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Now that the Supreme Court has ruled — again — that the structure of the Affordable Care Act is constitutional, it is time to move forward with making the law work better in our state.

The first, and most important, step is accepting federal funds to extend the benefits of affordable health insurance coverage to 500,000 more people in our state. Gov. McCrory said last year that his staff was assembling options to expand coverage and that he would make an announcement about his recommendation after the Supreme Court ruled in King v. Burwell. The ruling has arrived.

When asked about expansion today McCrory was sort of squishy and said he wants a North Carolina plan. We all do. But first we need the Governor to draft and release such a plan. Conservative Governors in Ohio, Indiana, Utah, Michigan, Tennessee and other states have either closed the coverage gap or assembled a strategy to accomplish a coverage expansion. There’s no reason our Governor can’t do the same.

Legislators are still critical of expansion. Sen. Ralph Hise says that he doesn’t think the federal government will be flexible enough to allow a state option. His wish list includes wanting to expand using private insurance and imposing co-pays on recipients above the federal poverty level.

Of course, the federal government has approved even more conservative measures than Hise mentions. Several states including Arkansas, Iowa, and Michigan do use private insurance to expand coverage. Some states are charging co-pays and premiums even on enrollees earning less than the federal poverty level. The federal government has shown a degree of flexibility that makes many advocates uncomfortable. The idea that our hands are tied is, to quote Justice Scalia, pure applesauce.

Recently released data from the National Health Interview Survey show the dramatic impact of expanding coverage. In Kentucky the adult uninsured rate dropped from 24.1 percent in 2013 to 15.6 percent in 2014. In Arkansas the rate went from 27.5 percent to 15.6 percent. And, most stunningly, in West Virginia the adult uninsured rate went from 28.8 percent in 2013 to 12.2 percent in 2014. These numbers reflect only the first year of expansion and states nearly cut their adult uninsured rates in half. In North Carolina the adult uninsured rate moved from 25.6 percent to 22.5 percent.

A majority of states are expanding coverage while reforming their Medicaid programs. More states will join their ranks now the Supreme Court has ruled that the Affordable Care Act is here to stay. The Governor must show leadership on this issue and ensure that all of our citizens have access to comprehensive, affordable health insurance.

News

Senate leader Phil Berger (R-Rockingham) and House speaker Tim Moore (R-Cleveland) filed a motion Tuesday asking the state Supreme Court to allow the controversial school voucher program to proceed for the 2015-16 academic year while the high court continues to debate the constitutionality of allowing families to use public dollars for tuition at private schools.

“Intervenor-Defendants respectfully request that this Court modify its 12 December 2014 Order granting in part a writ of supersedeas and permit the Opportunity Scholarship Program to move forward for the 2014-2015 academic year unimpeded by the Superior Court’s permanent injunction,” wrote attorneys who filed the motion on behalf of Senator Berger and Speaker Moore, who are defendant intervenors in a case that is seeking to halt the school voucher program.

The North Carolina Supreme Court last released opinions on June 11, and many expected a decision on the case at that time from the state’s highest court.

But a decision did not come, and the next scheduled date for Supreme Court opinions is not until August 21 — a point in time, as Tuesday’s motion highlights, when it will be nearly impossible to ensure that the program can continue for the upcoming academic year should the Court decide that the Opportunity Scholarship Program passes constitutional muster. (The Supreme Court is, however, able to issue opinions at any time and without regard to the scheduled dates, if the Court so desires.)

Last summer, Superior Court Judge Robert H. Hobgood put a halt to the Opportunity Scholarships program, enacted by the General Assembly in 2013.

Judge Hobgood found that the program failed constitutional muster for several reasons—chiefly because it funnels public dollars that should be used exclusively for establishing and maintaining the uniform system of free public schools to private institutions instead, which the state holds to almost no curricular requirements or standards of accountability.

“The General Assembly fails the children of North Carolina when they are sent with public taxpayer money to private schools that have no legal obligation to teach them anything,” Judge Hobgood said.

The state, along with defendant-intervenors for parents as well as then-Speaker Thom Tillis and Senate leader Phil Berger appealed Hobgood’s ruling to the Supreme Court, and the Court of Appeals ruled last fall that the program could continue for this past academic year as the fate of the program was debated.

State lawmakers passed a 2013 budget that tagged $10 million to be used for the Opportunity Scholarships beginning in 2014. The vouchers, worth $4,200 per student annually, funnel taxpayer dollars to largely unaccountable private schools––70 percent of which are affiliated with religious institutions.

Proponents of the voucher program say it’s necessary to provide low-income families with options outside of the public school system—especially for those whose schools do not have the means to ensure a student’s academic success.

The House’s 2015-17 budget, passed last month, proposes expanding the school voucher program from $10 million to $17.6 million for the upcoming fiscal year. The Senate’s proposal does the same, but with recurring funds instead and for both years of the biennium.

