Action NC policy and public affairs director Kevin Rogers has an opinion piece in the News & Observer arguing that the ACA is here to stay, so we should get down to the business of improving the law and fully implementing it in North Carolina.

Open enrollment, he reminds us, starts November 1. Our state is a national leader when it comes to signing up residents for Affordable Care Act plans. The many people who have these policies need added protections, not repeal votes, to make their insurance plans work better. And the working poor need our state leaders to stop blocking Medicaid expansion. This interposition is causing great pain, and unnecessary deaths, all across North Carolina.

You can read the entire editorial here. Rogers concludes with this message to lawmakers:

As we enter the third ACA enrollment period, it is high time for Congress and the General Assembly to accept reality, abandon partisan tricks and move forward to improve the economic and human well-being of our state. Until then, thousands of lives will be lost each year, and billions of dollars wasted that health care consumers, taxpayers and our government cannot afford. The ACA is here to stay – it’s time to start acting accordingly.

If they heed his advice that would be sweet indeed.

NC Budget and Tax Center

The General Assembly used a few of the last hours of the 2015 session to cut back how long unemployed North Carolinians in economically distressed counties can receive food assistance. Even though this weeks’ labor market data show that 9 out of 10 counties have more out of work people than job openings, the new rule would cut unemployed people off regardless of how hard it is to find work. The change could take food off more than 100,000 tables across North Carolina, and will pull money out of already struggling local economies, a doubly bad deal.

The one-sentence provision in the ratified bill (see section 16.a) permanently prevents the state from seeking to extend food assistance for people who can’t find work in their local economies, except in times of emergency. The federal Supplemental Nutrition Assistance Program (SNAP) allows states to temporarily waive a three-month time limit for unemployed childless adults who live in areas where few jobs are available.77 waiver counties - Updated for Blog Post

Recognizing that cutting off food aid to areas where there aren’t enough jobs hurts entire local economies, North Carolina sought this waiver for 77 of our 100 counties earlier this year. If the Governor signs this measure and SB119 into law, the ban on the waiver would go into effect in July 2016. Without the modest support of SNAP (formerly known as food stamps), between 85,000 and 105,000 North Carolinians would be subject to the three month-time limit and potentially will not be able to purchase food at their local grocery stores, depressing consumer demand further and driving use of food banks already stretched to capacity. Read More


One of the longest legislative sessions in more than a decade (possibly the longest since 2002) came to a close during the wee hours of Wednesday morning. Here’s a quick update on some last minute controversial proposals affecting public education that ultimately didn’t become law.

Charter school funding 

Sen. Jerry Tillman breathed new life back into a proposal heard earlier this session that would have diverted funds typically reserved for traditional public schools over to charter schools.

Using the ‘gut and amend’ process, Tillman shoved the complicated language into a House bill that was previously about school playgrounds a week and a half before the close of session. Loads of push back ensued from the school boards association, school administrators and other education advocates.

The bill would have allowed charter schools to receive more federal and local tax dollars—as well as private grants— than to which they are currently entitled. And some of that money could have been reimbursements for services that charter schools may not be providing to students, like school lunches. (State law doesn’t require charter schools to provide school lunches, although many do participate in the federal school lunch program.)

Senate lawmakers approved the measure Monday evening and sent it back to the House for concurrence—but the bill was left to die last night. It could come back next year.

School vouchers

Republican House lawmakers successfully banded together Tuesday morning in an effort to block a proposal put forward by school voucher champion Rep. Paul “Skip” Stam that would have set up the state’s new school voucher program for expansion.

Stam gutted and amended S456 to require the state to award more Opportunity Scholarships (also known as school vouchers) to kindergartners and first graders, a move seen by some as a set up for the program’s expansion down the road.

But there appeared to be growing discontent among some Republican lawmakers over the school voucher program, as Rep. Bryan Holloway led efforts to block Stam’s proposal by telling his colleagues they “might find it interesting” to look at what kinds of schools voucher students are picking and choosing.

Rep. Leo Daughtry (R-Smithfield) told colleagues that a private school in his district accepting school vouchers didn’t seem fit to take tax dollars.

