Carolina Journal News Reports
CJ Series

Obamacare in North Carolina

The federal Affordable Care Act was signed into law March 23, 2010, and affects residents of every state differently. Carolina Journal is reporting extensively on the impacts of the new insurance mandates, fees, and taxes on the quality and cost of health care in the Tar Heel State.

(11.12.15) Direct Primary Care Seen As Alternative To Insurance
RALEIGH — Amy Walsh remembers vividly the day she quit her job as primary-care doctor at a medical practice to seek a better way to provide health care. In a few weeks she will join nearly a dozen direct primary care family practices in North Carolina that deliver primary services for a monthly fee while not accepting medical insurance.

(11.10.15) Tillis Talks Energy, Budget With Activists
MOORESVILLE — Republican U.S. Sen. Thom Tillis talked Obamacare, energy policy, the federal budget, and the Export-Import Bank during a meeting with Americans for Prosperity activists during a luncheon Monday at the Langtree Plantation in Mooresville. He said that in some states, such as West Virginia, new emission standards from the Environmental Protection Agency would increase residents' energy bills on average an extra $1,200 annually.

(10.14.15) Experts: Government Impeding Medical Technology
GRAND RAPIDS, Mich. — Medical technology that seemed relegated to science fiction is at hand, but fast-moving innovations are threatened by established interests and government regulations, said a panel of medical and academic experts at the State Policy Network’s recent annual meeting in Grand Rapids, Mich. Advances in science allow personalized health care instead of government-regulated, one-size-fits-all, population-scale health delivery models.

(7.23.15) Mandating Our Way To Higher Health Costs
Even though Obamacare survived its latest Supreme Court challenge, some state lawmakers seek to add more mandates to the cost of health insurance.

(6.11.15) Obamacare Decision Will Affect N.C.
A court ruling striking down Obamacare subsidies could leave N.C. scrambling for new Medicaid money.

(2.26.15) CJ Editorial: With Medicaid, Patience Is a Virtue
The governors is wise not to expand Medicaid at a time the program is in flux.

(2.12.15) Obamacare Decision Will Not End Debate
If the Supreme Court rules that the federal government cannot issue subsidies to the 36 states using federal Obamacare exchanges, Congress may have to revamp the health insurance law.

(11.26.14) Counties Cut Hours, Jobs Due To Obamacare
RALEIGH — A partial survey of county and municipal governments conducted this month by Carolina Journal showed public workers being socked with fewer hours and decreased income, higher employee and government costs for health insurance, and local governments being hammered with a variety of taxes as a result of implementing the Affordable Care Act.

(11.20.14) Smaller Firms Brace For Obamacare Price Shocks
RALEIGH — The employer mandate in the Affordable Care Act, as Obamacare is formally known, requires businesses to provide health coverage for employees, or pay a $2,000 tax per worker. It also requires certain coverage provisions that ratchet up compliance costs. The mandates have been delayed twice for medium-size businesses employing between 50 and 99 workers. They will take effect in 2016.

(11.12.14) Poll: Medicaid Expansion A Loser, Say N.C. Voters
RALEIGH — More than half of North Carolina voters and 70 percent of Republicans would be less likely to re-elect Gov. Pat McCrory if he supported the expansion of Medicaid under Obamacare, according to a poll released today by the Foundation for Government Accountability. FGA senior fellow Christie Herrera says the poll finds “huge political consequences” for elected officials if Medicaid is expanded.

(9.23.14) Insurer: Obamacare Premiums About To Surge
RALEIGH — While North Carolina has been touted by supporters of the Affordable Care Act, as Obamacare is formally known, as one of the nation’s top success stories in recruiting uninsured people to sign up on the exchange, Rufus Langley, state leader of the North Carolina Association of Health Underwriters, predicted 10 percent of Obamacare participants may owe the IRS money at the end of the year.

(8.07.14) The Clash of Rights In Hobby Lobby
The tension between "positive" and "negative" rights will grow more prevalent.

(7.23.14) Supreme Court Likely To Settle Obamacare Dispute
RALEIGH — The D.C. Circuit overturned an IRS ruling that subsidies could be issued for Obamacare policies issued on the federal exchange, including those in North Carolina; the 4th Circuit upheld the IRS ruling. Because of the split decisions, legal observers believe the U.S. Supreme Court ultimately will decide the issue.

