NC Budget and Tax Center, public health

On Mother’s Day: Remember Medicaid works for women – but proposed cuts would have a harsh, disproportionate impact

This weekend we celebrate Mother’s Day. Next week we celebrate National Women’s Health Week. The fact is women play an important role in society every day and one thing we can always do for them is support them in having adequate health care. Currently, more than 40 million women and girls are enrolled in Medicaid. However, proposals in Congress to cap and cut Medicaid would have devastating consequences for the nearly 1.1 million women in North Carolina who rely on the program.

This is worrisome considering that Medicaid allows women to obtain the health care they need throughout their lives. According to a recent report, “women have unique health care needs — and nearly half of all women have an ongoing condition requiring regular monitoring, care, or medication.”

By the numbers: North Carolina Women and Medicaid

1.1 million: number of women in NC enrolled in Medicaid

54%: share of women in NC enrolled in Medicaid

898,200: number of women and girls in NC that live below the poverty line

17%: share of women and girls in NC that live below the poverty line (worse than U.S average of 16%)

54%: share of births in NC financed by Medicaid

The race and ethnicity of NC women in Medicaid

White: 44%

African-American: 35%

Hispanic: 14%

Asian/Pacific Islander: 1%

Other: 5%

Overall, women would bear an outsized share of harmful Medicaid cuts because they not only make up a majority (54 percent) of North Carolina’s Medicaid beneficiaries, but are also the primary users of maternity benefits and specific health care services for women. They are much more likely to use Medicaid’s long-term services.

North Carolina hurts when women and girls cannot access the health care that they need to lead healthy, full lives.

Current health bill proposals have disproportionate impact on women

The House-passed health bill also includes several provisions that are especially harmful to women with private insurance.

For example, it would allow states to opt out of the ACA’s Essential Health Benefits (EHB) standard, effectively allowing insurers to charge women more than men by leaving many women without affordable access — or any access — to maternity coverage.

Additionally, it also would give states the option of allowing insurers to charge far higher premiums to people who are pregnant, have had a c-section, or were treated for injuries resulting from domestic violence.

Learn more: To get a better understanding of Medicaid and its impact in North Carolina you can view various graphs in our NC Medicaid Chartbook or read our series, Medicaid Matters: Protect and Expand NC Health Care.

Commentary, Environment, public health, Trump Administration

Two paragraphs that sum up Trump’s attitude toward protecting the environment

The first two paragraphs of a New York Times story today sum up perfectly the approach the Trump Administration is taking towards protecting—or rather not protecting—the environment.

The Environmental Protection Agency has dismissed at least five members of a major scientific review board, the latest signal of what critics call a campaign by the Trump administration to shrink the agency’s regulatory reach by reducing the role of academic research.

A spokesman for the E.P.A. administrator, Scott Pruitt, said he would consider replacing the academic scientists with representatives from industries whose pollution the agency is supposed to regulate, as part of the wide net it plans to cast.

No reason to have actual scientists on a scientific review board. Let the polluters make the rules to protect us from pollution. That’s certain to work well.

News, public health

How NC’s Congressional delegation voted on repealing the Affordable Care Act

Members of the U.S. House narrowly (217-213) pushed through the Republican plan for repealing and replacing the Affordable Care Act on Thursday.

While critics of Obamacare praised the bill’s quick passage, the latest version came without any analysis by the nonpartisan Congressional Budget Office.

The North Carolina delegation split along party lines, with the exception of Republican Rep. Walter Jones. The Pitt County congressman voted against the bill noting that it would result in dramatically higher premiums for low-to-middle income seniors and discriminate against veterans.

