Health careThere are lots of obvious ways in which conservative ideologues are rolling back decades of progress in North Carolina. From taxes to guns, clean water to abortion rights, school privatization to voting rights, Medicaid expansion to predatory loans, the list of high-profile issues is a long one.

What’s more, it is not exhaustive. A lot of the damage is taking place largely under the radar as free market fundamentalists work in scores of unsexy nooks and crannies to lift up the god of unfettered casino capitalism and eradicate common good rules and regulations that curb greed and serve the public interest.

A very helpful op-ed in this morning’s edition of Raleigh’s News & Observer shines a light on a classic example of how right-wing nerds of ruining our state in an obscure but important area. The subject is so-called “Certificate of Need” laws or “CON.” For decades, CON laws have helped assure that major health care resources like hospitals and surgery centers are at least somewhat fairly distributed throughout the state and not just clustered in high wealth and highly populated communities.

Unfortunately, repeal of CON laws has been something close to an obsession amongst the groups in the Art Pope empire for many years. The drumbeat to repeal has now gotten so loud that lawmakers are seriously considering action in this area.

As the op-ed in the N&O this morning by  Roanoke Rapids hospital CEO William Mahone (“Why Certificate of Need laws are important to NC health care”) makes clear, however, repeal of CON laws would be a disaster for most folks not living amongst the state’s “haves.”

As Mahone, notes, the notion of “deregulating” an industry in which federal government reimbursements already account for two-thirds of hospital patients is just silly. All the repeal of CON laws will do is to effect a shift of resources away from community-based hospitals to free-standing specialty centers located in or on the fringes of affluent urban communities. This is from the op-ed: Read More


Health careCharlotte Observer reporter Ann Doss Helms makes things perfectly clear this morning just how big the stakes will be this week when the U.S. Supreme Court hears the King v. Burwell case challenging the lawfulness of Affordable Care Act health insurance subsidies in states like North Carolina.

“More than 500,000 North Carolinians stand to lose subsidized health coverage based on a challenge to the Affordable Care Act that goes to the U.S. Supreme Court this week.

Also at stake is the financial stability of the insurance companies, medical professionals and others that have come to count on the federal money the act provides to help low- and moderate-income people who don’t have workplace health coverage.”

And as was explained in last week’s N.C. Policy Watch Weekly Briefing, that could be just the beginning of our problems if the Court opts to provoke a crisis because of what amounts to a typo.

Fortunately, congressional Republicans have a contingency plan if the Court really issues such a terrible ruling…NOT. As Ezra Klein argues this morning on Vox, Congress isn’t at all likely to be able address the crisis if the Court sets it in motion:

“If the Court rules against the Obama administration, the outcome is perfectly predictable: nothing will happen. Some Republicans will come up with some plan to gut Obamacare that the Obama administration could never accept. The Obama administration will ask Republicans to simply fix the law, which they’ll never do. The two sides will blame each other just as always happens, and their attached partisans will think their side has the better of the argument, just as always happens. We have seen this movie before.”

Let’s fervently hope, however, that the Court does the right thing and if it doesn’t, Klein is wrong.


In case you missed it this morning, be sure to check out Adam Linker’s op-ed in this morning’s edition of Raleigh’s News & Observer. As Linker writes:

“Health insurance for more than a million North Carolinians is at stake, and Gov. Pat McCrory has two options: He can take the initiative to protect the people he has sworn to represent or he can sit back and let external forces decide our destiny.

Nearly 560,000 people have signed up for Affordable Care Act plans in North Carolina, and many of them receive tax credits to help pay their premiums. Thanks to outreach efforts by nonprofits, insurers, insurance agents and hospitals, our state ranked fourth in Affordable Care Act signups nationally.

Despite these impressive results, there are still more than 500,000 people, many of them the working poor, who do not qualify for North Carolina’s Medicaid program and who do not earn enough to purchase private insurance. Health reform set aside money for our state to provide this population with coverage through Medicaid, but first state leaders must consent to using these funds for that purpose. So far the governor and state legislature have left the money in Washington.”

Unfortunately, of course, Governor McCrory has failed to act. As Linker explains, however, it’s not too late:

“Now comes the governor’s moment.

He, along with legislative leaders, could change course and circumvent the Supreme Court by re-establishing state control over our insurance marketplace. In fact, most of the pieces are already in place. Our Department of Insurance is proactive about reviewing insurance policies. Our health care and insurance communities meet regularly and could easily form an oversight board. Our outreach and enrollment efforts are national models. All we need is for the governor to work with legislators to vest these organizations with the power to form a state marketplace.

McCrory then could release a state-specific plan to tap federal Medicaid funds to expand coverage to 500,000 additional people. This would boost local economies still staggering from the Great Recession. It would allow tens of thousands of women access to preventive screenings like mammograms and pap smears. It would allow thousands of people suffering from the disease of addiction to obtain the long-term treatment they need. Read More


McCrory contradictionsGovernor Pat McCrory announced a disastrous and destructive decision yesterday in an interview with an AP reporter. When asked whether he would recommend closing the insurance gap that currently leaves a half-million North Carolinians too poor to qualify for Obamcare subsidies and too well-off to qualify for Medicaid, the Guv said: “I will not make any recommendation as to whether or not we extend insurance for the uninsured until the court case because there are so many ramifications of the court case.”

As the story also noted: “The court’s oral arguments are next month and a ruling is expected in the summer, about when the legislature traditionally seeks to adjourn. That could push any legislative action on a recommendation to 2016.”

This means that a half-million struggling North Carolinians will have to wait at least another year for the health insurance they were promised and deserve. In all likelihood, thousands will die unnecessarily. Meanwhile, tax dollars paid by North Carolinians will flow to other states in which Governors (many of the Republican) have had the vision and courage to put human life ahead of politics.

The decision comes after months of dithering by the Governor and in spite of the clear signals sent by his Department of Health and Human Services officials that Medicaid expansion is both the right thing to do and essential to save lives.

The bottom line: If this is truly is his final word on this matter, Pat McCrory has now, officially, made the worst and most destructive decision of his governorship — a decision that puts supposed concerns about bureaucratic hassles ahead of saving human lives. Meanwhile, millions of people in Ohio and Arizona and other conservative states  enjoy access to decent and affordable health insurance on our nickel. Let’s hope and pray the U.S. Supreme Court does the right thing this summer, but whatever happens then and thereafter, Gov. McCrory has now seized the mantle from former chief naysayer Senator Phil Berger and cemented his legacy as the person who denied decent and affordable health care to a half-million of his fellow Tar Heels unnecessarily.


Medicaid expansionIn case you missed them while scraping your windshield earlier today, there are two new lead stories  over on the main Policy Watch site today that will be worth a few minutes of your time.

This morning’s Weekly Briefing is an open letter to the one man in North Carolina politics with the clout (and, one hopes, the human decency) to set politics aside and guarantee access to health care for hundreds of thousands of people like Dana Wilson.

Meanwhile, this afternoon’s Fitzsimon File examines what was certainly the strangest claim in GovernorWorkers comp McCrory’s State of the State speech and its apparent origins with a little known administration official who seems to be keeping some odd and perhaps worrisome ties to the private sector.