Commentary

North Carolina’s uninsured rate falls, but gains are muted by failure to expand Medicaid

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.

Commentary

Will Speaker Moore ignore the House rule regarding new budget provisions?

As noted in this space last Friday, the rules of the North Carolina House of Representatives clearly require that lawmakers refer the conference report on the 2016-17 budget to a standing committee for review prior to the full House vote that is scheduled for tomorrow.

House Rule 44(b) states that:

“a conference committee report which includes significant matters that were not in difference between the houses, shall be referred to a standing committee for its recommendation before further action by the House.”

House Speaker Tim Moore

House Speaker Tim Moore

The obvious point of this rule is to prevent lawmakers from cooking up new law changes that were not included in either of the original versions of the bill passed by the House or the Senate and then inserting them in to a conference report that’s negotiated and drafted in secret. It is, in other words, a modest but important rule to assure a modicum of sunshine and transparency so that rank and file lawmakers, the news media and the public at large can have at least some idea of what the hell it is that’s being voted on.

Though everyone is still sifting through the massive 429 page document, here are two significant matters that are in the conference report that were not in either version of the budget passed previously:

#1 – As Chris Fitzsimon pointed out this morning, the conference report includes a new and hugely destructive provision to undermine light rail plans in the Triangle.

#2 – A new, out-of-whole-cloth change to state law on the number of so-called terminal groins that will be allowed along the coastline (see page 207 of the report).

These are both extremely important law changes that were never approved by either House throughout the eight month-long legislative session. Read more

Commentary, Uncategorized

New ads ask Gov. McCrory, “Where’s the plan to expand coverage?” (AUDIO)

The North Carolina Justice Center launched radio and digital ads this week urging people to ask Gov. Pat McCrory to release a plan that expands affordable health insurance in our state.

We have the opportunity to tap federal funds to extend affordable insurance coverage to more than 500,000 people struggling to pay for care. Our tax dollars are sitting in Washington waiting to be used to boost rural health care in our state and save more than 1,000 lives every year.

We can expand Medicaid with this money or we can develop a state-specific plan to experiment with new coverage ideas. Conservative Governors in Arkansas, Iowa, Indiana, Montana, Utah, Tennessee and elsewhere have proposed specific policies. Gov. McCrory told news outlets at the beginning of the year that he was considering doing the same. The hold up, he claimed at the time, was the latest Affordable Care Act challenge at the U.S. Supreme Court. He would announce his support, or opposition, to expanding coverage after the high court ruled in King v. Burwell.

King v. Burwell came and went and still no word from the Governor.

The Governor and legislators all have access to taxpayer funded healthcare so they can afford to delay a decision. Many others in our state aren’t so lucky.

These 500,000 North Carolinians are mostly the working poor with jobs in construction and food service that do not provide health insurance benefits. They don’t currently qualify for Medicaid because eligibility is restrictive in our state. They can’t afford to buy private insurance. Now they are stuck and just need action from their elected representatives.

It starts with the Governor. He can change the dynamic by showing leadership and proposing a plan. Go to NC Left Me Out and share your story if you or a loved one are in the coverage gap. And then use the phone number listed to contact Gov. McCrory and ask him, “Where’s the plan to expand coverage?” We can’t wait any longer.

Commentary

The House rule that could delay next week’s budget vote

News reports this morning continue to advance the notion that state lawmakers will come together on a state budget prior to the expiration of the current continuing resolution next Friday. As most reports have noted, the issue is made more complex by a House rule that requires 72 hours of public notice prior to the final votes on the budget. This means that lawmakers have to cut their final deal and get it published by the beginning of next week in order to meet the deadline.

While this may, indeed, be possible to pull off, it is worth noting that another House rule could impact the timing of next week’s process as well.

House Rule 44(b) (click here and go to page 21-22) reads as follows:

(b) The conference report may be made by a majority of the House members of such conference committee and shall not be amended. If the Senate has a similar rule, only such matters as are in difference between the two houses shall be considered by the conferees, and the conference report shall deal only with such matters. If the Senate does not have a similar rule, a conference committee report which includes significant matters that were not in difference between the houses, shall be referred to a standing committee for its recommendation before further action by the House.

The matter at issue with this rule is the question of inserting new items into the conference report that were not in the versions of the bill passed by either body. The common sense principle is that conference committees established to work out the differences between the two houses ought not to be adding completely new provisions out of thin air that were never in either version of the bill.

Not surprisingly, the wild and crazy Senate has no rule barring such shenanigans, but the House (see above) does. The clear impact of this rule is to require, at a minimum, an additional House committee meeting (presumably of the Appropriations Committee) to consider the new provisions added by conferees.

This means that if, for instance, the final conference report has a provision on the construction of terminal groins along the coast (something that was not in either version of the budget) the House must have a committee meeting to consider and approve such an addition. And while such a meeting could, presumably, be put together in relatively short order, it does offer the prospect of at least some minimal public airing of the details of what is sure to be a massive, secretly negotiated document.

Let’s hope House Speaker Tim Moore does the right thing and enforces this rule.

News

House and Senate conferees agree to keep Office of Charter Schools within DPI

This just in: members of the House and Senate who were appointed to a conference committee appear to have brokered a deal to keep the Office of Charter Schools administratively within the Department of Public Instruction, despite Senator Jerry Tillman’s (R-Randolph) initial efforts to move that office under the State Board of Education. A final vote on the proposal is expected Monday.

According to a conference committee report filed late Thursday, “the Office of Charter Schools shall be administratively located in the Department of Public Instruction, subject to the supervision, direction, and control of the State Board of Education.”

While the charter school office would continue to be housed within DPI, according to the conference report, it would appear that the State Board of Education could exercise more oversight over that office—but how that would practically work isn’t yet clear.

The report also stipulates that Lieutenant Governor Dan Forest would head a three-person search committee to appoint a new Office of Charter Schools director. That position is currently vacant; its former director, Joel Medley, vacated his position this summer to go work for the new K12, Inc.-backed online virtual charter school NC Virtual Academy.

Other items of note in the proposed legislation:

  • Raises the statutory minimum number of students enrolled in a charter school from 65 to 80;
  • Offers more opportunities for charter school applicants to make corrections to their applications along the way;
  • Includes an anti-nepotism policy;
  • Allows a charter school board member to have a conflict of interest so long as they comply with the school’s conflict of interest policy;
  • Members of a charter school board may reside outside of North Carolina;
  • Charter schools may charge extracurricular fees consistent with what the LEA charges;

Notably, the conference report also contains a provision that is unrelated to charter schools. Section 10 deals with disability vouchers, which currently require eligible students to be reassessed by their LEAs every three years to ensure they still qualify for the special needs scholarships, which allow students to use state funds at private institutions.

The conference report appears to allow recipients of the disability vouchers to be reassessed for eligibility not only by the LEA, but also by a “licensed psychologist with a school psychology focus.”

Let me know if I missed any key provisions in H334.