Here’s how the full delegation voted:

Rep. G.K. Butterfield – 1st District – 202-225-3101
Rep. Walter Jones – 3rd District – 202-225-3415
Rep. David Price – 4th District – 202-225-1784
Rep. Alma Adams – 12th district – 202-225-1510

Rep. George Holding – 2nd District – 202-225-3032
Rep. Virginia Foxx – 5th District – 202-225-2071
Rep. Mark Walker – 6th District – 202-225-3065
Rep. David Rouzer – 7th District- 202-225-2731
Rep. Richard Hudson – 8th District – 202-225-3715
Rep. Robert Pittenger – 9th District – 202-225-1976
Rep. Patrick McHenry – 10th District – 202-225-2576
Rep. Mark Meadows – 11th District -202-225-6401
Rep. Ted Budd – 13th District – 202-225-4531

What select members of the delegation are saying about Thursday’s vote and the American Health Care Act of 2017 (AHCA):

Rep. Mark Meadows, (NC-11):

“This process has never been about getting a win for Republicans or a win for the Freedom Caucus—it’s been about getting a win for the countless Americans who are being crushed by the broken system of Obamacare. Today is a victory for them.

From the earliest stages of the discussion, I’ve stated that my goals were to 1) bring down premiums for Americans, and 2) protect those with pre-existing conditions. After weeks of negotiations, conversations, and substantive changes to the bill, I believe we reached the point where both of these criteria will be sufficiently met. I believe the revised AHCA will substantially reduce healthcare premiums and provide a strong net of protection for the most vulnerable Americans.”

Rep. Virginia Foxx (NC-5):

“For seven long years, families and small businesses have suffered the devastating consequences of Obamacare. Costs are skyrocketing, choices are diminishing, small businesses are struggling, and jobs are being destroyed. That’s what the American people have been forced to live with, and that’s why Republicans promised to provide a better way. We are on a rescue mission, and this vote is an important step in repealing a failed law and delivering free-market, patient-centered solutions.”

Rep. Walter B. Jones (NC-3):

“…the rushed, behind-closed-doors process they’ve used is shameful. Over the past several weeks, they cut deal after deal to secure members’ support, and then pushed the bill to the floor without a CBO score. As a result, no one has any idea how much those deals will cost the American taxpayers, or how they might affect the cost, quality and availability of health insurance coverage for American families. Seven years ago, Speaker Nancy Pelosi infamously said of the Obamacare bill: ‘You have to pass the bill so we can find out what’s in it.’ Sadly, the Washington Republican leadership is repeating the same mistakes.”

“Furthermore, there are many aspects of the bill that deeply trouble me because of their potential effects on Eastern North Carolina and rural America. For example, the bill discriminates against as many as 7 million American veterans by making them ineligible to receive tax credits provided in the bill. It would also result in low-to-middle income seniors paying dramatically higher premiums.”

Rep. G.K. Butterfield (NC-01):
“I am deeply disappointed that Republicans have once again decided to abandon the interests of the American people.  Today’s vote in favor of the latest version of Trumpcare, which repeals the Affordable Care Act (ACA), is shameful.

“No matter how Republicans try to spin it, this updated bill still rips health care away from 24 million people.  It still cuts Medicaid by more than $800 billion over the next decade.  It still hands a $1 trillion tax giveaway to corporations.  It still jeopardizes coverage for nearly 300,000 residents of the First Congressional District who have pre-existing conditions.”

Rep. David Price (NC-04):

“…this legislation will take affordable health care away from more than 24 million Americans, allow insurers to discriminate against those with pre-existing conditions, cause premiums and out-of-pocket costs to skyrocket, and threaten women’s health and special education.

 “Incredibly, House Republicans – the self-described champions of fiscal restraint and open government – are forcing a vote on legislation introduced late last night that has not been scored by the CBO and which many members admit they haven’t had a chance to read. The only thing we know for certain is that it would cut the numbers of people covered, and the quality of their coverage, more than the Republican bill that collapsed in the House last month.”

public health, Trump Administration

Trump budget weakens NC’s ability to respond to public health, workforce needs

President Trump and the GOP want to dismantle the Affordable Care Act and restructure Medicaid, and “American First: A Budget Blueprint to Make America Great Again” provides further evidence that they do not want to invest in a healthy and thriving North Carolina. While many North Carolinians may not feel the impact of the provisions outlined in the budget immediately, there are significant threats to public health, our state’s ability to address their health, and capacity to strengthen our healthcare workforce.