(6.26.14) Obamacare Sets Up SHOP
A plan within Obamacare that was sold as a way to expand health insurance options for employees in small businesses offers workers few enticements to get coverage.

(5.29.14) Unleash a Competitive Health Insurance Market
There are ways to cover "uninsurable" people without imposing new mandates.

(5.22.14) Obamacare Lawsuit Challenges Legality of ‘Death Panel’
RALEIGH — Attorney Christina Sandefur says the creation of the Independent Payment Advisory Board in the Affordable Care Act violates the separation of powers clause of the Constitution because it transfers congressional authority to an unelected executive branch agency. The language establishing the panel insulates it from congressional and judicial oversight.

(5.20.14) Democrats Push For Medicaid Expansion
RALEIGH — Medicaid expansion is an outgrowth of Obamacare. The federal government offered to pay 100 percent of the costs of newly enrolled Medicaid patients for the first three years in the states that expanded their eligibility, with the reimbursement rate shrinking gradually to 90 percent by 2020. But several analysts note that the Obama administration has altered the law in the past, so it's possible funding promises could be abandoned, too.

(4.17.14) The Vanishing Obamacare Mandate
The tax that once was viewed as the centerpiece of Obamacare is almost devoid of life.

(4.11.14) Burr Pushes Alternative to Obamacare
RALEIGH — Richard Burr, in his second Senate term, has no expectation that his or any other legislative health care proposal could become law until Obama leaves office in 2017. Yet he believes that Obamacare will be so unpopular when the next presidential race rolls around that even the Democratic nominee will have to promise to get rid of the president's signature health care legislation.

(3.20.14) Lawmakers Hear Dire Assessment of Obamacare Impacts
RALEIGH — State lawmakers were presented Tuesday with a litany of potential horror stories related to the federal Affordable Care Act. At its worst, Obamacare would sock North Carolina with thousands of job losses, double-digit insurance premium increases, deep Medicare cuts to help pay for the health reform, and insolvent hospitals and medical facilities.

(2.20.14) Burr Obamacare Replacement: Good Policy, Good Politics
The Obamacare replacement plan from Sens. Burr, Coburn, and Hatch would repeal the disastrous health care law and replace it with consumer-friendly reforms.

(2.12.14) Obama Exits the Fantasy
Will the administration really enforce the individual mandate on middle-class families while refusing the enforce the employer mandate on businesses?

(1.27.14) AARP Continues Push for Obamacare Medicaid Expansion
RALEIGH — State AARP officials Friday rolled out their 2014 legislative priorities, and among them were safeguarding Medicare from cost-cutting, expanding Medicaid, and helping more seniors not yet eligible for Medicare to enroll in the federal health exchange.

(12.11.13) Obamacare Supporters and Opponents Court Millennials
RALEIGH — A rhetorical battle over whether young adults should sign up for health insurance under the Affordable Care Act reached the White House last week, when President Obama called a conservative group’s efforts to inform so-called millennials about alternatives to the health care law “bizarre.”

(12.05.13) Americans: Failures of Obamacare Are Your Fault
Sen. Kay Hagan and other Democrats defending the new health care law are blaming consumers for purchasing insurance coverage they wanted.

(12.04.13) Butterfield Staff Eschews Switch to Obamacare
RALEIGH — Most of North Carolina’s congressional staffers — the men and women who work for the state’s two U.S. senators and 13 members of the U.S. House of Representatives — will be entering the District of Columbia’s health care exchange once the Affordable Care Act takes effect in January.

(12.03.13) JLF Report Explains Obamacare Problems Extend Beyond Troubled Website
RALEIGH — The federal health care law known as Obamacare creates more problems for North Carolinians than just the faulty website that has generated recent headlines. A new John Locke Foundation Spotlight report documents key Obamacare flaws and offers alternatives for addressing health care needs.

(11.25.13) Local Governments, Colleges Confront Obamacare Mandates
RALEIGH — With a few notable exceptions, government agencies in North Carolina do not expect a major hit from Obamacare mandates in the coming year. But that could change in 2015, when large employer requirements kick in for organizations such as the UNC system, where as many as 10,000 temporary employees could be affected.

(11.15.13) BCBSNC Scrambles to Assess Obama’s One-Year Cancellation Reprieve
RALEIGH — Blue Cross Blue Shield of North Carolina officials are scrambling to determine the impacts of accepting President Obama’s one-year delay in canceling policies that have been deemed illegal under the Affordable Care Act, also known as Obamacare.

