Briner: Wake Med, Atrium Health merger threatens State Health Plan solvency

(The Center Square) – Keeping the State Health Plan and other employee plans solvent will be tougher if the merger of Wake Med and Atrium Health reaches the finish line, first-term Republican Brad Briner said Tuesday.

A day earlier, the Board of Commissioners in Wake County approved the hospital merger 5-2 in a five-hour meeting inclusive of disruptions, tense exchanges and clearance of the room by sheriff's deputies. The shadowy move by the board, all Democrats, to put the articles of incorporation and transfer agreement on a consent agenda on a Friday before a Monday meeting four months ago led to a 90-day pause, public pushback, hearings, and amendments to the pact.

The finish line to clear still includes approval from the Federal Trade Commission and the U.S. Department of Justice. Briner called on first-term Democratic Attorney General Jeff Jackson for independent review.

The nation's ninth largest state of 11.2 million has nearly 750,000 teachers, state employees, retirees, lawmakers active and retired, and members of higher education in the State Health Plan. The plan was in a $1.5 billion structural deficit when Briner took office in January 2025.

Actions since have included a rise in premiums, control of long-term costs, introduction of cost-saving tiered benefits, protection of rural healthcare access through Atrium Health, consolidated efficiency with Blue Cross Blue Shield of North Carolina, and $200 million in consecutive fiscal years via appropriation through the Republicans' majority in the General Assembly.

"The concern is magnified by the fact that nothing has fundamentally changed from the original proposal and that basic market principles have not changed either," Briner said Tuesday. "Hospital consolidation leads to less competition and higher prices. And I'm not talking about a rural hospital getting acquired when it desperately needs a lifeline to ensure that rural North Carolinians have access to healthcare.

"I'm referring to when the merger happens as a means of having better market leverage. The result is that everyone's healthcare costs will go up. And we don't have to guess at that. The CEO was asked if costs will go up in his interview last week and he eventually responded simply, 'I hope so.'"

Briner was invited to be cochairman, with Health Department Secretary Dr. Devdutta Sangvai, on first-term Democratic Gov. Josh Stein's healthcare affordability commission. Interestingly, among the six core initiatives and advisements the governor wants from the panel is the second listed, saying improvement can come from "promoting competition in the market for healthcare services, including increasing system capacity."

Stein, having successfully gotten the merger participants to a cap on price increases for the next five years at not more than 1.5 times annual increases in Medicare costs, said he was no longer opposed to the merger.

"This decision makes it even harder for that effort to be successful," Briner said. "It also makes it even harder to keep the State Health Plan and other employer plans solvent. It's no different than when I'm trying to lose weight and rationalize having a second dessert. All the rationalization in the world cannot change the fact that it's a bad decision and I know it."

Briner, first-term Republican state Auditor Dave Boliek, state Republican Reps. Mike Schietzelt and Erin Paré, and Raleigh Democratic Mayor Janet Cowell each brought awareness to the issue when the board attempted to sneak it through.

Chairman Don Mial, Vice Chairwoman Safiyah Jackson, and members Cheryl Stallings, Susan Evans, Tara Waters, Shinica Thomas and Vickie Adamson instead removed it from the list, saying no action would be allowed for at least 90 days. Adamson and Waters were the two votes against on Monday.

Seats for Mial, Jackson, Stallings (unopposed) and Adamson (unopposed) are on the ballot this election cycle. The board expands to nine members with this election, and two at-large slots are also on the ballot chased by two Democrats and two Republicans. Evans, Waters and Thomas were 2024 election winners.

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