Talks about Medicaid expansion in North Carolina continue between members of both the House and Senate, with no imminent solution. N.C. Senate Leader Phil Berger, R-Rockingham, addressed that issue, along with abortion laws, the latest on court cases like voter ID, and Attorney General Josh Stein’s legal troubles at a press conference Tuesday.
“I do not see the Senate passing Medicaid expansion unless there is a significant change in North Carolina’s CON laws,” Berger told reporters, saying the reason for the holdup is the refusal of the hospitals to move an inch on Certificate of Need (CON) laws. If markets are allowed to provide facilities by easing CON laws, he thinks a deal could be reached quickly.
CON laws allow Department of Health and Human Services to prohibit “health care providers from acquiring, replacing, or adding to their facilities and equipment, except in specified circumstances,” according to their website. Critics call Certificate of Need a government “permission slip” that prevents the market competition that would improve services and reduce costs.
Berger said CON modification can address the issue of hospital mergers and the monopoly it creates for hospitals in the state, which is contrary to providing care at reasonable costs to people.
“Putting more competition into the availability of facilities,” he said. “I have felt for a long time that the FTC ought to be looking at how things operate in North Carolina with reference to providing healthcare, particularly in hospitals.”
Berger said the expansion is contingent on easing CON laws because Medicaid expansion means more people would have access to care, increasing the need for available facilities and medical providers.
“Our original bill both dealt with CON and the availability of individual practitioners with the SAVE Act,” he said. “We have been willing to compromise on the bill we sent over to the House. Unfortunately, the willingness to compromise on CON does not exist. We will continue to wait until we get some movement.”
Talks are ongoing between members on both sides of the aisle, but Berger says he is not part of the negotiations. Still, he said bills are easy to put together, but it depends on how quickly both sides reach a compromise before Medicaid expansion is passed.
N.C. House Speaker Tim Moore, R-Cleveland, told reporters that he is optimistic a compromise on Medicaid expansion could surface in December. The House passed its Medicaid expansion bill in June.
In regard to the North Carolina Supreme Court’s party-line 4-3 vote on Friday, Aug. 19, in which Democrats ruled that voter-approved state constitutional amendments — including voter ID requirements — could be tossed because they were placed on the ballot by a “gerrymandered” legislature, Berger said they are still analyzing the decision.
“I think the first blush response is that four partisan Democrats on the state Supreme Court have substituted their view of what policy in North Carolina ought to be for the views and votes of four million citizens of the state of North Carolina,” he said.
“If the voters care about voter ID, they ought to care about the Supreme Court elections this year,” he added.
Berger stated that although the legislature can pass legislation, as long as judges on the N.C. Supreme Court write decisions like Justice Anita Earls did in that case, North Carolinian will not see voter ID.
On the issue of abortion, Berger said he feels that limits should be placed after the first trimester, with exceptions of rape, incest, the health of the mother, and if the fetus will not survive due to a medical condition.
“After the first trimester, the state has an absolute interest in regulating the incidence of abortion,” he told reporters.
Current state law allows abortion into the fifth month of pregnancy, a regulation that Berger said is “too far down the road” for him, but added there should be some leeway if there is the possibility that the child won’t survive.
“I think you could look at what many of the Democrats have said and come to the conclusion their position is abortion on demand up until birth. I think we need to ask those questions and find out where they are,” he said. “At some point, I think the people have a right, and society has a right, to protect the life of the unborn child. The legislature is charged with the responsibility, under our system of government, deciding where you draw the line.”
Berger does not see the legislature passing an abortion restriction law next year prohibiting all abortions that don’t have exceptions for rape, incest, or the life of the mother. He also said there should be consequences for those who violate the law but more needs to be looked at, including whether or not to prosecute the mother for the violation.
The press conference with the Senate leader came just before the 4th U.S. Circuit Court of Appeals voted in a split 2-1 ruling Tuesday that granted Stein an injunction that will likely help him avoid criminal charges linked to a controversial 2020 campaign ad.
“That law has been on the books for almost 100 years,” he said. “The first time that a nonpartisan group has had a chance to look at whether or not the Stein ad was a violation of law, true or untrue. In some respects, this points out the problems we have in North Carolina with a partisan board of elections. I think if someone runs a political ad they know is false, there ought to be some accountability for that.”
Berger’s comments also came as the 5-4 majority-Democrat N.C. Supreme Court prepared to hear oral arguments next week on the Leandro school-funding lawsuit.
“I think that this is another chance for the Democrats on the state Supreme Court to show that they are not far leftist and understand that under our system of government, the representatives of the people decide how money is spent and how much,” he said. “Based on the decisions I have seen, I don’t hold out a whole lot of hope that you will see any level of sanity return.”