N.C. General Assembly Needs Special Session on Health Reform

Regardless of what the Supreme Court rules about the Affordable Care Act (aka Obamacare) tomorrow, the North Carolina General Assembly needs a special session on health reform, the sooner the better.

If the Supreme Court upholds the entire law, our state is woefully behind in moving to set up health insurance exchanges (think Orbitz.com, but for health insurance) that would be required by the law. If the State doesn’t address the details, the federal government will set up and run an exchange for our state, but it is hard to believe that anyone thinks that is the best option for North Carolina.

If the Supreme Court strikes down the entire law, there will be an incredible vacuum created and it is hard to see how Washington will respond quickly, as much as they need to do so. The people of North Carolina deserve to know what our elected leaders plan to do about health reform, and this should be a center piece of the Fall election. If this occurs, opponents of the Affordable Care Act will have their chance to say what they are for.

If there is a muddled decision that strikes down parts of the law while upholding others, which is the most likely outcome, our State leaders need to decide how to proceed in the way that is best for the people of North Carolina. This will take time, but we need to get started right away.

During the most recent session of the General Assembly, the primary health reform effort put forth by Republicans who controlled both Houses of the General Assembly, was House Bill 2, that said in essence that the Affordable Care Act did not apply in North Carolina. Rep. Paul Stam (the second highest ranking member of the State House) yesterday said that the General Assembly may revive this effort after the Supreme Court decision (it passed and was vetoed by Gov. Perdue).

While I am no constitutional scholar, two of the High Court’s decisions this week cast great doubt on this strategy. In both the Montana campaign finance case (a win for Conservatives/Republicans), and in the Arizona immigration case (a win for Liberals/Democrats), the notion that States can decide what federal laws to abide by was downgraded quite a bit.

The State needs a better health reform plan than saying the Affordable Care Act doesn’t apply in North Carolina.

While many will say the middle of an election is a terrible time for a special session, I think it is the opposite. Both parties need to make a clear case for what they would do to address the related problems of health reform: coverage, cost and quality of health care.

The people are waiting.

About Don Taylor
Professor of Public Policy (with appointments in Business, Nursing, Community and Family Medicine, and the Duke Clinical Research Institute), and Chair of the Academic Council at Duke University https://academiccouncil.duke.edu/ . I am one of the founding faculty of the Margolis Center for Health Policy. My research focuses on improving care for persons who are dying, and I am co-PI of a CMMI award in Community Based Palliative Care. I teach both undergrads and grad students at Duke. On twitter @donaldhtaylorjr

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