News

State lawmakers could soon decide to anoint pro-school privatization nonprofit Parents for Educational Freedom in North Carolina (PEFNC) to distribute taxpayer dollars to new charter schools in the state, according to the Associated Press.

From the AP:

The budget proposal being considered by the General Assembly may break new ground in state spending by letting Parents for Educational Freedom in North Carolina decide which fledgling charter schools get a piece of $1 million a year, N.C. Center for Nonprofits vice president David Heinen said.

“This is probably unique to have a completely independent 501(c)(3) nonprofit having discretion without a lot of criteria,” said Heinen, citing the chapter of federal tax law describing charity and educational groups. “I don’t know of any other that is quite like this.”

If the Senate endorses what is currently a House proposal, PEFNC would be tasked with doling out up to $1 million annually in start-up funds for new charter schools (up to $100,000 each) to set up shop in geographic areas where charter schools are few in number.

When the House rolled out this idea earlier this year, lawmakers on both sides of the aisle expressed concern over the idea that a private group beholden to virtually no public oversight could be tasked with handing out taxpayer dollars.

Legislative efforts have attempted to direct similar responsibilities to PEFNC in years past.

In 2013, lawmakers proposed giving the nonprofit $1 million over two years to develop charter schools in rural parts of the state, but that measure did not pass. A similar bill was filed last year too, but also did not survive.

None of the taxpayer funds can go toward administrative or management fees, according to the current proposal. Darrell Allison, executive director of PEFNC, already receives a large compensation package that has has increased considerably over a short time.

In 2010, Allison received $107,889 for his work running the non-profit; in 2012, Allison reported an income of $156,582—a 45 percent pay increase in just two years. In 2013, his salary bumped up again to $167,085, according to tax records.

PEFNC has received millions of dollars from the Walton Family Foundation (owners of Wal-Mart) over the past several years. The Waltons are known for supporting education initiatives such as vouchers, charter schools and other privatization measures.

For more background on PEFNC, click here.

The Senate begins the process of rolling out their budget later today in committee meetings. I’ll be tweeting from Senate Ed at 4pm — follow me on Twitter @LindsayWagnerNC.

Commentary

IMG_0831Last year Mayor Adam O’Neal from the tiny, scenic town of Belhaven, NC, made national headlines as he walked nearly 300 miles from Beaufort County to Washington, DC, to protest the closing of his rural hospital and to urge states to accept Medicaid expansion.

On Monday, June 1, O’Neal left Belhaven to replicate last year’s feat. And this year he is taking along advocates from around the country. As marchers filed out of town yesterday to start the arduous journey they wore shirts advertising their home states. A team of advocates travelled from Texas, some came from West Virginia and Alabama, a rural hospital CEO from Kentucky joined the walk, as did a woman from Seattle, Washington.

The message of the marchers is clear: we must save rural health care.

A key part of that agenda includes expanding Medicaid, as an Episcopal priest from Belhaven reminded the audience during a prayer before the send off. Rev. William Barber from the NC NAACP noted that Jesus made health care a central part of his ministry.

You can follow the march at this website. You can also tweet with the hashtag #savethe283. That refers to a national estimate that 283 rural hospitals are at risk of closing this year.

You can also join the final rally as marchers reach Washington, DC, and gather at the Capitol on June 15 at 10am.

And, finally, you can ask legislators and the Governor in North Carolina to accept new federal Medicaid funds to expand insurance coverage to 500,000 more people in our state.

Commentary

In 2013 the North Carolina General Assembly rejected new federal funds to expand health insurance coverage in the state, but that hasn’t stopped local governments from urging the Governor and legislators to change course.

Counties such as Mecklenburg and Durham have passed Medicaid expansion resolutions as have cities like Greensboro and Winston-Salem. Even Sen. Phil Berger’s hometown of Eden officially went on record endorsing expansion. The Rockingham County towns of Reidsville and Madison have since joined Eden.

This month three more counties — Nash, Edgecombe, and Chatham — joined the chorus.

As retired cardiologist Jim Foster pointed out to the Chatham Commissioners there are tremendous economic benefits to accepting more federal Medicaid dollars. From news coverage of the resolution:

“Anytime money flows into the economy, it ripples through and multiplies,” Foster said.

He pointed to a George Washington University study that broke down the costs and revenues from expanding Medicaid.

The study broke figures down for the state and for its 100 counties.

In Chatham, for example, the study stated that not expanding Medicaid cost 136 jobs and $6 million in gross product.e study Dr. Foster mentions can be found here.

Approval of the Nash County resolution was unanimous and Commissioners added a call for simultaneous reforms to Medicaid. This makes sense. In fact, nearly every expansion state is also reforming the program at the same time.

There is no reason North Carolina’s leaders can’t learn to walk and chew gum like most other states in the country.