NC House Republicans want the state to negotiate for a Medicaid expansion work requirement

A NC House Republican proposal for Medicaid expansion would require the state’s health department to negotiate for a work requirement for enrollees before the question of offering health insurance to low-income adults comes to a vote of the legislature.

A new committee of House members and senators, called the Joint Legislative Committee on Medicaid Rate Modernization and Savings, would decide on Dec. 15 whether the state Department of Health and Human Services’ expansion plan meets criteria set out in Senate bill 408. If the joint committee decides the plan checks all boxes, the legislature would vote on it. House Speaker Tim Moore said the House would vote before the end of the year on an expansion plan that made it through the new joint committee.

House Speaker Tim Moore and Rep. Donny Lambeth discuss the future for Medicaid expansion.


“I think we’re at a good point right now where we have something that we can address some really critical needs, and we can do so in a way that is fiscally responsible to the taxpayers of the state,” Moore told the House Health Committee on Thursday morning.  “I don’t want to see us do anything as a General Assembly that would incentivize a person or persons from not getting a job.”

A different legislative committee of House members and senators that met earlier this year heard that many people who would gain health care coverage under Medicaid expansion already work but have jobs that do not offer health benefits.

Rep. Carla Cunningham, a Charlotte Democrat, said she was encouraged House Republicans were talking about expansion, but was underwhelmed by a proposal that would further delay it.

“Another study? I’m not down for another study,” Cunningham said. “We’ve been carrying this ball and chain around for 10 years.”

North Carolina is one of a dozen states that has not expanded Medicaid. The hold-out states have a new financial incentive to expand, which for North Carolina would mean about $1.5 billion over two years.

Medicaid expansion has become a major point of disagreement between House and Senate Republicans as the legislative session slowly winds down. The Senate overwhelming passed Medicaid expansion last month. 

The Senate proposal would also give registered nurses with advanced degrees the ability to work without doctors’ supervision and would loosen state regulations governing approval of new health care facilities and major medical equipment.

Medicaid expansion in North Carolina would cover about 600,000 adults who make too much to qualify for Medicaid but too little to qualify for subsidized commercial health insurance offered under the Affordable Care Act. Most adults without dependent children do not qualify for Medicaid. Parents must have very low incomes to qualify.

The federal government pays 90% of the cost of people with health insurance under expanded Medicaid. In proposals the legislature has considered over the years, hospitals would pay the other 10% of the cost.

The Biden administration has withdrawn permission for Medicaid work requirements in states that had them, and courts have dismissed state appeals.

Moore said after the committee meeting that under the House proposal, the Cooper administration would have to try to negotiate a work requirement. If that doesn’t fly, the plan must include something about work, he said. “There are no poison pills in here,” he said.

NC House members decline to gamble on ‘predatory’ sports wagering bill (w/ video)

Supporters of sports gambling failed to advance legislation in the state House Wednesday that would have authorized online sports wagering for North Carolina. The vote against Senate Bill 688 came after lawmakers narrowly approved a companion bill (SB 38) of sports wagering amendments.

But without both piece of legislation getting a joint nod from the House, it’s unclear what avenue bill sponsors will take in the waning days of the summer session.

Rep. Pricey Harrison (D-Guilford) said other states that have gone down this road have not had the payday they anticipated.

“The house is always going to win. North Carolinians are not going to win with this bill, and the argument that there’s offshore betting now and we should just do it and get the revenue, we know that offshore betting is going to continue because those companies are going to avoid paying the taxes and fees they are going to have to pay to do legalized betting.

“So, we’re not achieving anything except robbing North Carolinians of lots of money and funding the gambling industry. And we’re gonna have a lot of heartache and a lot of expense to our state and our taxpayers, and I can’t believe anybody can vote ‘yes’ for this bill.”

Rep. Pat Hurley (R-Randolph) was among more than 30 Republican members to join Harrison in opposing the fast-moving legislation, which cleared two committees earlier on Wednesday.

“Conservative estimates suggest North Carolina can expect to see tens of thousands more of our state’s citizens and their families being victimized by gambling addiction,” Hurley said. “What some people don’t even think about [it] adds to our social service budget.”

Rep. John Autry (D-Mecklenburg) dealt the bill another blow by successfully running an amendment that removed all college sports betting from the measure.

Rep. Jason Saine (R-Lincoln), the chief proponent of the bill in the House, is now looking for another approach to legalize sports betting before the end of the session.

SB 38, the companion bill that did win approval on Wednesday, faces one more vote in the House before heading back to the Senate.

Medical marijuana advances to NC House after historic vote in Senate

Photo: Getty Images

On Monday, the state Senate passed a historic bill that would allow patients to receive medical marijuana through a trained physician for medical conditions such as cancer, PTSD, epilepsy and more.

