Environment, Legislature, public health

DEQ, DHHS reveal their $2.5 million emergency budget request to address GenX, contaminants in drinking water

 

DHHS Secretary Mandy Cohen (Photo: DHHS)

Two top state officials have asked lawmakers to appropriate $2.5 million in emergency funds to help their respective agencies address unregulated, emerging contaminants, such as GenX, in drinking water.

Secretaries Mandy Cohen of the Department of Health and Human Services and Michael Regan of the Department of Environmental Quality sent a letter to Rep. Ted Davis Jr. outlining the request. Davis is a Republican representing New Hanover County.

Davis could not be reached immediately for comment.

GenX has been found in drinking water in New Hanover, Brunswick and Pender counties, a result of discharge of the compound from the Chemours plant in Fayetteville into the Lower Cape Fear River.

Chemicals from the same family, known as PFOS, have also been detected in Greensboro’s water system, according to a nationwide database compiled by the Environmental Working Group.

DHHS is asking for $530,839 to develop a Water Health and Safety unit within the Division of Public Health. This would include four positions, plus other resources for educating the public and analyzing health data.

These are the requested positions, according to the agency:

Medical risk assessor, a physician who has experience with poisoning and environmental toxicity;

PhD Toxicologist, to research and review available studies and develop strategies to lessen harmful health effects;

Informatics/ epidemiologist, to organize data and perform high-level analysis to determine the causes of harm to human health;

Health educator, to establish adequate public notifications and provide educational materials and briefings to the public.

DEQ Secretary Michael Regan (Photo: DEQ)

DEQ, which has been decimated by budget cuts and the elimination of 70 jobs since 2013, has requested $2,049,569, detailed here:

  • Funding for long-term water sampling for GenX at a cost of $14,000 per week for a full year. Currently the cost is being funded by Chemours, which is responsible for the contamination, as well as the Environmental Protection Agency and private labs, but only temporarily.
  • An additional 16 positions within the Division of Water Resources: Four engineers, three environmental specialists, two environmental senior specialists, two hydrogeologists, two program consultants, a business technology Analyst and two Chemist III positions.
    “These water quality scientists and experts would work with local governments to identify where contaminants occur and where they came from,” the letter says.

Money would also be used to move the permits from paper copies to an electronic database. This would integrate wastewater, drinking water and groundwater information and allow for easy searches.

The most recent DEQ budget cut 16 positions agency-wide; it also directed Secretary Regan to find $1.9 million in savings within the department. If lawmakers approve the funding when they reconvene in September, this appropriation, although not restoring positions outside of Water Resources, would still allow DEQ to tackle its backlog of wastewater discharge permits.

The review time for these permits can take as long as two years, the letter states. “Adding experts would give us more thorough and timely review … and would strengthen the Division of Water Resources so it can address unregulated compounds in the water discharge permitting program and allow more frequent sampling and faster evaluation.”

“The EPA is not up to speed,” Harrison said. “We don’t know what these chemicals do. We don’t have a handle on it. And we shouldn’t continue to expose our citizens to these chemicals.”

The proposed legislation would also direct the Environmental Review Commission, composed of a dozen lawmakers, to study whether there should be an exemption to the so-called “Hardison amendment.”  This amendment prevents the state from enacting stricter standards than the federal government.

Pricey Harrison,  a Guilford County Democrat, has long opposed the Hardison measure. “EPA regulations should be a floor, not the ceiling,” she said. “Every state and local area is different; we need local control.”

Conservative lawmakers have often hamstrung DEQ’s efforts to employ stricter standards than the EPA’s. Most recently, during the one-day legislative session last week, lawmakers introduced a new version of House Bill 162, which seemed to quash any hopes of DEQ to enact permanent rules regarding GenX.

“We need to rethink these restrictions,” Harrison said. “DEQ has been handcuffed by the legislature.”

Even in the case of “serious and unforeseen threats,” the bill reads, DEQ could not make permanent rules stricter than the federal government’s. Currently, there are no federal standards for GenX and other “emerging contaminants,” such as Chromium 6, a byproduct of coal ash and also a naturally occurring compound, and 1.4-dioxane, found in the Haw River.

The bill, under protest from Harrison, did not advance to a floor vote. Instead, Speaker Tim Moore sent the measure back to the House rules committee. It could be voted on in September.

 

 

NC Budget and Tax Center, public health

NC’s and the nation’s uninsured rate has fallen to a historic low under ACA, but you’d never know that listening to Senate leaders

Here’s some important and quick facts that all Americans and North Carolinians should know this week, when the Senate will formally vote in an attempt to repeal the Affordable Care Act:

The United States has made significant progress over the past seven years when it comes to reducing the number of people that are uninsured, according to data from the Centers for Disease Control and Prevention (CDC). In 2016, only 9 percent of America’s population was uninsured, compared to 18.2 percent in 2010. That’s the lowest share since the CDC began tracking this statistic 45 years ago! If you prefer numbers: 28 million people were uninsured last year, compared to over 48 million in 2010. In NC, only 11.4 percent of all North Carolinians were uninsured last year, compared to 21.3 percent in 2010. Take a moment to think about that.