(11.12.13) O’care Presentation Reminiscent of White House Talking Points
HILLSBOROUGH — Though a League of Women Voters presentation on the Affordable Care Act on Monday sounded more like talking points from the Obama administration than a current assessment of the national healthcare law’s impacts and flaws, some uninsured people in attendance said the session was informative.

(11.07.13) League of Women Voters Presenting ‘Unbiased’ Session on Obamacare
HILLSBOROUGH — An announcement for the session says it will provide "unbiased" information. But the website of the local League of Women Voters unit sponsoring the event states: "The League is opposed to a strictly private, market-based model of financing the health care system. The League also is opposed to the administration of the health care system solely by the private sector or the states."

(10.29.13) Officials: Obamacare To Have Modest Effects on State Health Plan
RALEIGH — The General Fund cost of operating the State Health Plan is expected to rise about $90 million from fiscal years 2013-14 to 2015-16, but that is a slower growth trend than in past years, officials say. Despite that mostly good news for taxpayers, the state has been besieged with calls from frustrated State Health Plan members, complaining they could not process their health plan selections for the coming year.

(10.24.13) Second Obamacare Lawsuit Gets Green Light In Court
RALEIGH — For the second time in recent weeks, a federal judge has issued a ruling favorable to plaintiffs seeking to block the IRS from collecting tax penalties from employers in states such as North Carolina that do not have a state health insurance exchange under Obamacare. If any of several lawsuits arguing against the IRS rule prevails, it would cripple implementation of the national health reform.

(10.23.13) N.C. Chamber Private Exchange Could Give Companies Options
CHAPEL HILL — The private exchange will allow employers to work around the coverage mandates of the federal Affordable Care Act, aka Obamacare, by letting employees select the coverage they wish to purchase. Rather than providing traditional, one-size-fits all defined-benefit insurance plans, employers would give employees a fixed amount of money (a defined contribution) to purchase the coverage they choose through the exchange.

(10.09.13) Oklahoma Lawsuit Could Derail Obamacare
OKLAHOMA CITY, Okla. — Oklahoma’s lawsuit claims Obmacare limits the collection of tax penalties from large employers that do not provide health coverage for their employees to those states that created their own health-care exchanges. Companies in states such as North Carolina and Oklahoma, which are using the federal exchanges, cannot be taxed if they do not provide employee health policies.

(9.26.13) Community Health Centers Hope To Survive Obamacare
RALEIGH — Concern is rising among community health centers that serve nearly a half million patients in North Carolina yearly — most of them uninsured — that Obamacare may drain away their patients and doctors. Meantime, officials say, patients are antsy about how the law will affect them.

(9.26.13) CJ Editorial: The Predictable Consequences of Obamacare
The president's health care law will increase costs, reduce coverage, and limit patients' choices. But we've been saying that for three years.

(9.23.13) Campbell Med School Seeks To Fill Gaps in Rural Coverage
BUIES CREEK — Campbell University expects to play a lead role in the transformation of health care delivery in North Carolina, and to aid ailing rural communities by sending them health care professionals from its new School of Osteopathic Medicine, school officials said Thursday. With plans to graduate 150 physicians and 40 physician assistants per year, Campbell could become the state's second-largest medical school.

(9.17.13) N.C. Chamber Considers Private Exchange Instead of Obamacare
RALEIGH — Private exchanges have developed as companies move away from traditional defined benefit plans and shift to a defined contribution model, under which the employer pays employees a set amount they can use to help pay for insurance the employees choose.

(9.16.13) Experts: Consumers Will Notice Absence of Competition in Obamacare
RALEIGH — North Carolina consumers could be the biggest losers after one of three insurance carriers that applied to participate in the Obamacare federal exchange announced its decision on Thursday to withdraw from the government-approved marketplace, health experts say. They cite the lack of competition in providing coverage on the individual market for consumers who will be required to purchase health insurance when the federal law takes effect in January.

(9.13.13) Obamacare Exchange Down To Two Insurance Providers
RALEIGH — FirstCarolinaCare Insurance Company is withdrawing from participation in the federal health exchange. Uninsured North Carolina consumers will have only two provider options from which to purchase policies approved by federal regulators and mandated under the Affordable Care Act (aka Obamacare) from the electronic marketplace.