The bill would also remove the state-level criminal penalties for medical use, cultivation and distribution of marijuana. The measure would not change civil or criminal laws governing marijuana for nonmedical use. 

Filed last year by the Senate as the “North Carolina Compassionate Care Act,” Senate Bill 711 passed its final required reading with a 36-7 vote. Sen. Bill Rabon (R-Brunswick) spoke about the benefits of medical marijuana and its necessity during the second reading last Thursday, which passed after having a floor debate.

“It is our duty as lawmakers to pass legislation that helps people who need our help,” said Rabon, a primary sponsor of the bill and a cancer survivor who has worked on the legislation for five years. “It is not going to make them ashamed or reluctant to seek help if it is recommended to them by their physician.”

Another primary sponsor of the bill, Sen. Micheal V. Lee (R-New Hanover), also acknowledged that patients might need treatment that only marijuana can provide. “The patient gets to pray that this works because a lot of times nothing else does,” Lee said.

Though the bill has bipartisan support, opponents such as Sen. Jim Burgin (R-Harnett) remains unconvinced. “Marijuana does not treat the ailment; it only masks the symptoms,” Burgin said.

Sen. Julie Mayfield (D-Buncombe) requested to amend the bill for in-state growers and retailers to participate in the medical marijuana trade. “This is a bill that the public clearly wants, but it is not quite there yet,” said Mayfield who ultimately voted against it.

The bill outlines limited and rigorous requirements – for individuals, physicians and suppliers – which the Department of Health and Human Services would enforce. The physician would also have to note whether benefits of smoking or consuming marijuana outweigh the risks for the patient. 

According to the bill, requirements for patients would include having a “debilitating medical condition.” These include cancer, PTSD, epilepsy, HIV/AIDS, ALS, Crohn’s disease, sickle cell anemia and other health conditions.

Patients would need to have shown diagnosis for a condition and a written certification from their physician. Afterward, they apply to DHHS to receive a registry identification card for consuming medical marijuana.  The card would go to a designated caregiver of the qualified patient. The caregiver – who needs to be at least age 21 – would assist the patient with the medical use of marijuana. Patients can have two designated caregivers, and caregivers can serve two qualified patients.

Both the qualified patient and the designated caregiver would be required to carry their registry indentation card when possessing medical marijuana or marijuana-infused products.

Duke University medical professor David Casarett, a supporter of medical marijuana, said that the drug is not for everybody or every condition. “I think we go into this with the honest assessment that it’s not a wonder drug, it’s not a panacea, it’s not a cure-all and it has some risks,” Casarett told WUNC. “As long as we go into it with eyes wide open and an honest assessment of risks and potential benefits, I think it is the right time.”

The bill will now go to the House. However, it is uncertain whether that chamber will pass the measure or wait until the next legislative session. In that case, the bill’s chances of becoming law would be delayed until possibly next year. 

Currently, North Carolina allows the use of industrial hemp-based products that contain 0.3 percent THC – the chemical that makes someone high.

If the bill becomes law, citizens would be able to consume a higher amount of THC, like in regular marijuana.

As of May 27, 37 states and the District of Columbia have removed state-level criminal penalties for medical marijuana, including Virginia, Alabama and New York. 

James Burrell is a summer journalism fellow with NC Policy Watch, sponsored by the States Newsroom. He graduated from NC Central University, where he co-edited the student newspaper, the Campus Echo.

As NC marks National Gun Violence Awareness Day, gun reform faces an uncertain future in Congress.


On Friday, Governor Roy Cooper joined others in recognizing June 3rd as National Gun Violence Awareness Day, an effort to raise awareness and remember the lives lost to gun violence.

North Carolina has the 17th highest rate of gun deaths in the nation. In 2020 there were 1,699 firearm related deaths in our state, according to North Carolinians Against Gun Violence.

“We cannot forget these tragedies when they fade from the news,” said Governor Cooper in a release. “It’s past time for common sense reforms that must take place at the congressional and legislative levels – stronger background checks, red flag laws, banning assault weapons and community violence interventions so that we can prevent these horrific events.”

But despite the recent mass shootings in Buffalo, Uvalde, and Tulsa, getting lawmakers to agree on an approach to reducing gun violence may be difficult.

During Thursday’s U.S. House Judiciary Committee meeting, North Carolina Republican Congressman Dan Bishop (NC-09) balked at raising the age of purchasing semiautomatic rifles from 18 to 21.  He also rejected efforts to ban high capacity magazines.

“What are you willing to do to stop the epidemic of gun violence in this country?” Rep. Mondaire Jones, a New York Democrat, asked Bishop.

