MVA Monitor – August 9

The state budget impasse enters its seventh week today, with no visible progress. Some reports claim communication is almost non-existent between the two sides.

While the budget remains in gridlock with Medicaid expansion one of the big issues, progress was made on several other fronts with respect to health care this week.

Issue Insights

State and Legislative Issues

State Budget

House Speaker Tim Moore intends to keep trying for an override of the Governor’s veto, maintaining that House Republicans can garner enough Democratic support to gain the necessary three-fifths majority of those voting to override. On Wednesday, House Democrats responded with an open letter to Speaker Moore and Sen. Phil Berger, the leader of the Senate. The letter was signed by 51 of the 55 House Democrats and expresses the commitment of those members to vote against an override motion. The other four House Democrats have not yet taken a public position on the override – two of the four originally voted for the bill, one against it, and the other was absent.

This leaves House Republicans with few options to obtain the necessary support to override the veto. If all 120 House members voted and that all Republicans and the four uncommitted Democrats voted to override, the motion would still be three votes short of obtaining the necessary support.  Another option to override would be waiting until a enough opponents were absent to take the vote. If all Republicans and the four uncommitted Democrats voted to override, at least five of the committed House Democrats would need to be absent for the motion to pass. It’s unclear how this public declaration of opposition might change the negotiating tactics going forward.

As impasse continues, speaker won’t stop override effort (WSOCTV)

State Health Plan

It appears as if resolution may have been reached in the long-running dispute between the State Health Plan, administered by State Treasurer Dale Folwell, and most of the state’s hospital systems. The State Health Plan covers more than 700,000 state employees, retirees, and dependents. State Treasurer Folwell has pushed for a program that would reduce costs by setting reimbursement rates based on Medicare rates. Hospitals have argued that the plan would result in unsustainable losses. Previously, only five hospitals in the state had signed on to the Treasurer’s plan.

On Monday, UNC Health System again rejected the plan. The impasse would have significant impact on State Health Plan members – as most hospitals in the state would be treated as out-of-network.  On Thursday, Treasurer Folwell announced that his revised State Health Plan would include Blue Options Network through Blue Cross and Blue Shield of N.C. The addition of this option would bring all the state’s major hospital systems into the State Health Plan.

NC revises new health care plan for state workers after pressure from hospitals (Raleigh News & Observer)

Association Health Plans

On Wednesday, the House advanced legislation that would allow statewide trade groups to band together to set up health insurance plans without all the federal mandates that come with the Affordable Care Act. Proponents have argued that the proposal helps provide a lower-cost option for small business to provide health insurance. Opponents have pointed out that the plans are not required to provide all the coverage required for plans under the Affordable Care Act. For example, the plans would not be required to provide maternity care. In addition, opponents have argued that the plans could destabilize the health insurance market if relatively healthy people opt for the plans (which may be cheaper because they cover less) and leave the ACA plans with an insured population with greater needs (raising costs for those plans).

The bill must still pass the Senate and obtain the approval of the Governor. Even if the proposal does become law, it’s unclear when it could go into effect. A plan may not be allowed due to a federal case that is on appeal – a process that could take years to play out.

‘Association health plans’ bill easily clears House (WRAL)

Elections

On Thursday, House leadership rolled out a bill making numerous changes to state election laws. Among other things, the bill would allow counties to adjust early voting hours, allow continued use of touchscreen voting machines through the 2020 elections, and provide for a pilot program that would cover postage for individuals returning absentee ballots. The bill has not yet cleared the House and must still get approval from the Senate and Governor.

Proposal offers new absentee ballot security, tweaks early voting hours (WRAL)

Local Issues – Charlotte

Liquor Sales

The Mecklenburg Board of County Commissioners voted 7-2 this week to pass a symbolic resolution opposing state legislation that would do away with the state operated ABC stores and would privatize liquor sales. The bipartisan bill would reform liquor sales in the state and regulate spirit sales more like beer and wine. Commissioners cited several reasons for opposition, including losing tens of millions of tax dollars collected by the ABC Commission.

North Carolina could close its ABC stores and privatize liquor sales, but Mecklenburg County isn’t on board (Charlotte Agenda)

Local Issues – Raleigh

Moore Square Reopens

Last Saturday, Raleigh reopened the historic Moore Square in downtown Raleigh. The square dates to 1792 and was part of the original design of the capital city. Over the centuries, it has been a gathering place for Baptists, temporary campground for Union soldiers, and a venue for free concerts by the Violent Femmes and Joan Jett. The square was the recipient of a $13 million face lift funded by a bond approved by Raleigh voters. The four-acre square, a few blocks southeast of the Capitol, has been closed since 2017 for the renovation.

Moore Square, Raleigh’s ‘four-acre playground,’ reopens (Raleigh News & Observer)

News Roundup