(9.06.13) Obamacare Expected To Cause 80-Percent Spike In Average Individual Premiums
RALEIGH — Younger, healthy consumers representing one-third of individual Blue Cross Blue Shield of North Carolina policy holders would bear “substantial increases” to offset the costs of insuring older, less healthy populations and the requirements of the Affordable Care Act, BCBSNC officials acknowledged.

(9.03.13) Childhood Obesity Task Force Looks Into Home Visits
RALEIGH — The North Carolina Institute of Medicine’s Task Force on Early Childhood Obesity Prevention, which has spent the last two years brainstorming new policy ideas to decrease obesity in children, soon may go beyond school cafeterias and private child care facilities and take its programs right through parents’ front doors.

(8.22.13) Statewide Health Records Exchange Raises Privacy Concerns
RALEIGH — As the North Carolina medical community presses ahead with a sweeping conversion to electronic health records, privacy advocates warn that confidential medical data is in jeopardy, and patients’ most intimate health information could be used in harmful ways against them — or at a minimum mined for profit by pharmaceutical companies, medical providers, or other entities.

(7.12.13) Friday Interview: Obamacare and Religious Liberty
RALEIGH — The 10th U.S. Circuit Court of Appeals in Denver ruled recently that an Oklahoma City-based company, Hobby Lobby, could proceed with a lawsuit challenging a U.S. Department of Health and Human Services mandate linked to Obamacare. The mandate requires companies to provide insurance covering birth control. Hobby Lobby’s owners contend the mandate violates their religious liberty. Months before appellate judges handed down their decision, the John Locke Foundation and Federalist Society listened to a presentation on Obamacare and religious liberty from Eric Kniffin, legal counsel for the Becket Fund for Religious Liberty, which has worked with Hobby Lobby. Kniffin discussed the health care law’s impact on religious liberty with Mitch Kokai for Carolina Journal Radio.

(6.25.13) Stimulus-Funded N.C. Health Exchange Gathers Dust
RALEIGH — The North Carolina Health Information Exchange originally was charged with creating a state-level information technology clearinghouse to store patient medical records that could be used to expedite care and aid researchers and health providers across the state. Instead, few facilities and practitioners are using it.

(6.03.13) State GOP Officials Mum About Joining Obamacare Lawsuits
RALEIGH — One of the state’s largest business organizations is keeping a close eye on two federal lawsuits challenging the authority of the IRS to collect Obamacare taxes in states, including North Carolina, that did not set up state-run health insurance exchanges. Even so, GOP elected officials will not say whether the state should join the litigation.

(4.18.13) Blue Cross Policy Holders Could Pay More Under Federal Exchange
RALEIGH — Because Obamacare requires that insurers pay the government a 3.5 percent fee to sell their plans on the exchange, all Blue Cross policy holders would pay higher premiums if the giant insurer is selected to provide insurance plans on the federal health exchange that will operate in North Carolina, according to Blue Cross Blue Shield of North Carolina officials.

(4.12.13) Friday Interview: The Negative Impact of Health Care Mandates
RALEIGH — Much of the debate about the 2010 federal health care reform law involved the so-called “individual mandate,” the notion that the government could force everyone to buy health insurance. But that’s not the only troubling mandate tied to health insurance. Stephan Gohmann, BB&T professor of free enterprise at the University of Louisville, discussed health care mandates during a 2012 speech at Campbell University. Gohmann shared themes from that speech with Mitch Kokai for Carolina Journal Radio.

(3.26.13) Obamacare’s Impact on Low-Income Workers Debated
RALEIGH — Tax subsidies in Obamacare could push at least half of privately insured, lower-income North Carolinians into the federal health exchange and off of private coverage, critics of the federal health reform law say. Backers of the law say such “crowd-out” will be much smaller, perhaps less than 10 percent.

(3.06.13) Obamacare Takes Fiscal Hit
What is needed isn’t just flexibility on the use of Medicaid-expansion funds but also flexibility on products available in the health insurance exchange.

(2.15.13) Feds: Exchange Cost To N.C. = Zero
RALEIGH — Published reports that North Carolina must pay $181 million to the federal government annually as a consequence of failing to set up a state-run health exchange under Obamacare are false. The money would come from fees assessed on health insurance providers, according to the U.S. Department of Health and Human Services and the N.C. Department of Insurance.

