1.5 million North Carolinians without coverage. NC experiencing double the national rate in the percentage increase of people who are uninsured. Workers in NC losing their employer-sponsored health insurance at nearly double the national rate. These are just a few of the recent statistics on health coverage in NC. But talk to anyone you know and it’s likely they have a story about someone who can’t get, can’t afford, or is paying too much now for health insurance. This critical issue doesn’t seem to have registered with our legislature however.
On this last day of the General Assembly session, the old “deny the problem and hope it goes away” mentality was on full display. First there was the puzzling inaction of the Senate (at least as of this writing) on dealing with the problem with the State Employees’ Health Plan. Reports of unexpected huge deficits have been roiling the legislature this week, culminating in the House’s action yesterday to authorize $100 million from the state rainy day fund to pay for any potential shortfall.
Unfortunately, there is not a single written document or a single straight answer available from anyone as to why the state health plan is in so much trouble, what the exact amount of any potential shortfall will be (even a consistent estimate within $50 million would be nice), or why the extensive oversight process governing the health plan failed to pick up this problem. Perhaps the problem isn’t as big as it appears. That’s certainly what the NC Senate seems to be saying. Without action, it will likely take a special General Assembly session called by the Governor to find additional money for the plan or to raise copays, premiums, and deductibles – something that Senators have repeatedly put on the table as an option to close the financial gap. It’s not clear to me though why state employees should be required to pay for management failures and lack of legislative oversight of the state health plan.
The other bit of inaction regarded the idea to establish a health care policy council to bring together all interests to come up with NC-friendly solutions to extend affordable health coverage to all North Carolinians. [Read my essay on “The Demise of the Health Care Policy Council.] This got watered down to a few lines in the general study bill that basically ask the NC Institute of Medicine – a neutral policy research institution – to come up with a few recommendations to expand coverage to some. The Institute, while an important NC health organization, simply isn’t suited to the politically fraught task of negotiating the turbulent waters of real health reform.
And, yes folks, that was it. The sum total of legislative efforts this year to address the health crisis in North Carolina. Where were the proposals to guarantee health care to all NC children? What about a subsidized health plan for small businesses that provided quality health plans such businesses could actually afford? How about help for parents of children we already cover? Not on the agenda. Will they ever be?
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