“There has never been a decline this large and over such a short period of time.” –Rachel Garfield, associate director for the Kaiser Family Foundation’s Program on Medicaid and the Uninsured.

The last time the percentage of uninsured in our country was close to the historic low of 9 percent we saw in 2016 was 39 years ago, in 1978. Here are a few things that happened back in 1978 (when the percentage of persons under 65 without health insurance was 12 percent):

    • President Jimmy Carter signed H.R. 1337 into law, which allowed home-brewing of beer in the United States (sparking the craft beer revolution).
    • U.S. Senate proceedings were broadcasted on radio for the first time.
    • Grease, starring John Travolta and Olivia Newton-John, was released.
    • Woody Allen’s Annie Hall won Best Picture.
    • The rainbow flag of the LGBT movement flew for the first time at the San Francisco Gay Freedom Day Parade.
    • Pope John Paul II became the 264th pope.
    • Mavis Hutchinson, a 53-year-old grandmother, became the first woman to run across the U.S.
    • The Dallas Cowboys defeated the Denver Broncos in Super Bowl XII.
    • Pete Rose, the all-time MLB leader in hits, gets his 3,000th major league hit.

Below you can see the official U.S long-term trends in health insurance coverage since 1968:

CDC_US Healthinsurance1968-2015 by LT on Scribd

Luis A. Toledo is a Public Policy Analyst for the Budget & Tax Center, a project of the North Carolina Justice Center.

public health, Trump Administration

The silent killer of the Affordable Care Act

Screen grab from one of the HHS videos used as part of a multi-pronged social media campaign against the ACA.

A new report from the Daily Beast found that the Trump Administration is quietly using taxpayer money to undermine the Affordable Care Act, which remains law despite the Senate’s best efforts.  Tom Price, the Secretary of Health and Human Services, released a series of 23 testimonials videos featuring individuals describing how they have been burdened by the Affordable Care Act (ACA). The videos appeared on YouTube last month and have only accumulated a few hundred views each.

While this may seem like a small spiteful action, the money to produce these videos came from the “consumer information and outreach budget” which is intended to be used for informing the public about the ACA and encouraging enrollment.

In addition to the videos, HHS has pushed a multi-pronged social media campaign against the ACA. Not to mention, one of Trump’s first actions as President was to effectively kill ACA commercials with just 5 days left in Open Enrollment. This resulted in 424,000 less people enrolling in health insurance when compared to enrollments during the same time in the previous year.

This all seems relatively inexpensive, but the Trump Administration requested  $574 million for this specific budget item, though HHS declined to detail how much it has devoted to specific line items.

The true silent killer of the ACA has been reconstruction of the HHS.gov website. The website refuses to refer to the Affordable Care Act by name, replacing it with “the current law.” All info-graphs outlining the benefits of the ACA and key information, such as links to HealthCare.gov and critical enrollment dates, have been removed altogether. The website encourages consumers to use “private sector alternatives” instead of the Health Insurance Marketplaces established under the law.

HHS has also altered the HealthCare.gov website, removing the “Cost and Savings” tab where consumers can find information about where to find prices, if they have to pay penalties, or if they qualify for savings.

Needless to say, the Trump Administration is disregarding its responsibility to administer the Affordable Care Act and is putting significant resources into sabotaging the law through all means necessary. By quietly publishing anti-Affordable Care Act propaganda and removing vital information about the law from government websites, the Trump Administration continues to strip citizens of their rights under the ACA.

Andy Slavitt, former director of the Center for Medicare and Medicaid Services, puts it this way: “you’re not hired into the administration to decide whether you agree with the law you’re asked to execute. That’s not your job… Congress appropriates funds for you to carry out laws that they passed, not to spend those funds on activities that counteract those laws.”

Sydney Idzikowski is an MSW inter at the NC Justice Center

 

NC Budget and Tax Center, public health, Trump Administration

Warning: Last-ditch GOP effort offering $200 billion to buy votes won’t fix unfixable Senate health bill

Earlier this week we reported that the Senate GOP health “repeal without replacement” proposal would do great harm to NC, as it would double the number of uninsured in North Carolina.

Unfortunately, the latest is that in a last-ditch effort to save their bill to repeal the Affordable Care Act (ACA), Senate Republican leaders are reportedly offering $200 billion to win the votes of senators from states that expanded Medicaid under the ACA.