In addition to an 18 percent cut to the U.S. Department of Health and Human Services (HHS), the Trump budget outlines a $5.8 billion cut to the National Institutes of Health (NIH), a 31 percent cut to the Environmental Protection Agency (EPA), and the only mention of the Centers for Disease Control and Prevention (CDC) is in reference to a $500 million block grant to states. These cuts are threats to North Carolina’s public health because the NIH funds research that could help identify innovative cancer treatment, the EPA helps to ensure that rural communities have access to safe drinking water (Note: 80 of North Carolina’s 100 counties are rural), and cuts to the CDC could impact vaccine development for the next epidemic. Read more

Environment, News, public health

Six things to have on your radar this week ahead of Easter

Making it official – Dr. James C. “Jimmie” Williamson, who began his role as the eighth president of the NC Community College system in July, is officially being installed today on the campus of Richmond Community College.

Dr. Williamson has a background steeped in education, business, economic development, workforce development and community service. Most recently, he served two years as the System President and CEO of the South Carolina Technical College system.

Two notable bill’s on the House Calendar – Members of the House reconvene at 4:00 p.m. with two notable bills to watch. Representatives are expected to give final approval to the Agriculture and Forestry Nuisance Remedies bill (HB 467) and the School Calendar Flexibility bill (HB375).

Learn more from Policy Watch’s Lisa Sorg about the troubling rush job on HB467.

Education reporter Billy Ball has a rundown on HB375 and another school calendar bill (HB389) that would impact the school start dates of 20 rural counties.

“Brunch Bill” back before lawmakers –  Tuesday at 9:00 a.m. members of the House Alcoholic Beverage Control committee will consider a bill that would allow liquor sales at restaurants beginning at 10:00 a.m. on Sundays instead of noon.

Members will also consider ABC Omnibus Legislation that would allow North Carolina breweries to self-distribute up to 200,000 barrels per year and would make it easier for small breweries to terminate distribution agreements.

The House Alcoholic Beverage Control meets is Room 1425 of the Legislative Building at 9:00 a.m.

Medicaid expansion – Proponents of Medicaid expansion have repeated this talking point for quite some time: There are currently more than 500,000 uninsured in North Carolina, more than 300,000 of these individuals and families have no affordable options for health insurance.

On Tuesday House Bill 662, entitled “Carolina Cares,” will be introduced creating a healthcare program that addresses the needs of North Carolinians who are ineligible for Medicaid due to income levels but are otherwise unable to afford health insurance.

Primary Bill Sponsor Rep. Donny Lambeth holds an 11:00 a.m. press conference in the legislative press room to discuss the ins and outs of the bill. For now, here’s how the News & Observer’s Lynn Bonner explains the legislation:

Under the bill, adults whose incomes are at or below 133 percent of the federal poverty level – less than $16,000 for a single person – would qualify. They would have to pay annual premiums equal to 2 percent of their household income, with some hardship exemptions. In most cases, adults would have to be working or “engaged in activities that promote employment” to be eligible for the coverage.

Legislation caregivers will want to watch – The House Aging Committee will vote on the Caregiver Relief Act – House Bill 543. This bill would provide support in the workplace under state law for caregivers who provide direct care to certain family members in need of care in instances where such leave would not be afforded to the caregivers under federal law.

The bill would require that employers that comply with the federal Family Medical Leave Act of 1993 with respect to a spouse, son, daughter, or parent of the eligible employee’s sibling, grandparent, grandchild, stepchild, stepparent or parent-in-law.

Why does this matter? Well, bill sponsors note there are 1.7 million family caregivers in North Carolina providing care to an adult with limitations in daily activities at some time during the year.

The Aging Committee meets at 11:00 a.m. in Room 423 LOB.

Funding a solution to NC’s food desert– Finally, Tuesday at noon the House Ag. Committee will discuss the Corner Store Initiative. House Bill 387 would establish a source of funding and assistance for small food retailers in both urban and rural areas to increase the availability and sales of fresh fruits, vegetables, and other nutrient dense foods at affordable prices to local residents.

The  goal is to improve the diet and health of residents in food desert zones. The Agriculture committee meets in Room 643 of the Legislative Office Building.