Under the Dome

May 14, 2014

NC proposal to limit Affordable Care Act sidelined

A North Carolina legislative proposal to limit the Affordable Care Act ran into trouble because it would kill a proposal to expand health insurance coverage for autism.

A legislative proposal to limit the Affordable Care Act was sidelined Wednesday because state House members feared the measure would inadvertently kill a bill to expand health insurance coverage for autism.

The legislative impasse blocks a Republican strategy to highlight the Affordable Care Act’s economic damage in North Carolina and impose a one-year moratorium on new health insurance mandates from the Obama administration.

The proposal before the Joint Study Committee on the Affordable Care Act and Implementation Issues wasn’t defeated by a vote. Rather, opponents simply didn’t show up for Wednesday’s hearing, which required a quorum of at least 23 legislators.

It was the third time in the past two days that opponents boycotted a vote by not showing up. But Wednesday’s meeting was the last chance to keep the anti-ACA package alive before the legislature convened for the short session.

“Anytime you have three committee meetings where members don’t show up, that’s an organized effort,” said Rep. Charles Jeter, a Republican from Mecklenburg County.

Jeter was troubled by the proposed legislation because he supports requiring health insurance coverage for certain autism treatments. He had planned to introduce an amendment to save the autism bill; it would have said the moratorium on new health care insurance mandates didn’t apply to autism coverage.

But he was unsuccessful in convincing his colleagues to come to the legislative office building for the vote.

“One thing you have to understand: Not all mandates by definition are bad,” Jeter said. “Sometimes we let terminology get in the way of good decisions.”

He said requiring autism coverage is a “good mandate” and compared it to requiring polio vaccinations. Jeter is the president of Intermodal FCL, a Huntersville trucking and logistics company.

“If we catch these children early and give them this treatment, their ability to function in life is exponentially greater,” Jeter said. “They can lead human lives with a treatment that’s affordable and readily available.”

The autism bill has been adopted in some form in 37 states over the objection of health insurance companies. North Carolina’s version passed the House last year 107-5 but stalled in the Senate. Supporters are urging the Senate to pass it soon.

The bill would require North Carolina health insurers to cover a behavioral treatment to help children with autism learn how to respond to others and interact with them. Insurers say the therapy is more educational than medical and should be paid for by school systems. Blue Cross and Blue Shield, the state’s biggest health insurer, opposes the bill.

Jeter said parts of the anti-ACA bill could be resurrected in the short session by being added to other bills, but the mandates will remain a point of contention.

Other aspects that could have less difficulty: assessing the Affordable Care Act’s economic cost to the state, and requiring insurers to inform customers how much of their premium is because of the health care law.

Supporters included Republican Sen. David Curtis, an optometrist in Lincoln County. He said the committee’s public hearings pointed to widespread discontent of small-business owners over rising insurance costs.

“It was a big disappointment,” Curtis said. “We thought that when the House leaders agreed to this meeting and this agenda, that we could take it to the bank.”

Republican Sen. Fletcher Hartsell Jr, a Concord lawyer, was also surprised by the opposition that could stymie proposals to limit the Affordable Care Act.

“I didn’t know the autism bill existed until last Thursday afternoon,” Hartsell said.

The bill passed the House last May, but the Senate sent it to an insurance committee and never brought it to the floor for a vote.

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