NC Health & Legislation Update

Under the Dome

At this moment, North Carolina’s 2022 primary election, which will set the playing field for Democrats and Republicans vying for control of both chambers of Congress and the state legislature, will take place in May. That could change in the coming days, and it’s just one part of the 2022 primary that is still in flux.

The dates when candidates will be able to file for election remain in limbo. It’s unclear if state legislative and congressional districts drawn by North Carolina’s Republican-controlled legislature will remain intact. The state elections board is delaying a challenge to one high-profile candidate’s eligibility for office. Whether the primary election ends up in May or June, political maps are redrawn, or U.S. Rep. Madison Cawthorn can run for reelection, the primary’s results will influence which party makes gains in the general election, and ultimately, what happens in our state and country in the coming years.

North Carolina’s map for the U.S. House of Representatives, as currently drawn, has 10 seats that are all-but-guaranteed to elect a Republican, three seats that are all-but-guaranteed to elect a Democrat, and one competitive seat. So 13 of the 14 people who will represent North Carolina in the U.S. House are likely going to be decided in the primary election, not the general election in November. And even in that one competitive seat, the primaries will be important. Both Republicans and Democrats will have competitive races since the incumbent, Democratic Rep. G.K. Butterfield, is not running for reelection. 

Hospital Billing in NC

North Carolina nonprofit hospitals too often are billing poor people for medical care when they should write the expenses off as a result of their tax-exempt status, according to a report released Wednesday by the state treasurer’s office. The report, developed by the State Health Plan and the National Academy of State Health Policy, declared a “lack of transparency obscures” how common such billings are and how “existing law offers little protection to patients and taxpayers.”

A bipartisan group of state lawmakers, along with State Treasurer Dale Folwell, held a news conference about the report and called for reforms, according to news outlets. They include setting minimum requirements for how much charity care nonprofit hospitals must provide. “The findings in this report show the need for greater accountability,” Folwell said in a news release. “Despite lucrative tax breaks, nonprofit hospitals do not always provide more charity care than their for-profit counterparts.”

The North Carolina Healthcare Association, which represents for-profit and nonprofit hospitals and hospital systems, said in an extensive written statement that “charity care spending and community benefit investment activity is transparent and accountable.” The group blasted the news conference as a “public relations stunt” by Folwell at a time when hospital staff is stretched thin while handling record hospitalizations during COVID-19.

Folwell, a Republican re-elected in 2020, also released a report in October that found a majority of the state’s largest nonprofit hospital systems failed to provide monetary charity care that exceed 60% of the value of the system’s tax breaks they had received in recent years.


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