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Old North State Report

March 15, 2023

Old North State Report – March 15, 2023


On Tuesday, a Senate committee approved the specifics of the agreement on North Carolina's Medicaid expansion that top Republicans reached last week. House Bill 76 outlines how the state would provide coverage for up to 600,000 low-income adults who would otherwise earn too much to be eligible for traditional Medicaid. It instructs the state to enroll in a federal program through which hospitals would get more Medicaid reimbursement money. Hospitals will be able to use this funding to help with the state's 10 percent portion of expansion healthcare costs. The bill also specifies which "certificate of need" laws, which call for health regulators to approve plans before medical entities can construct facilities or buy equipment, would be relaxed or repealed entirely. 

After passing out of the Senate Rules Committee on Thursday, Senator Ralph Hise (R-Mitchell) predicted the bill would be heard on the Senate floor early next week. After that, the House would need to formally approve it before it goes to Governor Roy Cooper for signature.

The bill's language specifies that even if Cooper signs it quickly, the section that expands Medicaid coverage will not go into effect until a separate state budget bill is passed. That most likely will not occur until the beginning of the summer. Last week, Speaker Tim Moore and Senate Leader Phil Berger stated that it makes sense to match budgetary provisions with expansion, which will result in additional spending of billions of dollars. Also, Cooper would be deterred from vetoing the budget bill out of concern for hindering expansion.

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On Wednesday, legislative leaders revealed they had reached an agreement on the amount to be allocated for spending over the next two years. The initial step in the budget process, the agreement between the House and Senate, has been completed earlier than expected this year. In the fiscal year that starts in July, lawmakers said they will increase spending by 6.5% to a total of $29.7 billion, and by 3.75% the following year. According to revenue estimates, the state will have a surplus of about $3 billion this year, but revenue growth will be fairly flat over the following two years. According to Speaker Tim Moore, the first draft of the budget should be made public by the end of the month. A spending plan will be put to a vote in the House, after which the Senate will craft its own version and Governor Roy Cooper will receive the final compromise. In the coming weeks, Cooper will probably also present lawmakers with his own budget proposal.

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A bill that would stop patients from receiving a surprise bill for a medical service that is not covered by their insurance was unanimously approved by the state Senate. Even so, it is still unclear how the bill will fare in the House. A similar bill was unanimously approved by the Senate last year, but the House rejected it amid concerns that a federal law might obviate the need for a state law. According to Senate Bill 46, patients must be informed in advance if they will be charged for a service that is not covered by their insurance by hospitals and other healthcare facilities. The written notice would need to be submitted "as soon as reasonably possible" in case of an emergency or at least 72 hours before a scheduled procedure. The Senate passed the bill on a 48-0 vote. The House referred the legislation to its Rules Committee, where the previous year's version of the legislation sat without being put to a vote.

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On Thursday, the North Carolina Senate approved House Bill 40 that would toughen penalties for violent protests in response to 2020 demonstrations over racial injustice that turned violent at times. A potential veto showdown with Democratic Governor Roy Cooper, who successfully vetoed a similar measure two years ago, is now possible following approval by a vote of 27-16, which was largely along party lines. However, Republican seat gains in the midterm elections and some bipartisan support for the legislation in the House increase the likelihood of an override. Six Democrats joined all House Republicans last month in supporting the bill, which is being guided by Speaker Tim Moore, as was the 2021 version of the bill. 

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The majority in the North Carolina House decided on Wednesday to call a meeting to discuss amending the U.S. Constitution, stating that the time has come to take into account changes to the federal government's powers and finances as well as term limits. The House approved two resolutions that would have included North Carolina in the group of states pursuing a national "convention of states" as allowed by the Constitution. Supporters of the convention in the state House argue that constitutional amendments are necessary to curb excessive spending and debt, prevent governmental overreach, and curtail the authority of legislators. By a vote of 69-48, the House approved House Joint Resolution 151 which was solely concerned with term limits. Term limits and fiscal restraints in Washington, D.C. were addressed in House Joint Resolution 235 and approved 61-55. The two resolutions will now go before the state Senate, where it will also require votes in favor to pass them. The Governor cannot veto a resolution.

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On Tuesday, lawmakers and families affected by the opioid and fentanyl crises advocated for tougher penalties for fentanyl and opioid drug offenses. Senators Danny Britt (R-Robeson) and Michael Lazzara (R-Onslow) introduced Senate Bill 189, which calls for stricter penalties for dealers, an expansion of the Good Samaritan Law to encourage people to call 911, and the formation of a task force to assist law enforcement in cracking down on the importation, distribution, and manufacturing of fentanyl, heroin, and other similar controlled substances. "We're going to put whatever we can in the budget to ensure that all the tools are there so that law enforcement can do what they need to do, so this task force that's created in this bill can do what it needs to do to target those people and let them know. If you're out there pushing fentanyl in our communities, we're coming after you, and we're going to come after you together," said Senator Danny Britt. The Senate approved the bill on its first reading. If passed into law, it would become effective on December 1, 2023.

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