Policy in the N.C. General Assembly likely spent a bit more time in the hospitals than you did over your summer vacation.
In a summer session largely dedicated to discussions about redefining the N.C. medical system to better provide for patients and avoid hefty costs of the Medicaid program, two N.C. House bills stand apart in their significance.
House Bill 465
House bill 465 stole summer headlines with its early potential for barring UNC-Chapel Hill and East Carolina University healthcare facilities from conducting abortions.
But Courtney Mitchell, a spokesperson for the UNC Women’s Options Clinic — which provides abortion care and services — said in an email this is no longer a feature included in the bill.
She asserts that the clinic will continue to function under all N.C. laws and regulations.
“The clinic will continue to offer superb care to women referred to the clinic, or seeking the clinic’s services,” she said.
The bill further enumerated that these maternal health care procedures or incited miscarriages can only be conducted under the authority and direct involvement of a willing and qualified physician, nurse or emergency care worker.
Mitchell said she believed this provision was no different than the status quo, and that religious exemptions from providing abortion care are explicitly permitted in North Carolina.
“When persons object to doing something they feel is against their conscience, they generally refer the patient,” she said.
Another significant alteration of the state’s medical care is that an emergency abortion will only be administered if the patient is believed to suffer from life-threatening or permanently damaging risks in the case of a 72-hour delay — as opposed to the previous 24-hour period.
Doctors must additionally inform the patient of a series of medical provisions, which include other viable alternatives to abortion and medical assistance benefits for maternal health care throughout the pregnancy process.
House Bill 372
Following a tense series of negotiations about the role and adequate provision of Medicaid in North Carolina, House bill 372 — titled “Medicaid Modernization” — marked the next step in compromises about the Medicaid system.
The bill establishes a more provider-led model, which will function under the supervision and direction of a new board — selected and approved by both the N.C. Senate and House.
Katherine Restrepo, a health policy analyst from the conservative-leaning John Locke Foundation, said she understands the desire for legislators to create a department to control the logistics of the Medicaid program but is unsure of its success.
“I don’t know if a separate department is going to create more unnecessary red tape, or if it’s going to help by making the program run more efficiently,” she said. “(In Oklahoma), it turned into a nightmare just the way people were appointed to the board to oversee (the program). It almost became its own sort of Medicaid Kingdom.”
Other provisions under the bill exclude the potential board workers from the N.C. Personnel Act, or N.C. Human Resources Act — which includes the provision of authority and oversight of personnel actions for state employees involving classification and compensation.
Restrepo said this might offer greater flexibility to the legislature to incentivize work on the Board.
Allowing greater interaction and state jurisdiction to private healthcare providers and managed care companies is another prominent feature of the bill.
States including Virginia, California, Alabama and Florida have transitioned to a more privatized, managed-care model.
“The ultimate compromise is really to have those managed care companies come in because they’ve been around for a while,” Restrepo said.
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