Under the Dome: Health bill moves forward along party lines — with three exceptions

Good morning and welcome to the Under the Dome newsletter. I’m Luciana Perez Uribe Guinassi, joined today by my colleagues Dawn Baumgartner Vaughan, Kyle Ingram and Avi Bajpai.

The North Carolina Senate passed its first bills of the session Wednesday, including one that would limit new requirements on health insurance.

Senate Bill 24 ties new health insurance mandates to the repeal of existing ones, requires state funding to cover the costs of enacting such mandates and requires any mandate enacted after July 1 apply to the State Health Plan.

It passed on a largely party-line vote, with most Democrats voting against it, except for former Minority Leader Sen. Dan Blue and Sens. Paul Lowe and Gladys Robinson. Blue and Lowe were sponsors of the bill.

Republican sponsors say the bill will help control health care costs, but some Senate Democrats worry that it could lead to insurance benefits being cut.

“In order to improve the health outcomes for one group of people, this bill mandates that we reduce the health outcomes for another group of people,” said Democratic Sen. Julie MayfieldTuesday during a meeting of the Rules Committee.

Sen. Amy Galey, a Republican and a bill sponsor, said that private insurance companies already make decisions about what they’ll cover and what they won’t cover (such as through prior authorization requirements), “but I’m led to believe that those decisions are currently being made behind closed doors.”

This bill is about “helping people to understand how the cost gets passed on to other users of the same health insurance or the same health plan,” she said.

— Luciana Perez Uribe Guinassi

SENATE LEADER BERGER NOT MAKING DECISION YET ABOUT 2026

The right wing website The Daily Haymaker, which has long been a critic of Senate leader Phil Berger, wrote this week that Berger has been called “disloyal” by the Duplin County GOP.

The local party organization accused Berger of supporting a Democratic judge’s campaign in 2022, according to a letter posted on the site. I asked Berger if he had a response, and he said he hadn’t seen it.

“Somebody said something about it, but I don’t know the details, so I probably shouldn’t comment on something I haven’t seen,” he said.

As far as Berger’s plans for another term in 2026, he noted that “the filing period is in December, and I continue to enjoy what I get to do.”

“But I don’t want to prejudge any decision that really doesn’t have to be made until later in the year,” Berger said.

In other Berger news, he told me he supports increasing unemployment benefits, which you can read more about here.

— Dawn Baumgartner Vaughan

JUDGE REINSTATES FEDERAL ETHICS OFFICIAL FROM NC WHO WAS FIRED BY TRUMP

A federal judge has temporarily reinstated a top U.S. ethics official after he was fired by President Donald Trump.

That official, Hampton Dellinger, leads the Office of Special Counsel, a federal agency tasked with protecting whistleblowers and enforcing the Hatch Act, which restricts political activity by government employees.

A North Carolina native, Dellinger previously served as legal counsel for Gov. Mike Easley and unsuccessfully ran in the 2008 Democratic primary for lieutenant governor.

Trump fired Dellinger, who was appointed by President Joe Biden, in a one-sentence email sent on Friday night.

Dellinger quickly filed a lawsuit against Trump, noting that longstanding federal law prohibits the president from removing him unless for “inefficiency, neglect of duty, or malfeasance in office.”

“Since my arrival at OSC last year, I could not be more proud of all we have accomplished,” Dellinger said in a statement. “The agency’s work has earned praise from advocates for whistleblowers, veterans, and others.The effort to remove me has no factual nor legal basis – none – which means it is illegal.”

The U.S. Justice Department is appealing Dellinger’s reinstatement.

— Kyle Ingram

HOUSE REPUBLICANS PROPOSE NEW COMMITTEE ON MEDICAID SUSTAINABILITY

A House bill Republicans filed Wednesday would create a Joint Legislative Committee on Medicaid Sustainability.

The 12-member committee — split evenly between Senate and House appointees — would study ways to adjust the state’s Medicaid program if federal funding declines.

Possible changes include reducing or eliminating coverage for optional services such as optometry, chiropractic care, and podiatry, as well as lowering provider reimbursement rates or tightening eligibility. A final report, including potential legislation suggested, would be due from the committee to the General Assembly by April 30, 2026.

