It certainly seems that we are in for some hot, hot weather in the coming days!
I hope that you can stay cool and avoid heat-related illnesses. As always, things in the General Assembly seem to heat up rapidly! I want to share some concerns that have arisen recently.
Mental Health Parity
North Carolina is one of only 13 states that currently do not require private health insurance carriers to provide coverage for mental health illnesses. The House recently passed by a margin of 116 — 1, legislation that would require health insurance policies to provide such coverage.
The House restricted application of the law to exempt policies provided to companies with fewer than 25 employees. With this exemption, only one in six employees will receive this expanded coverage.
Blue Cross/Blue Shield (BCBS) has historically opposed such an expansion of coverage. Representatives for BCBS have reportedly approached the State Senate leadership with a proposal that the company would support expansion of coverage to all employees with private health insurance if the benefits were limited to nine specific mental conditions.
In its current form, the legislation will not cover treatment for substance abuse. While other state have included such coverage without any appreciable rise in premiums, it is unlikely that the Senate will amend the bill to include coverage for such treatment.
Legislation to establish mental health parity has been introduced for over a decade and has never come close to enactment. I support mental health coverage parity and believe such coverage should be available to all employees with private health insurance. However, I believe it is critical that North Carolina start on the road to mental health parity. I will support the reasonable compromises necessary to obtain successful passage of this legislation.
High Risk Insurance Pool
North Carolina is one of only 16 states that currently do not have a high risk insurance pool. I introduced such legislation in the Senate as a companion bill to the House version which was passed by the House and is currently in the Senate Commerce Committee.
This bill will assess all policies issued by private health carriers to create a high risk insurance pool that will provide coverage to approximately 9,000 citizens who have pre-existing conditions. These conditions make it nearly impossible for them to obtain coverage. Hemophiliacs, in particular, have difficulty in maintaining coverage and will be one group of individuals likely to benefit under this expansion of coverage.
Budget Update
The Joint House and Senate Committee on Health and Human Services held several meetings last week in an attempt to resolve differences in the two budget proposals. We are close to being able to present a recommendation to the Joint Full Appropriation Chairs this week, but we still have eight or ten differences over money issues. The Senate made the last counter offer before the committee recessed to reconvene on Tuesday.
We have conducted these negotiations publicly. Lobbyists for a multitude of healthcare interests continue to make up the audience viewing our negotiations to distribute a fixed pool of money to be budgeted for healthcare needs. Personal care services for the elderly comprise an optional program that a state does not have to fund in order to receive federal matching dollars in the Medicaid program. Since North Carolina expanded its budget to include these services, it has been one of the fastest growing areas of the budget. The legislature has been taking measures to try to reign in the costs of this program. On Friday, the House tentatively agreed to a Senate proposal requiring that such services be subject to be pre-authorized by an independent entity before such services can be paid for with Medicaid dollars. The projected savings would be over $2 million if pre-authorization is required. Currently, a nurse employed by the home health agency provides the documentation to support the need for such service.
A lobbyist for private companies providing healthcare services for the elderly verbally attacked both Senator William Purcell and me at the close of our latest negotiation session. I had given this lobbyist for the home healthcare industry repeated opportunities to speak to our committee; nonetheless, he chose to attack Senate members after the house agreed to pre-authorization, and the Senate had not agreed to couple the savings from pre-authorization with an increase in payments to the industry for services rendered.
The reality is that North Carolina has limited funds to meet pressing healthcare needs. It is incumbent upon the General Assembly to ensure that the limited funds are utilized as efficiently and effectively as possible.
I know that all of you join me in extending sincere sympathy to Senate President Pro Tempore Marc Basnight upon the death of his wife Sandy. Mrs. Basnight died on Sunday, June 10th following a long illness. Many legislators, staff members, and friends attended her funeral on Wednesday, June 13th in Wanchese, North Carolina.
I hope that you will share your questions, concerns, and comments with me about any and all issues involving legislative matters. I do appreciate the opportunity to serve as your Senator, and I will continue to work hard to represent you well.
Sincerely,
Doug Berger