While North Carolina lawmakers were hard at work in committee meetings and holding floor vote sessions this week, the U.S. Supreme Court heard oral arguments on a North Carolina case. The case deals with the how the state’s congressional districts were drawn. North Carolina’s current congressional districts were drawn to benefit Republicans, something that most no longer dispute. Republicans elected 10 of them to the state's 13 U.S. House seats. The Supreme Court’s nine justices are now tasked with deciding whether partisan gerrymandering is constitutional.

Back in Raleigh, both House and Senate legislators are preparing for yet another full week of session. The House will reconvene on Monday, April 1 at 7:00pm. The Senate will hold a no vote session on Monday, April 1 at 2:00pm and reconvene again at 7:00pm for a voting session.

Education Bills

House lawmakers approved several education reform bills on Wednesday, three of which affect the way North Carolina’s public schools are graded. The state’s public schools are currently graded on an A-F letter scale. A school’s grade is primarily based on test performance. State test scores make up 80 percent of the grade, while the other 20 percent comes from how much growth students are showing on these tests.

Supporters of the current grading system say that the A-F scale makes it easier for parents to see how schools are performing. Critics of the current system believe it primarily shows that high-poverty schools do much worse than affluent schools. This bill would change the current system and give schools two letter grades. If HB 266: School Annual Report Card is signed into law, one grade would be based on student achievement, the other on growth.

Another option approved by the House, HB 354: Modify Weighting/School Performance Grades, would change the weight given to each of the components of the schools grades – 50 percent achievement and 50 percent growth. The third option, HB 362: 15-Point Scale For School Performance Grades, would make the 15-point scale that is currently being used to set school performance grades permanent. The bill would only change the letter grades for the schools, not individual students.

All three of these bills cannot become law because components of each contradict one another. House members say they want to give the Senate multiple options to choose from. The House has passed these bills before, but the Senate never took action. Whether the Senate will take action on any of the bills this time around is still unclear.

State Health Plan Study

A bill that would slow down state Treasurer Dale Folwell’s proposal to reduce what the state employees’ health plan pays hospitals and other providers passed a crucial vote on Wednesday. HB 184: Study State Health Plan would create a multidisciplinary study committee tasked with looking at ways to manage and control costs in the State Health Plan. The bill would create a 17-member commission that would need to come up with their recommendations by December, with lawmakers implementing changes by December 2020.

The State Health Plan currently covers around 726,000 state employees, retirees, and their family members. Despite months of back and forth between Treasurer Folwell and legislators, the bill passed with wide margins. Folwell’s proposal would pay providers about 177 percent of what they receive from federal Medicare. Rural hospitals, primary care doctors, and mental health providers would receive an additional increase.

Folwell’s attempt to present his proposal as a way for state employees to have better transparency on what they’re paying for was met with opposition from hospitals and doctors’ groups. Those opposing the Treasurer’s proposal argue that they are facing a multitude of changes in the healthcare system already, as the state prepares to move Medicaid from a fee-for-service system to one controlled by managed care organizations. Rep. Donny Lambeth (R-Forsyth), who opposes the Treasurer’s plan, believes Folwell’s proposal will only prolong the transition to a different payment model and in two years, legislators will be right back to where they are now.

Health Care Expansion

Senate Republicans unveiled what they believe could be an alternative to Medicaid expansion on Tuesday. SB 361: Health Care Expansion Act of 2019 has three main components. The bill would provide funding to the Intellectual/Developmental Disability (IDD) Medicaid program in order to reduce its years-long waitlist. SB 361 would repeal Certificate of Need (CON) regulations governing expanding healthcare facilities. SB 361 would also add North Carolina to a multi-state agreement that allows licensed psychologists to provide telemedicine and services in other states that are part of the agreement.

The IDD program provides in-home care and services to people with intellectual and developmental disabilities. The program has about 12,000 people on a waiting list for about 12,000 slots, creating individual wait times of up to seven years. The bill would allocate $41 million to add 2,000 more slots to the program. Sen. Joyce Krawiec (R-Forsyth), one of the bill’s sponsors, believes the IDD program should be prioritized over the population served by expanding Medicaid. Proponents of Medicaid expansion feel the two issues should not be treated as an either-or situation. In Governor Roy Cooper’s budget, released earlier this month, additional slots to the program would be added starting in 2020. Gov. Cooper’s proposal calls for a smaller allocation by several million dollars.

The repeal of the CON law for medical facilities, which requires new and expanding healthcare facilities to acquire a state-issued certificate that attests to the need for the facility, would take effect on January 1, 2020. Supporters of the repeal, such as bill sponsor Sen. Dan Bishop (R-Mecklenburg), argue the existing law creates unnecessary hoops to jump through for healthcare providers. The N.C. Healthcare Association, which represents the state’s hospitals, is among those who oppose CON repeal, arguing that new facilities without regulation have the potential to harm struggling rural hospitals that provide care to the uninsured.

Lastly, SB 361 would add North Carolina to a seven-state Psychology Interjurisdictional Compact. This compact allows psychologists to serve patients across state lines without needing licenses from multiple states. The House has their own version of this component of the bill as well. HB 297: Psychology Interjdtl. Compact (PSYPACT) would allow out-of-state psychologists to use telemedicine to care for those in underserved areas of the state. North Carolina would be the seventh state to enact the compact.