The General Assembly continues to move at a quick pace, with both chambers advancing several of their priority policy proposals this week. A major announcement was also made this week by legislative leadership - an agreement between the House and Senate chambers has been reached on Medicaid expansion. Leadership also expressed optimism around having a budget passed out of the General Assembly by the end of June.

Republican leadership also reported that they expect to file a much-awaited abortion access bill next week. In an interview, House Speaker Tim Moore (R-Cleveland) told reporters he expects a bill to “reduce the number of weeks at the start of pregnancy when abortion will be legal” but did not indicate what the cutoff would be. The Senate also officially passed their medical marijuana legalization bill. Senate Bill 3: NC Compassionate Care Act now heads over to the House, where Speaker Moore has expressed that the bill has “decent prospects of passage.”

Medicaid Expansion

An agreement to expand Medicaid to hundreds of thousands of low-income adults in North Carolina was announced on Thursday by legislative leaders. House Speaker Tim Moore (R-Cleveland) and Senate President Pro Tempore Phil Berger (R-Rockingham) joined health leaders from both chambers to announce the compromise plan that has taken several years to reach. North Carolina is currently one of 11 states that has not adopted Medicaid expansion.

Senator Berger told reporters they would use the House’s Medicaid expansion bill, House Bill 76: Access to Healthcare Options, which passed the House in February, as a vehicle to implement the law. The plan would be effective through the 2023 budget, both leaders said, but a separate bill outlining the policy would be published soon. The plan calls for the elimination of the state’s certificate of need laws for behavioral health beds and ambulatory surgical centers for some counties and raises the threshold for certain medical equipment and facilities to three million dollars.

Last year, the Senate passed a bill that expanded Medicaid while also nearly eliminating all certificate of need laws, but the House did not take up the measure. The Senate’s previous expansion bill included a number of additional healthcare reforms, which were not included in the plan announced this week. Speaker Moore called the compromise a “balanced approach” that came about after consulting with stakeholders from all sides of the debate.

Neither leader said they had spoken to Democratic Governor Roy Cooper about the deal prior to the announcement, but in a statement the governor said it was “a monumental step that will save lives” while also pressuring lawmakers to make it effective “immediately.” President Biden also promoted the plan by sharing Cooper’s statement on his Twitter account, saying “that’ll be 40 states who’ve expanded. 10 more to go.”

The House bill was referred to the Senate Health Care Committee Thursday after the legislative leaders’ press conference.

Literacy Test Repeal

Lawmakers moved in a bipartisan step this week to remove a mundane Jim Crow-era provision from the North Carolina Constitution. Article VI of the state constitution currently requires a literacy test to register to vote. The section is obviously unenforceable today and few North Carolinians likely even know the provision exists in the constitution. In 1971, the section was denied preclearance by the United States Department of Justice pursuant to the Voting Rights Act of 1965.

House Bill 44: Constitutional Amendment/Repeal Literacy Test would repeal Section 4 of Article VI, which contains the literacy test provision. The bill calls for the voters to approve the repeal of the amendment in the 2024 general election. Members of the House Judiciary 2 committee unanimously approved the bill and sent it to it's final stopping place before making it to the House floor.

Bill sponsor Representative Kelly Alexander (D-Mecklenburg), a former North Carolina NAACP President, recounted to the committee about the state’s first Black Chief Justice, Henry Frye, being presented with a literacy test before being allowed to register to vote.

The amendment was initially ratified in 1899, during a time of political upheaval in the state that saw white supremacists backlashing against African Americans serving in government. Lawmakers attempted to repeal the provision in 1970, but voters rejected the amendment. A similar effort in 2013 passed the House but did not advance in the Senate. Representative Terry Brown Jr (D-Mecklenburg) told committee members he “believes the stars might be aligning this year for us to finally get this done.” Senate President Pro Tempore Phil Berger (R-Rockingham) publicly backed repealing the amendment earlier this year, giving the initiative momentum.

The North Carolina Department of Health and Human Services (DHHS) announced Monday that the implementation of the Medicaid Managed Care Behavioral Health and Intellectual/Developmental Disabilities Tailored Plans would be delayed. Initially scheduled to launch April 1, the tailored plans are now set to go live on October 1. DHHS stated that the delay was needed to allow Local Management Entity/Managed Care Organizations (LME/MCOs), which will operate the plans, additional time to contract with more providers. 

During a Joint House and Senate Committee on Appropriations, Health and Human Services meeting Wednesday, DHHS Secretary Kody Kinsley told lawmakers the delay was due to the LME/MCOs not yet having large enough provider networks to meet the needs of the populations they will serve. The managed care organizations, of which there are six in the state operating in different regions, will provide Medicaid recipients with complex care needs niche services, in addition to all standard services that other Medicaid beneficiaries receive. Several health leaders expressed frustration with the delay and the timing of the announcement. Representative Donna White (R-Johnston), told Secretary Kinsley it "would have been a bit more professional to give [the six managed care organizations] a heads up." Secretary Kinsley responded saying any announcement earlier may have jeopardized contract negotiations, and said there "was not one" organization ready for the launch.

The six LME/MCOs were represented by their CEOs at the joint legislative committee. The CEOs also took questions from members of the committee and spoke about the process of negotiating with providers.

Upcoming Legislative Meetings

Monday, March 6

4:00 PM Senate: Session
6:00 PM House: Session - Governor Cooper Delivers State of the State Address

Tuesday, March 7

10:00 AM House: Local Government
10:00 AM House: Health
1:00 PM House: Education K-12
2:00 PM House: Energy and Public Utilities
3:00 PM House: Judiciary 2

Wednesday, March 8

10:00 AM House: Appropriations, Information Technology
12:00 PM House: Wildlife Resources
1:00 PM House: Agriculture