Here’s a brief explanation from the Center on Budget and Policy Priorities:

“This new fund would presumably supplement private coverage for those who gained Medicaid coverage under the expansion but would lose it under the Senate bill.  No senator should fall for it. While $200 billion seems like a lot of money, it’s only 17 percent of the bill’s $1.2 trillion in cuts: $756 billion from Medicaid and $427 billion from subsidies to help low- and moderate-income people buy coverage in the individual market.”

Overall, it is clear that this additional money would do nothing to fix the major and fundamental problems that the bill would create:

  • It would do nothing to offset the Medicaid cuts resulting from the per capita cap, which would affect children, seniors, and people with disabilities in all states.  These cuts would shift ever-increasing costs to states, forcing the states to respond by making ever-deepening cuts in eligibility, benefits, and provider payments.
  • It would do nothing to address the bill’s harm to people with private coverage, including the loss of coverage for millions of people (due largely to sharp cuts in marketplace subsidies), increased costs for those who stay covered, and the loss of access to health care for millions with pre-existing conditions.
  • It would do nothing to address the fact that millions of lower-income marketplace consumers in non-expansion states (like North Carolina) would see their deductibles jump many thousands of dollars under the Senate bill.

No one should be fooled:  The reported $200 billion cannot fix this bill, and does not come close to undoing coverage cuts.

Here’s what would really help, as we stated earlier this week:

“Based on the facts, it is clear that NC’s two U.S. senators should support the idea of starting from scratch with a different, bipartisan approach that leaves Medicaid aside and focus on making real improvements to marketplace stability and affordability.”

Luis A. Toledo is a Public Policy Analyst for the Budget & Tax Center, a project of the North Carolina Justice Center.

NC Budget and Tax Center, public health

Senate GOP health “repeal without replacement” proposal would do great harm to NC

By now many have heard that the proposed Senate GOP “repeal and replace” health care bill is dead after some Senate Republicans could not support it. However, the bad news is that Senate Majority Leader Mitch McConnell says they will now pursue a vote to repeal without replacement. McConnell announced last night that the vote— which is expected to fail — will occur next week, at President Trump’s request.

What does this mean for North Carolina? If the Senate proceeds to repeal the ACA without a replacement, the number of uninsured North Carolinians would rise (and double) from 1.1 million to 2.1 million in 2019 alone. Furthermore, Federal government investments on North Carolina’s health care would be reduced by $1.6 billion in 2019, and by $59 billion from 2019 to 2028, because the Medicaid expansion, premium tax credits, and cost -sharing assistance would be eliminated.

This type of negative impact on the state’s most vulnerable and on the state’s budget is dangerous considering we recently reported that North Carolina is not on track to achieve its 2020 health objectives, and that the legislature’s Fiscal Research Division has projected state budget shortfalls of $1.2 billion to $1.4 billion in fiscal years 2019-20 to 2021-22.

Based on the facts, it is clear that NC’s two U.S. senators should support the idea of starting from scratch with a different, bipartisan approach that leaves Medicaid aside and focus on making real improvements to marketplace stability and affordability. We now know that it would not be in North Carolina’s best interest to see the GOP health bill, or elements of it, arise down the line and in other forms.

What would “Repeal without Replace” do?

Sen. McConnell now says that he plans to bring to a vote a version of the 2015 Affordable Care Act (ACA) repeal reconciliation bill that President Obama vetoed. Assuming a similar timeline to the 2015 version, that bill would:

  • Completely end expansion as of Jan. 1, 2020. There would be no phase-out and no statutory option for states to keep their expansions, even if they could afford to do so at regular match.
  • Completely eliminate the ACA’s tax credits and cost sharing subsidies – with no replacement – as of Jan. 1, 2020.
  • Immediately repeal the ACA’s high-income and corporate taxes, cutting taxes for households with incomes over $1 million by over $50,000 per year.
  • Immediately repeal the ACA’s individual and employer mandates.

What would the consequences of “Repeal without Replace” be?

The Congressional Budget Office (CBO) analyzed the consequences of this approach in January 2017, and found: Repealing much of the Affordable Care Act (ACA) would cause 32 million people to lose coverage by 2026 and roughly double premiums in the individual insurance market. Specifically, the report showed:

  • Coverage: 18 million people would lose coverage in 2018, 27 million would lose coverage by the early 2020s, and 32 million would lose coverage by 2026.
  • Individual market premiums: Compared to current law, premiums would be 20-25 percent higher in the first year, 50 percent higher by the early 2020s, and would double by 2026.
  • Individual market stability: By the early 2020s, about half of U.S. population would live in areas with no individual market insurers, increasing to 75 percent by 2026. Essentially, the individual market would collapse in most of the country.

According to the Urban Institute:

“The vast majority of those becoming uninsured would be members of working families (82percent), and more than half (56 percent) would be non-Hispanic whites. The vast majority of adults becoming uninsured would lack college degrees (80 percent).”

Luis A. Toledo is a Public Policy Analyst for the Budget & Tax Center, a project of the North Carolina Justice Center.