(2.13.13) Bill Rejecting Key Obamacare Provisions Headed to House Floor
RALEIGH — Buoyed by Gov. Pat McCrory’s announcement that he does not support expanding Medicaid rolls or creating a state-run health insurance exchange, a state House committee voted Tuesday over Democrats’ objections in favor of Senate Bill 4, legislation rejecting the same provisions of Obamacare.

(1.16.13) Rally Urges Republican Officials To Nullify Obamacare
RALEIGH — Speakers at the Jan. 9 rally called on Republican Gov. Pat McCrory and Republican members of the General Assembly to return $73.5 million in what they called federal “bribe” money Democratic former Gov. Bev Perdue accepted to set up a state health insurance exchange under the federal Affordable Care Act.

(12.18.12) UNC Healthcare CEO Calls for Single-Payer Health Insurance
RALEIGH — Among the so-called myths Dr. Bill Roper attempted to debunk was the notion that “the American health care system is the best in the world” and President Obama’s promise that “if you like your health care the way it is, nothing about it will need to change.”

(12.14.12) New DHHS Secretary Wos Will Oversee Medicaid, Obamacare Exchanges
RALEIGH — Lame duck Democratic Gov. Bev Perdue signed up North Carolina for a federal-state partnership to create a health insurance exchange but McCrory, a Republican, said Thursday he has yet to decide whether to leave the partnership in place, create a state exchange, or opt out, having North Carolina join an exchange run by the federal government.

(12.10.12) McCrory Mum On Obamacare Exchanges
RALEIGH — The intent of the health care reform was for states to set up the exchanges, which are clearinghouses through which tax-subsidized health care plans would be offered to uninsured individuals and small businesses. If states don’t create their own health care exchanges, the federal government would offer its own.

(7.11.12) Insko: N.C. Will Create Health Care Exchange
CHAPEL HILL – While some states are opting out of expanded Medicaid provisions in the Patient Protection and Affordable Care Act, state Rep. Verla Insko confidently predicts North Carolina will participate in the expansion despite a temporary spike in costs to the state.

(7.06.12) North Carolina Democrats Divided On House Health Care Repeal
RALEIGH — Democratic Reps. Mike McIntyre of the 7th District and Larry Kissell of the 8th District say they will vote July 11 to repeal the Affordable Care Act. Retiring Reps. Heath Shuler of the 11th District and Brad Miller of the 13th District have not said what they will do.

(8.17.11) Perdue Bet Big on ObamaCare
It was foolish and irresponsible for North Carolina to stay on the health-policy sidelines while the representatives of dozens of other state governments remained engaged.

(5.12.11) N.C. Republicans File Brief Challenging ObamaCare
RALEIGH — On Wednesday, state legislative leaders joined Minnesota in filing a friend-of-the-court amicus brief in a 26-state lawsuit challenging the constitutionality of the federal health care law.

(4.01.11) Friday Interview: ObamaCare Earns Poor Marks in First Year
RALEIGH — Advocates of free markets and limited government raised red flags before Congress approved federal health care legislation last year. Now that the ObamaCare legislation has been in place for a year, critics continue to question its value. Sally Pipes is president and CEO of the Pacific Research Institute and author of multiple books on the American health care system, including The Truth about ObamaCare. Pipes discussed the legislation’s impact with Mitch Kokai for Carolina Journal Radio.

(3.23.11) ObamaCare Anniversary Highlights Need for N.C. Medicaid Reform
RALEIGH — North Carolina needs relief from a year-old federal health care reform law that will strain the state's budget, divert resources to Medicaid from other critical needs, and lead to worse health care in the state. A new John Locke Foundation Spotlight report reaches those conclusions. Today marks the anniversary of President Obama signing the Patient Protection and Affordable Care Act -- ObamaCare -- into law.

(3.08.11) VIDEO: GOP Seeks to Implement and Outlaw ObamaCare At Same Time
RALEIGH — Republicans in the House need to find four Democrats to join their caucus in voting to override Gov. Bev Perdue's veto of House Bill 2. At the same time, House Republicans are working on a bill to create health benefit exchanges mandated in the law. The constitutionality of the law likely will be decided by the U.S. Supreme Court.

(1.27.11) House Committee Passes ObamaCare Mandate Exclusion
RALEIGH — The bill advanced after less than two hours of debate. Democrats said the process was moving too fast. Republicans said members and voters understood the issues.