage are able to receive treatment for opioid addiction compared to only 20 percent of the uninsured.

One of the most sobering comments came from a representative from Coastal Children’s Services. The Wilmington area is one of the the state’s hardest hit for opioid abuse and this has impacted the care at Coastal Children’s Services as between 15 and 20 percent of babies in the NICU are experiencing opioid withdrawal. Stories like this further reinforce comments along the line of one of the more pointed and succinct ones uttered last evening: “Obviously we need to expand Medicaid. Everyone knows that except for ten people in legislature.”

Commentary

63 years ago today, a Republican-led Supreme Court struck down school segregation as unconstitutional

Chief Justice Earl Warren – Image: Wikipedia

For the millions of Americans who’ve come of age in recent decades, it may seem hard to believe, but there was a time in U.S. history in which the Republican Party (i.e. the party of Lincoln) often led the fight to combat racism in America, while many Democrats — especially in the South — dragged their feet. Today, May 17, offers a potent reminder of that long ago-expired reality as it is the 63rd anniversary of the U.S. Supreme Court’s unanimous, landmark ruling in the case of Brown v. Board of Education.

Read once more the words of Chief Justice Earl Warren, a Republican appointed by a Republican president:

“Segregation of white and colored children in public schools has a detrimental effect upon the colored children. The impact is greater when it has the sanction of the law, for the policy of separating the races is usually interpreted as denoting the inferiority of the Negro group…Any language in contrary to this finding is rejected. We conclude that in the field of public education the doctrine of ‘separate but equal’ has no place. Separate educational facilities are inherently unequal.”

Now try to imagine any of the modern day conservative ideologues who inhabit the Court — much less any of the extremists who would lower themselves by accepting a nomination from the current Prevaricator-in-chief — authoring any such powerful and progressive words. And if we could somehow bring back to life the troubled haters and segregators who sought to resist the Court’s ruling in the years that followed the Brown ruling, there can be little doubt as to what their stance would be vis a vis the current inhabitant of the White House — much less as to which side they would take in the modern ideological debate between those who want to save public education and make it work for all and those who want to crucify what they derisively refer to as “government schools” on the disingenuous altar of “school choice.”

Environment

After another legal setback, Charah will ask state appellate court for temporary stay in coal ash disposal suit

A map of the Brickhaven mine, where coal ash is being disposed. (Map: Chatham County)

For a second time, Chatham County Superior Court Judge Carl Fox told Charah to talk to the hand.

Fox yesterday rejected Charah’s request for a stay of his original order to stop disposing coal ash in parts of the Brickhaven mine while the case wends through the higher courts.

Charah, the Kentucky-based coal ash disposal company, is “immediately” seeking a temporary stay from the state Court of Appeals, said Scott Sewell, Charah’s chief operating officer.

The company can still place coal ash in formerly excavated parts of the mine, which is near Moncure. Although the current order “does not have an immediate impact on the placement of coal ash at Brickhaven,” Sewell said, the company plans to also request a permanent stay.

Earlier this month, Charah had petitioned the Chatham County court for a stay, asserting that the company would lose tens of millions of dollars and suffer “irreparable” harm to its reputation if it couldn’t continue to dispose coal ash in new parts of the Brickhaven mine.

In the petition, Sewell told the court that “Charah has a long relationship with Duke, which will suffer irreparable harm if the order is not stayed.”

However, Duke Energy seemed unfazed by the ruling. “We do not anticipate any immediate impacts to those plans and our vendor, Charah, continues to receive ash at the site,” said Jeff Brooks, Duke Energy spokesman.

The ash comes from Duke Energy’s Riverbend and Sutton plants. The impoundments at those plants must be excavated and closed by December 2019.

The Blue Ridge Environmental Defense League, Chatham Citizens Against Coal Ash Dump and Environmentalee had filed a contested case with the Office of Administrative Hearings against the NC Department of Environmental Quality in July 2015.  Judge Melissa Lassiter dismissed the case, and the complainants appealed to Chatham County Superior Court.

On March 31, Fox ruled that two newly excavated parts of the mine were tantamount to landfills, not structural fill areas, and that state environmental regulators had improperly issued permits to Charah.

Structural fill cells are abandoned areas that had already been excavated by the mining company; they can accept coal ash waste under the permit. However, landfills require a different permit for that material. In both cases, the disposal areas must be lined.

