Adam Searing
As the NC General Assembly gets underway this week – even in a so-called short session year, it’s a little like watching an aircraft carrier try to do a three-point turn in Beaufort channel – a reasonable citizen might wonder what steps legislators will be taking to make health care more affordable and accessible. The answer is likely to be a disappointing “not much.â€
It’s not that North Carolinians aren’t having any problems affording decent health coverage. Premiums are skyrocketing, small businesses are struggling even to offer any employee coverage and people on the individual market who have a pre-existing health condition often can’t buy any plan at all.
No, the problem, as always, is political will. Although North Carolina is much better off financially than most other states in this economic downturn, we still have far less money to meet growing state needs than in previous years. Combine tighter finances with an upcoming election, and all indications point to a General Assembly where bold initiatives to address major state problems will be in short supply.
The high-water mark this session is likely the governor’s recently released budget. The governor proposes spending $68 million on the deteriorating mental health system; about $10 million keeping our affordable health insurance program for kids in working families, Health Choice, open to more children; and spending a few million more on quality-of-care improvements. Bold it’s not, but at least it’s a solid performance.
One problem for the governor’s proposals is that much of this sort of expansion – including some of the cost of raises for teachers and state employees – is funded by a proposed 20 cent increase in the cigarette tax and a few cents increase in the alcohol tax. Tax hikes – even on cigarettes – have already been firmly pronounced dead on arrival by General Assembly leaders.
Where does that leave us? Just keeping the health coverage we have for families is likely to be a fight. Therefore, don’t look for funding for the new sliding-scale premium health insurance program for working families passed last year to go into effect. Pres. Bush (aided by North Carolina senators Dole and Burr) effectively nixed federal help for child health expansions like this last year, so North Carolina would have to come up with the money all on its own.
Of course, we could guarantee health coverage for all children in the state for about $20 million in state dollars and thumb our noses at the federal government. That’s only a couple million more a year than the $15 million the governor proposes in his budget to renovate the Mattamuskeet Lodge in Hyde County combined with $3 million spent on upgrading the state zoo’s polar bear exhibit and setting up a state trade office in Shanghai.
In the end, I’d expect some nod toward mental health; no help beyond current public programs for children, parents or small businesses struggling to afford health coverage; and no rise at all in the cigarette tax, regardless of the huge health benefits that result from a substantial – say $1 – increase.
North Carolinians really shouldn’t stand for this. Regardless of what happens in Washington next year, we should move our state toward providing a choice of affordable and quality health plans for everyone. A place to start would be a $1 increase in the cigarette tax coupled with affordable child health plans. This simple step would guarantee that no child in our state – healthy or sick, disabled or not, poor or middle class – would ever go without quality health insurance again. But then again, it’s an election year.
Adam Searing is the project director at the NC Justice Center’s Health Access Coalition.