NC Health & Legislation Update

Under the Dome

NAHU completed our 2022 Capital Conference last week. This event is always a yearly high-point for our Association because of its “boots on the ground” advocacy for the work we do as agents and brokers. Attending each year not only gives members an opportunity to hear what is happening legislatively around the country but to also participate in very important healthcare discussions with our federal legislators.

This year Amy Walter, the Editor-In-Chief and Publisher of The Cook Political Report gave the keynote address. For those not familiar, The Cook Political Report is a a non-partisan national newsletter that analyses elections and campaigns for the Presidency, Congress, and governors races. In her comments, Ms. Walter gave a comprehensive overview of the state of the Presidency, what is happening in congressional races and mapping and discussed how events in Ukraine could impact congressional mid-term races.

Locally, NCAHU members have been holding virtual meetings with our federal legislators to discuss 2022 federal legislative priorities. Thus far, all active, non-retiring members of Congress are scheduled with their respective chapter representatives.

The NC General Assembly joint committee studying Medicaid expansion has now met twice. The second meeting convened with a full slate of presentations about how expansion would work, how it could be paid for, and whom it would help. They also heard how the state compares nationally. Speakers at the last meeting included the NC State Association of Healthcare Plans, DHHS Medicaid Secretary Dave Richard, and the NC Rural Center among others. On the heels of that meeting the NCAHU General Assembly Action Committee Chairs, myself and David Smith met with Senior Policy Advisor to the NC Senate, Nathan Babcock and Legislative Research Assistant to Rep. Donny Lambeth, Blair Burr to discuss how, expanding Medicaid would impact NC employers and the agent/broker community. The discussion was positive and NCAHU has been asked to be a part of the April 26th joint committee meeting.

Finally, the NC General Assembly asked the U.S. Supreme Court to intervene and stop the new congressional maps approved by the NC State Supreme Court. Republican leaders had asked the U.S. Supreme Court to find that under the “independent state legislature” doctrine, state courts have no authority to overrule the legislature’s authority to create congressional districts. The U.S. Constitution, they argued, leaves that question in the hands of the legislature, not the courts. A majority of the justices declined the requests with Justice Kavanaugh saying the petition was too close to the May 17th primaries to take up the case.

The new congressional map can be found here

Healthcare Take-Aways from the State of the Union Address

President Biden gave his first State of the Union address to Congress and while the war in Ukraine dominated the first half of his speech, the second half outlined a few of his healthcare policy issues. While it is easy to dismiss policy positions in the SOTU, they are a helpful indicator of the Administrations policies and focus.

Here is a recap of the top healthcare issues the President spoke about:

Lowering Drug Prices, Including the Cost of Insulin

  • The President spoke about the need to cut the cost of prescription drugs specifically citing the high cost of insulin. A study released by the RAND Corporation in October found that insulin prices are more than eight times higher in the United States than in 32 comparable nations combined, while the average list price nearly tripled between 2002 and 2013 and doubled between 2012 and 2016. President Biden urged Congress to cap the cost of insulin at $35 a month. He also renewed his call to let Medicare negotiate lower prices for prescription drugs noting that Medicare already establishes VA drug prices.

Nursing Home Quality-of-Care Standards

  • The president promised nursing home reforms through the Medicare program that would lead to higher quality-of-care standards. It is clear that this administration has been closely watching the emergence of private equity firms acquiring nursing homes and the reported decline of care in patients once acquired. DHHS through the CMS have proposed a number of reforms that include setting minimum staffing requirements and a deeper dive into private equity ownership.

Unity Agenda for the Nation

  • In his speech Biden unveiled his “Unity Agenda for the Nation” which includes initiatives aimed at ending the opioid epidemic, tackling adult and children’s mental health needs, improving veterans services, and ending cancer. He was also pointed that it was this administrations priority to protect access to health care, preserve women’s reproductive rights, and advance maternal health care.

Expansion of the Affordable Care Act Subsidies 

  • President Biden reviewed the impact of the American Rescue Plan noting that this legislation not only advanced coronavirus vaccination efforts and provided economic relief to Americans, but it also reduced healthcare coverage costs. The American Rescue Plan Act expanded subsidies for marketplace health insurance plans to many Americans — more than 3 million — who didn’t previously qualify for them. The subsidies meant Affordable Care Act insurance premiums for many families were much lower. The Department of Health and Human Services estimated that for 4 in 5 enrollees it would cost $10 or less a month, after tax credits, to sign up for health insurance. Biden urged Congress to close the coverage gap by making subsidies expansion permanent.

“Cancer Moonshot” 

  • The president also pledged to increase focus on “Cancer Moonshot.” This $1.8-billion cancer research program that began five years ago and was slated to run for another two, wanted to cut the cancer death rate by at least 50% over the next 25 years. This initiative has three primary goals: to accelerate scientific discovery in cancer, foster greater collaboration, and improve the sharing of data.


  • The government is launching a “test to treat” initiative that will allow people to get tested for COVID-19 at a pharmacy and, if positive, receive antiviral pills on at the pharmacy at no cost. President Biden specifically mentioned Pfizer’s COVID-19 antiviral pill regimen, Paxlovid, which was found to reduce the risk of death or hospitalization by about 89%. The president also pledged to investigate major cases of criminal fraud in federal COVID-19 programs such as the Paycheck Protection Program and Unemployment Insurance. 


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