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Old North State Report – March 21, 2023
Tuesday, March 21, 2023

MEDICAID EXPANSION BILL HEADED FOR FINAL VOTE

After passing the Senate on Wednesday, a bipartisan agreement to increase the number of low-income adults eligible for Medicaid coverage while removing or reducing a number of regulatory barriers to the construction of additional healthcare facilities may receive its final votes next week. In a 44–2 vote, senators approved House Bill 76, directing state health officials to accept Medicaid coverage under the Affordable Care Act.

One of 11 states that have not yet enacted expansion, North Carolina has 2.9 million people enrolled in traditional Medicaid coverage. Up to 600,000 people between the ages of 18 and 64 might be eligible. Hospital assessments would be used to cover the state's 10% portion of the costs incurred by recipients of Medicaid expansion. However, hospitals also anticipate receiving higher payments from a federal program that the state is asked to include in the legislation for the treatment of Medicaid patients. The legislation would also relax "certificate of need" regulations, which, for instance, required state health officials' approval before hospital beds for patients with mental health issues were opened or MRI machines were purchased.

The bill is now headed to the House, where it will be voted on as soon as next week. After receiving final approval, the bill will be forwarded to Governor Roy Cooper, a longtime proponent of expansion. According to the bill’s language, expansion cannot be implemented until a new state budget is approved in the coming months, even if the bill is signed into law.

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MEDICAL DEBT LEGISLATION REINTRODUCED

A contentious, bipartisan healthcare consumer protection bill that addresses medical debt was reintroduced in the state House on Tuesday. A similar bill with the same title, “Medical Debt De-Weaponization Act” failed during the 2022 Session. The goal of House Bill 367, according to the legislation and a 2021 statement by State Treasurer Dale Folwell, is to "create a family-friendly, pro-poverty and consumer-protective law that sets parameters for the delivery of charitable care and limits the ability of large medical facilities to demand and use unfair tactics in debt collection." The bill contains language that could provide certain low-income families with free medical care or significant financial rebates. Folwell claimed that medical debt affects not only the uninsured and underinsured but also those with employer-based or government health insurance, who he claimed face irrational payment expectations from healthcare systems. No matter how Medicaid is expanded, medical debt will remain a problem, according to Folwell. On Wednesday, the bill was sent to the House Appropriations Committee for further debate.

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MOBILE SPORTS BETTING BILL ADVANCING IN HOUSE

The House of Representatives could vote on a bill to legalize mobile sports betting in North Carolina as soon as next week, according to one of the bill's main sponsors. A bipartisan group of House members introduced House Bill 347 on Monday. This bill is similar to one that failed last year by a single vote.

If passed, it would be legal to wager on professional, collegiate, amateur, and even video games on January 1, 2024. A state commission would be mandated by the bill to issue licenses to 10 to 12 operators. A $1 million licensing fee would be paid by those operators. In the first few years of operation, they would pay tax on gross wagering revenue at a rate of 14 percent, with deductions for bonuses and promotional credits.

The North Carolina Department of Health and Human Services would receive $2 million annually for gambling addiction programs; $1 million would go to the state's Division of Parks and Recreation; $300,000 would be given to each of the state's seven historically Black colleges and universities for athletic programs; and $1 million in grants would be awarded to the North Carolina Outdoor Heritage Advisory Council.

The mobile sports betting bill has bipartisan support, but it has also encountered bipartisan opposition from some who are concerned about issues like problem gambling and whether the state will receive as much revenue from legalization as it could. Governor Roy Cooper is in favor of legalization.

The bill is scheduled for hearing in the House Commerce Committee on Tuesday, March 21.

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CONSUMER ENERGY CHOICE BILL MOVES TO SENATE

By a vote of 76-38 on Wednesday, the North Carolina House approved a bill that would forbid local governments from discouraging citizens from using particular energy sources. Under House Bill 130, consumers would be free to select their energy sources without regard to limitations placed on them by local governments. According to the bill, local governments would not be allowed to pass ordinances that would limit the "connection, reconnection, modification, or expansion of an energy service based on the type or source of energy" provided to the customer. Republicans only need one Democratic vote to override a Cooper veto, even though the majority of House Democrats opposed the measure. The bill has a better chance of becoming law this year thanks to Michael Wray's (D-Northampton) sponsorship. The bill now moves to the Senate for consideration.

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UTILITY DAMAGE LEGISLATION APPROVED BY SENATE

Following substation shootings in Moore County last year, which cut power to 45,000 homes and small businesses for several days, the North Carolina Senate unanimously approved Senate Bill 58 that would toughen the penalties for purposefully damaging utility equipment. A new law would be established under the proposal making it a high-grade felony to intentionally harm or attempt to harm an energy facility, including those that transmit or distribute electricity or fuel, and any related hardware, software, or digital infrastructure. According to a summary created by the nonpartisan staff of the General Assembly, a person with no criminal history could spend just over six years in jail and pay fines of up to $250,000. A person with a lengthy criminal history might get a longer sentence. If the damage results in death, the offense carries a maximum sentence of 13 years in prison for first-time offenders and just over 16 years for repeat offenders. Additionally, a victim of a utility attack may file a lawsuit against the offender to recover costs incurred as a result of their injuries or property damage. On Tuesday, senators approved an amendment to remove a restriction on the amount of any punitive damages sought. The bill now goes to the House for consideration.

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GUN LEGISLATION SENT TO GOVERNOR

After a contentious debate and protests by Democrats over House Speaker Tim Moore's decision to not consider any amendments to the bill, a package of gun rights measures — including the repeal of the state's permit law for buying handguns — cleared the legislature on Wednesday.

Senate Bill 41, entitled "Guarantee 2nd Amend Freedom and Protections," passed the House by a vote of 70-44 (with three Democrats voting aye) and is now on the desk of Governor Roy Cooper. Cooper previously vetoed two of the bill's main gun rights proposals, including the elimination of the permit requirement. Before moving to the Senate floor last month, the measures—which had been initially submitted as three distinct proposals—were merged into a single bill.

In addition to repealing the permit requirement, Senate Bill 41 would also permit people attending religious services at places of worship that double as schools or have attached schools to carry concealed handguns for protection. The legislation also permits a two-year statewide awareness campaign to encourage secure gun storage.

The bill's supporters contend that the permits, which buyers of handguns must obtain from their local sheriff's office, are an arbitrary restriction on people who are lawfully purchasing firearms and who frequently already undergo a federal background check.

Opponents of the legislation have claimed that the permits are a useful tool in the hands of local law enforcement, who are familiar with their neighborhoods, to prevent guns from falling into the wrong hands. Additionally, they assert that keeping the permit requirement in place will prevent the dangerous loophole that repealing the law will introduce for private sales.

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