In the Realm of Healthcare, the Fight Continues | Eastern North Carolina Now

   Publisher's note: This post, by Karen Duquette, was originally published in the Health section of Civitas's online edition.

    The North Carolina General Assembly has officially concluded its business for 2012, ending a biennium that brought much needed policy changes to our state. While a significant portion of the short session was focused on budget adjustments, in the realm of health care, several steps were taken in the right direction.

    Medicaid was one area that received considerable attention. Legislators worked to address the Medicaid shortfalls that have been prevalent over the past few years. In the final compromise version of the budget bill, $200 million in additional spending was given to Medicaid programs to ensure recipients continue to receive services. However, looking forward, lawmakers must find ways to streamline Medicaid services so that North Carolina taxpayers and Medicaid recipients are getting the most for their money.

    The Affordable Care Act, better known as Obamacare, will also impact future Medicaid services. Due to the Supreme Court decision, North Carolina must determine whether to further expand its Medicaid program. If North Carolina chooses to expand its Medicaid coverage to individuals up to 138 percent of the federal poverty line (133 percent but with a 5 percent income disregard), it has the potential to bankrupt our state in a time of already high economic distress. North Carolina must look to solutions that are patient-centered and also cost-effective, putting patients back in the driver's seat. Continuing to expand Medicaid services while not addressing the costs of this expansion could be disastrous for our state.

    Similarly, in the 2011 session the legislature attempted to push through HB 2, the Protect Healthcare Freedom Act, which would have protected North Carolinians against the overly intrusive Obamacare individual mandate. Lawmakers successfully passed the legislation in both chambers but Gov. Perdue vetoed the bill and the legislature was unable to override it. Protecting North Carolinian's healthcare decisions is an area that must be considered when the legislature returns in January.

    The General Assembly also successfully resisted pressure to implement an unnecessary health benefit exchange, HB 115. While the House chose to pass it last year, the Senate refrained from passing the bill, which would only further burden North Carolinians with unaffordable and mandatory health insurance plans. By setting up an exchange, the state would be further promoting Obamacare. In the end, it will make little difference if the exchange is run by the federal or state government, because the U.S. Department of Health and Human Services will have the final say in what qualifies as an exchange.

    In a missed opportunity, lawmakers failed to address an issue affecting developmentally disabled North Carolinians as mental health services transition to a new delivery system. A law passed in 2011 changed the delivery system of Medicaid mental health recipients by expanding a model used by Piedmont Behavioral Health Services. The hope was to increase efficiency in the system by streamlining services. While good in theory, developmentally challenged individuals may fall through the cracks as thousands of patients lose case management services. All mental health organizations will be required to shift by January 1. Unfortunately, legislators were unable to implement this patch in time and will hopefully reconsider this issue with better success in the 2013 session.

    With the Supreme Court's decision finding Obamacare constitutional and with November elections looming, North Carolina and federal lawmakers will be tasked with finding real health care solutions for real people. Regardless of the ultimate outcome of Obamacare, lawmakers must pass patient-centered reforms that give Americans quality, accountable, and efficient health care coverage and services.