This week, state Senators Joyce Krawiec (R-Forsyth), Dan Bishop (R-Mecklenburg), and Ralph Hise (R-Mitchell) filed Senate Bill 361, the Health Care Expansion Act of 2019.
By focusing on free market, supply-side reforms, the bill reflects a positive shift in the conversation around healthcare policy for the state. Instead of asking how government can “help” by getting more involved, the state should look to reduce government interventions that strangle the healthcare market, driving up prices and restricting supply for all North Carolinians.
The bill also addresses a shortfall in Medicaid services for a truly needy population.
It is no secret that progressives are pushing for North Carolina to expand Medicaid this year. Proponents of expansion claim that providing government insurance to the uninsured will improve their access to care. This is an incorrect equation – coverage does not equal access to care.
Expanding Medicaid addresses the symptoms of government interference in health care with more government interference.
In a recent opinion editorial, John Locke Foundation Chair John Hood articulated the point well: “Shifting the cost from one pocket to another doesn’t make it go away. We need more innovation, more competition, and more information. Smart state policies can help.”
Senate Bill 361 takes strides towards improving access to healthcare by accomplishing several objectives:
Increase innovation waiver slots. The first part of the bill would expand funding and slots for the North Carolina Innovations Waiver. The waiver is part of the state’s current Medicaid program, providing funding for individuals with intellectual or developmental disabilities to receive care and support in their home or community. This helps individuals with disabilities to have more autonomy and independence. The program currently has a waiting list with an average wait time of 7 years, according to the bill sponsors.
Repeal the Certificate of Need law. Certificates of Need (CON) are a government-issued permission slip required by the state for would-be healthcare providers to open their doors or provide certain services. The CON law limits supply and drives up prices; repealing it would encourage competition in the healthcare sector and expand our healthcare industry’s capacity to serve patients.
Allow Interstate Reciprocity for Psychologists. This section would add North Carolina to an existing interstate compact granting licensing reciprocity to psychologists. Essentially, psychologists licensed by other states in the compact could practice in North Carolina without also getting a North Carolina license. This would apply to both telemedicine and temporary in-person practicing.
The bill also allows Licensed Marriage and Family Therapists to perform first level involuntary commitment evaluations and makes other minor regulatory changes.
Easing restrictions for these providers will also expand choices for North Carolinians with healthcare needs.
These are great steps that the legislature can take to help make affordable healthcare more accessible for all North Carolinians. But there is still more work to do.
Civitas has championed several access-expanding options, including the CON repeal and telemedicine expansion present in Senate Bill 361, as well as association health plans, which were passed by the Senate earlier this year. Other needed reforms include expanding scope of practice for certain healthcare professionals, loosening mandates and restrictions on health insurance options and removing burdensome insurance regulations from Direct Primary Care physician-patient arrangements.
Through Senate Bill 361, as well as the association health plans, the North Carolina Senate has emerged as a leader in healthcare policy in the state. They have shown a willingness to embrace the capacity of the free market to increase quality and decrease prices. Hopefully, the House will soon follow their lead.