“I wouldn’t let teachers prop doors open. I would make sure police are not discouraged from going in and saving children who are being assaulted, while the assault is going on,” Bishop said, referencing the Uvalde massacre that left 19 children and two teachers dead at the hands of an 18-year-old.

“I can translate that for you, he’s willing to do nothing,” responded Rep. Sheila Jackson Lee, a Texas Democrat.

Watch that heated exchange below:

The gun control package advanced along a party-line vote, 25-19, and is expected to be on the House floor next week. In an evenly divided Senate, it’s widely expected Republicans would block most gun control measures. That has some Democrats again calling for an end to the filibuster.

Back in Raleigh, Gov. Cooper’s budget proposal for FY 2022-23 provides $38.7 million to enhance community and school safety.

The spending plan also includes $2.5 million in recurring funds for violence education and prevention programs for at risk and juvenile justice-involved youth and $1 million for the purchase of gun locks.

Safe storage is one area where local officials are hoping to find common ground. Officials in Durham County pulled together this week to distribute more than 200 gun locks in their community.

The North Carolina Child Fatality Task Force is also encouraging legislators to fund a statewide firearm safe storage education and awareness initiative. The task force estimates that modest proposal would cost a minimum of $155,000 in nonrecurring funds for a two-year initiative.

This weekend (June 3 – 5) the North Carolina Executive Mansion will be lit orange in honor of Gun Violence Awareness Day. You can read the governor’s proclamation here.

New bill would provide schools with free feminine hygiene products, exempt them from state sales tax

A new bill would exempt sales tax on feminine hygiene products and make them free in public schools through a recurring grant program, Rep. Julie von Haefen, the primary bill sponsor said Tuesday.

At a press conference at the General Assembly, students and legislators explained how the measure could help families afford feminine hygiene products, which can be expensive.

“It is a monthly expense that many individuals and families simply can not afford,” said von Haefen (D-Wake) at the press conference. “Access to menstrual products is a factor that impacts students well being, attendance and performance. For this reason, we worked hard in a bipartisan effort to ensure that the budget had funding for The Feminine Hygiene Products Grant Program.”

The funds would be directed to public schools to purchase the products.

Feminine hygiene products will include tampons, panty liners, menstrual cups, sanitary napkins and other similar products. Grooming and hygiene products such as cleaning products, soaps, shampoos, toothpaste, etc. are not included in the bill.

Von Haefen also mentioned how the rise of inflation is a key factor in the affordability of feminine hygiene products. The products are considered luxury items, and subject to a 4.75% state sales tax, too.

“This tax has a disproportionate impact on low-income menstruators and can lead to having to choose one essential over another,” said one Cary high school student. “For low-income students, in particular, a lack of access in affordability of [menstrual] products can make a difference in their education.”

Rep. Julie von Haefen (D-Wake)

Currently, states such as Virginia, New York and California have already passed legislation requiring schools to provide free menstrual products for students. More than 20 states have also ended the sales tax on feminine hygiene products – some include Vermont and Maine.

Students and advocates also mentioned the safety measures the bill will give those who need the products – menstruates have had to resort to using toilet paper and rags to manage feminine hygiene – such measures can be unsanitary.

Some students have also had to go to their school’s front office to receive menstrual products or leave early altogether – hindering attendance and learning.

The Menstrual Equity for All bill will be the next step of what the assembly had previously passed for local schools and diaper banks to reduce menstrual poverty and increase equity for families who can not afford feminine hygiene products.

The End Menstrual Poverty Act, passed last year as part of the state budget, let public school units apply for grants of up to $5,000 to purchase feminine hygiene products. Grants were awarded on a first-come, first-served basis.

Money ran out in less than a week according to The Department of Public Instruction, which sent a report to the legislature. 

The $250,000 appropriation was claimed in less than a week, and fewer than half of the 134 applications were funded. The legislature made the money available only for the 2021-2022 fiscal year.

Funding for the grant program in the new bill will be appropriated from the General Fund to the Department of Public Instruction (DPI) with $500,000 in recurring funds going into the next fiscal year. 

Along with Rep. Haefen, the bill is sponsored by Rep. Allison Dahle (D-Wake), Sen. Natalie Murdock (D-Durham), and Sen. Natasha Marcus (D-Mecklenburg). Sen. Kathy Harrington (R-Gaston) helped appropriate the funding for the bill, with Sen. Julie Mayfield (D-Buncombe) assisting with last year’s funding.

James Burrell is a summer journalism fellow with NC Policy Watch, sponsored by the States Newsroom. He graduated from NC Central University, where he co-edited the student newspaper, the Campus Echo.