Under the Dome: NC lawmakers propose bipartisan bill aimed at lowering health care costs
Good morning and welcome to the Under the Dome newsletter. I’m Emily Vespa. First up, a dispatch from Avi Bajpai and Luciana Perez Uribe Guinassi.
State lawmakers have said additional Helene relief is at the top of their agenda as this year’s long session gets underway, but we’re also starting to see what other legislation could be quick to move through the General Assembly.
Among the emerging focuses is health care policy, with a pair of Senate committees set to take up legislation this afternoon that could help address rising costs, at least according to Rep. Donny Lambeth, a supporter of the bill.
“Health care has gotten to the point where it’s just so expensive” and in the General Assembly “we’ve done so much to help (health care systems) in terms of funding,” Lambeth, a key player in health care policy and a former hospital executive, told us Tuesday morning.
“I do think it’s time that they work with us to try to figure out how to reduce the cost of health care,” he said.
Lambeth said the bill helps tackle issues like duplication and lack of coordination within the system.
The Senate bill — introduced by Republican Sens. Jim Burgin, Amy Galey and Benton Sawrey, and sponsored by more than 20 other Republicans and two Democrats, former Minority Leader Dan Blue and Sen. Paul Lowe — does two main things:
Requires the repeal of one existing health benefit mandate — or certain regulations impacting a health benefit plan or the State Health Plan — for each new mandate added.
Regulations subject to this include those that mandate coverage of health care services, place requirements on cost-sharing mechanisms like copays and deductibles, and regulate cost-control mechanisms like prior authorizations.
Requires that any legislation containing one or more health benefit mandates include a provision appropriating recurring funds to the State Health Plan or another relevant state agency.
Research shows health care mandates can be costly but can also be beneficial, as they protect access to essential services.
While the state treasurer’s office did not request the bill, it supports the legislation, according to spokesperson Loretta Boniti.
“Runaway health care prices are a problem for everyone in our state, and the State Health Plan is unfortunately no exception,” State Treasurer Brad Briner said in a written statement shared by Boniti.
“It helps to address one of the root causes of health care inflation — unfunded mandates that can unnecessarily add to costs. We are happy to support this worthy effort to begin the process of getting health care cost growth in line,” Briner said.
The State Health Plan provides health insurance to approximately 750,000 state employees, teachers, retirees, and family members. It is facing a $507 million deficit under the plan, Briner has said. Thomas Friedman, the new executive administrator of the State Health Plan, will testify in support of the bill at the committee hearing Wednesday, Boniti said.
— Avi Bajpai and Luciana Perez Uribe Guinassi
ICE MAKING ARRESTS VIA WAKE SHERIFF’S OFFICE
The Wake County Sheriff’s Office confirmed last week that it has received detainer requests from U.S. Immigration and Customs Enforcement and turned over custody of an unspecified number of individuals sought by the federal agency since the Trump administration began on Jan. 20.
Rosalia Fodera, a spokeswoman for the sheriff’s office, told The News & Observer that ICE had issued an unspecified number of detainers — requests for local law enforcement to temporarily hold individuals ICE believes are in the country illegally, to allow the agency to take custody — and made arrests.
Fodera said the sheriff’s office uses a record-keeping system that doesn’t allow it to retrieve the total number of detainers issued in that time, and referred The N&O to ICE for the number of arrests the agency made through the Wake sheriff’s office.
ICE spokesperson Lindsay Williams declined to comment.
Meanwhile, the Durham County Sheriff’s Office said it received nine detainer requests in January, seven of them since Jan. 20. Spokeswoman AnnMarie Breen said ICE hadn’t taken anyone into custody.
The Orange County Sheriff’s Office said it hadn’t received any detainer requests.
In a statement, Wake Sheriff Willie Rowe said his office “has been and will continue to conduct meetings with federal officials regarding immigration enforcement,” and is “currently awaiting any future directives to come down that would impact the actions of this office.”
Rowe said his office is honoring detainer requests as required under House Bill 10, the ICE cooperation law enacted last year that targeted Rowe and other sheriffs in Democratic counties who had vowed to limit their cooperation with the agency.
At the same time, Rowe said, he doesn’t want “our community to fear interacting with the Wake County Sheriff’s Office, especially if they are in need of assistance.”
Rowe said the sheriff’s office has seen an increase in misinformation about raids and enforcement operations being shared online, and discouraged people from sharing unverified information.
“Inaccurate information posted on social media can cause fear and make our immigrant community hesitant to call for law enforcement assistance, thus increasing the likelihood that they may become victims of crime,” Rowe said.
— Avi Bajpai
NEW HEALTH SECRETARY SAYS ACCESS TO CARE, CHILD WELFARE ARE PRIORITIES
North Carolina’s new secretary of health and human services, Dr. Devdutta Sangvai, just finished his first month leading one of the state’s largest agencies. He told Luciana Perez Uribe Guinassi that he’s planning to focus on bolstering Medicaid, expanding access to care and addressing the state’s health care worker shortage.
Gov. Josh Stein appointed Sangvai, who is the first Indian American cabinet member under a North Carolina governor. Sangvai is a family medicine physician and Duke University professor, and he previously served as president of Duke Regional Hospital and the North Carolina Medical Society.
Though congressional Republicans have reportedly considered cuts to Medicaid spending, which could jeopardize North Carolina’s Medicaid expansion, President Donald Trump on Friday said he wouldn’t target Medicaid unless his administration finds fraud or abuse.
Sangvai said North Carolinians worked to achieve a bipartisan agreement for Medicaid expansion, and he’s hopeful that the same “spirit of collaboration and consensus building” can help the state navigate any potential program changes at the federal level.
Read the full Q&A with Sangvai here.
FEDERAL COURT RULES AGAINST RIGGS IN NC SUPREME COURT LITIGATION
GOP state Supreme Court candidate Jefferson Griffin’s challenges to over 65,000 ballots will be heard in state court this week after a federal appeals court ruled against his opponent on procedural grounds, reports Kyle Ingram.
Democratic incumbent Allison Riggs and the State Board of Elections asked the 4th Circuit Court of Appeals to hear the case, arguing it implicated federal election laws. But since the North Carolina Supreme Court dismissed Griffin’s attempt to bypass lower courts — the case Riggs and the State Board asked a federal court to consider — the 4th Circuit ruled the issue moot.
A Wake County Superior Court judge will hold a hearing on the case Friday.
WHAT ELSE WE’RE WORKING ON
Top Republican lawmakers in the state legislature are backing a bill to allow permitless carrying of concealed handguns, reports Avi Bajpai.
Stein said there will likely be less revenue and greater demands on the state budget this year, meaning the state is heading toward “an era of fiscal tightness,” reports Dawn Baumgartner Vaughan.
Today’s newsletter was by Emily Vespa, Avi Bajpai and Luciana Perez Uribe Guinassi. Check your inbox tomorrow for more #ncpol.
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This story was originally published February 5, 2025 at 5:00 AM.