“I went to visit this school [receiving school vouchers, in his district]. It’s in a back of a church, and it has like 10 or 12 students. And one teacher. Or one and a half teachers,” said Rep. Daughtry. “And I think you need to go slow with Opportunity Scholarships. From what I saw…the school there that I visited didn’t seem to be a school that we would want to send taxpayer dollars to.”

Stam’s proposal was narrowly defeated in the House appropriations committee, 24-26, after a careful count of the ayes and noes.

Achievement school district

Rep. Rob Bryan (R-Mecklenburg) pushed hard for months behind closed doors to pitch a proposal to his colleagues that would have created an ‘achievement school district’ in which some of North Carolina’s lowest performing schools would be placed, teachers and staff at those schools could be fired, and the schools would be subject to the management of for-profit (or not-for-profit, too) charter school operators tasked with bringing them up into the ranks of the state’s top performers.

The idea is controversial thanks to the mixed results its seen in places like Tennessee and Louisiana, coupled with the notion that for-profit charter operators subject to fewer checks and balances and not accountable to an elected school board would be tasked with the care of a vulnerable student population.

As the end of session neared, it began to look as if Bryan’s proposal would be heard publicly only at the very last minute—but ultimately the bill, which was another ‘gut and amend’ of a Senate proposal that had already passed that chamber, never made it into committee. Rumors of the idea being placed into a ‘study committee’ never materialized, but the pitch could come back next year.


You should read our earlier post about Rep. Nelson Dollar’s excellent objections to Medicaid reform. Dollar deserves kudos for pointing out that our system is not broken.

Despite these objections the legislature is charging ahead. If we want reform, however, the state needs to expand Medicaid at the same time. Why? Because to reform Medicaid we need permission from the federal government. According to the bill passed by the General Assembly we will officially seek this permission from the federal government by June of 2016. The Obama Administration is unlikely to make privatizing our Medicaid program a major priority in its last few months of office. That is not the sort of legacy he is interested in leaving.

If we do not get approval from the current leadership at Health & Human Services then North Carolina will need to wait until a new President takes office. Then the new President will have to nominate an HHS Secretary and we will have to wait for the Secretary to be confirmed. At some point after that HHS will begin to review our reform proposal.

Alternatively, North Carolina could include expansion in the reform plan. Then the Obama Administration would act quickly to approve our waiver. Certainly HHS is not excited about dismantling our model Medicaid system, but they could live with legislative changes if it meant covering 500,000 more people in our state.

With expansion reform will move quickly and our proposed changes will be accepted by HHS. Without expansion reform will be a long, long road to an uncertain destination.


North Carolina’s uninsured rate fell in 2014 thanks to the implementation of federal health reform but data released today show our state is leaving many citizens behind by refusing to expand Medicaid.

The Census Bureau today released the country’s official data on health insurance rates, which shows that 1.27 million North Carolinians lacked health insurance in 2014 compared to 1.5 million uninsured North Carolinians in 2013. Expanding Medicaid would have resulted in a more dramatic drop in the uninsured rate.

We see that many of the states that expanded Medicaid such as West Virginia and Kentucky now have single-digit uninsured rates whereas North Carolina’s uninsured rate was 13 percent in 2014 compared to 15.6 percent in 2013. The Affordable Care Act is working, but it would work better if policymakers stopped blocking coverage for the working poor families who don’t earn enough to buy private insurance and don’t currently qualify for Medicaid.

A study by George Washington University released last year shows that expanding Medicaid in North Carolina would extend coverage to 500,000 more people while creating 43,000 jobs and attracting $21 billion in federal funding over five years.

Nationally, the Census data show that the uninsured rate dropped to 10.4 percent last year, down from 13.3 percent in 2013. These numbers reflect individuals who were uninsured throughout the year. The Affordable Care Act helped more than 8.8 million people gain health insurance coverage.

It’s not too late for North Carolina to catch up with the rest of the nation. The Governor could propose, and the legislature could adopt, a state-specific plan to close the coverage gap at any time.