DEQ and the state attorney general’s office then took the case to the state appellate court. The has not yet appeared on the court’s calendar.

“We are encouraged that Judge Fox’s March 31st ruling remains in place while Charah and DEQ pursue their appeal,” said Therese Vick, coal ash coordinator for BREDL. “It is time for DEQ to be sure that Charah complies with his order immediately. This must be done in a transparent way. We are watching.”

Commentary

Berger tries and fails to offer credible defense of 3:00 a.m. amendment blitz

The numerous unflattering news stories and commentaries that have arisen in recent days in response to last Friday morning’s outrageous Senate budget blitzkrieg appear to have had an impact on Senate President Pro Tem Phil Berger. Whereas the usual response from Berger to just about any criticism from any corner is to lash out with barbed/venomous attacks in which he derides his critics and/or calls them names that he intends to be derogatory, the Senator was strangely muted in a statement he gave to Raleigh’s News & Observer yesterday.

This is from reporter Colin Campbell’s story:

“N.C. Senate leader Phil Berger is defending Republican legislators’ controversial 3 a.m. move to strip funding from several education programs in counties represented by Democrats. He argues that the change was necessary to address the state’s opioid epidemic without raising taxes.

The budget amendment was passed moments after it was introduced early Friday morning, following a two-hour Senate recess called when GOP leaders became visibly upset with Democrats for prolonging the budget debate with amendments….

On Tuesday, Berger issued a statement about the amendment – his first public comment on the issue.

‘This amendment helped address, without raising taxes, the opioid crisis that Sen. (Paul) Lowe tried to address with a large tax increase in his amendment,’ Berger said in an email.

Lowe’s amendment, which was rejected, would have added about $15 million for opioid treatment programs – a proposal from Gov. Roy Cooper’s budget – by scaling back the Senate’s proposed personal income tax cut.”

Berger’s somewhat less strident than usual tone didn’t rescue the statement from being anything other than nonsense, however.  The notion that the budget (which socked away hundreds of millions of dollars in a “rainy day fund” and gave millions in new tax cuts to the state’s wealthiest taxpayers) could only address the need for opioid services by slashing already underfunded programs in areas served only by Democrats — i.e. the people who had just had the temerity to question some of the overarching policies in the budget — is an insult to the intelligence of all North Carolinians. As Chris Fitzsimon noted yesterday, whatever Berger says in an attempt to defend his Trump-like behavior, it remains indefensible:

“Senator Berger and his fellow bullies were willing to punish students and schools in North Carolina because their Democratic colleagues made them stay up late and defend the budget they unveiled only a few days before.

Just a few years ago, the shocking undemocratic episode in the General Assembly would have resulted in screaming headlines and been the talk of the political world for days.

Not now, with bizarre news from Washington almost every day.

Maybe Senate leaders think they can do anything they want any time they want with no repercussions.

They are certainly acting like it, democracy and common decency—and the people of North Carolina be damned.”

The bottom line: Berger’s slightly-less-hostile tone is welcome, but he has a long way to go if he wants to start engaging in genuine and honest dialogue about the issues confronting the state.

News

Sen. Thom Tillis collapses during charity race

Senator Thom Tillis (R-NC) collapsed while running a charity race Wednesday morning, according to reports.

From the Associated Press story:

 

Tillis, 57, was seen on the ground being administered CPR by bystanders at about 15-20 minutes into the race, which started at 8 a.m. The three-mile race was being held in Anacostia Park in the southeast part of the city.

Tillis at first appeared unconscious but was revived and breathing when taken away by ambulance from the ACLI Capital Challenge Three Mile Team Race. Tillis was participating in the ACLI Capital Challenge race, an annual event in Anacostia Park in the district. He was leading his own team, “Team Tillis.”

 

It was not immediately clear to which hospital Tillis was taken.

Tillis tweeted a photo of his team before the race:

A local television news anchor tweeted a photo after the collapse, as Tillis was being treated.

Tillis served in the N.C. General Assembly from 2006 until 2015, serving as the Speaker of the N.C. House from 2011 to 2014. He was elected to the Senate in 2014 and serves on a number of influential committees including Senate Armed Services, Housing and Urban Affairs,
Veterans Affairs and Banking.

UPDATE:

Tillis has tweeted a video in which he says he’s doing fine, just got overheated after about 2.5 miles and will see everyone back on the Hill.