Congressional Republicans have reportedly considered Medicaid cuts, which could jeopardize North Carolina’s Medicaid expansion,

Republican Rep. Donny Lambeth, a key figure in North Carolina’s Medicaid expansion and one of the sponsors of the House bill, previously told me that if federal funding drops, “there’s no way, under a new scenario, that it (expansion) would pass” again.

— Luciana Perez Uribe Guinassi

NEW CAMPAIGN TO EXPAND ACCESS TO ADDICTION SERVICES, TREATMENT PROVIDERS

A statewide campaign to expand access to quality addiction services was announced Tuesday morning at a press conference at the legislature.

Called the North Carolina Treatment Connection, the campaign aims to be “a trusted resource to connect individuals with ethical, effective treatment providers in their communities,” said Sara Howe, CEO of Addiction Professionals of North Carolina (APNC).

The initiative builds on the 2023 passage of the Stop Addiction Fraud Ethics (SAFE) Act, which put new regulations in place to prevent misleading marketing and unethical referral practices in substance use disorder treatment.

Michael Roberts, APNC’s director of outreach, has been in long-term recovery for more than nine years, seeking treatment more than 26 times before “finally [finding] the right help — the kind of help that wasn’t looking to profit off of my desperation,” he said. He said vulnerable individuals often fall prey to “patient brokers” who see them as “dollar signs instead of lives worth saving.”

Howe said it is difficult to determine the full scope of the problem, as patient brokers operate underground and “pop up a little bit like whack-a-mole.” However, she said, campaigns like this will help expose them by educating the public on ethical treatment options.

Republican Sen. Jim Burgin, one of the lawmakers behind the SAFE Act, said the state uses a rating system to evaluate day cares and “we need to do something very similar” for treatment providers.

Republican Rep. Timothy Reeder, another backer of the SAFE Act, said substance use disorder claims the lives of 12 North Carolinians each day and alcohol and drug abuse costs the state $6.8 billion annually in health care expenses. “But the devastation on the families and the patients is really what we worry about. It destroys families,” he said.

The campaign is a joint effort between the General Assembly, the state’s health and human services department, the Alcohol/Drug Council of North Carolina, and APNC, according to speakers at the press conference.

— Luciana Perez Uribe Guinassi

LAWMAKERS WANT TO CREATE A RETIREMENT SAVING PROGRAM FOR SMALL BUSINESS WORKERS

A bipartisan group of House lawmakers wants to create a new retirement savings program for employees of small businesses who don’t have access to pensions, 401(K) plans, or other options.

The proposal, which has the support of the AARP, would allow eligible employees to save for their retirement with automatic deductions from their paychecks into a state-overseen program.

Rep. Jarrod Lowery, a Lumberton Republican who is sponsoring the legislative effort, said during a news conference on Wednesday that the state needs to step in to provide small business employees with an option for retirement savings that is easy to enroll in and take advantage of.

“We’re talking about barbers, we’re talking about laborers, factory workers, farmers, landscapers, electricians that keep North Carolina moving,” Lowery said. “If they are prepared for retirement, they can live those golden years in the decency they deserve.”

House Bill 79 would establish a 12-member North Carolina Small Business Retirement Savings Board to oversee the retirement program. The board’s members would be appointed by the state treasurer, the governor, and the leaders of the N.C. House and Senate.

The AARP estimates that nearly half of North Carolina’s private-sector employees, around 2 million people, work for employers that don’t offer traditional pension or retirement savings plans.

Rep. Jeff McNeely, another primary sponsor of the bill, said this issue is personal for him, as his family-operated small business, a feed milling company in Statesville, has struggled to compete with larger companies for good employees.

McNeely said the business, which was started by his parents in 1957 and today has more than 20 employees, would benefit from being able to offer employees the added incentive of a retirement savings program.

— Avi Bajpai

Today’s newsletter was by Luciana Perez Uribe Guinassi, Dawn Baumgartner Vaughan, Kyle Ingramand Avi Bajpai. Check your inbox tomorrow for more #ncpol.

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