NC lawmaker wants oversight of WakeMed-Atrium merger + When to expect a budget bill

Good morning and welcome to the Under the Dome newsletter. I’m politics reporter Luciana Perez Uribe Guinassi.

After a whirlwind Tuesday, when top Republicans announced they had reached an agreement on raises, taxes and funding for a children’s hospital — three sticking points in budget negotiations — Wednesday brought a slower pace. We reporters have been using that bit of breathing time to ask more questions and sort out details about what has been shared so far.

No budget bill has yet been released, and one isn’t expected for several weeks, with Rep. Donny Lambeth, a top Republican budget writer from Winston-Salem, saying during Wednesday’s House session that the week of June 15 “could be a very busy week,” with a final conference report possible then.

A conference report is the final, negotiated document produced by legislative leaders to resolve differences between the House and Senate versions of a bill.

Here are some stories to read about what is known so far about the budget deal:

• Police, teachers, state workers set to get raises in NC budget deal. When and how much
• What NC budget deal means for your income tax rate, and how you can vote on it
• NC budget breakthrough has over $200 million for Duke-UNC children’s hospital
• NC Republicans have a deal on the overdue state budget, with raises and tax cuts

WakeMed and Atrium merger oversight bill

And while budget negotiations are the main focus right now at the legislature, lawmakers have also filed bills since the session kicked off on April 21. There have also been several lobby days and press conferences. Topics of discussion have included proposals on liquor laws and hemp, tobacco and marijuana regulations. They’ve also included a bill dealing with hospital mergers.

The WakeMed and Atrium proposed merger has raised questions — especially after news of it came via a news release on a Friday afternoon, with a vote scheduled for the following Monday by Wake County commissioners to amend WakeMed’s articles of incorporation as well as a transfer agreement. Commissioners have since delayed their decision by 90 days, and WakeMed will hold a series of public forums on the topic.

The way this was rolled out has led one lawmaker to file a bill that would increase oversight by Council of State members.

That lawmaker is Sen. Jim Burgin, an Angier Republican who is chairman of the Health and Human Services Appropriations Committee, who told The News & Observer he first heard a rumor about the merger three or four weeks ago. He reached out to Atrium contacts but “they would neither confirm nor deny” and so “I took that as a yes.”

“A lot of people are afraid of what it’s gonna do to costs, and Atrium and WakeMed — as big as they are ... should have brought this out months and months ago, had discussion, answered everybody’s questions and been very transparent about it. I think that’s the problem that people have with health care, with hospitals, is there’s no transparency in pricing. There’s no transparency in things like this. And I think it could have been handled completely differently,” Burgin said.

Thad McDonald, a retired OB-GYN who heads the WakeMed board of directors, spoke during an Atrium-WakeMed joint press conference last week to share details and lay out the vision and benefits of the merger. He said he is “acutely aware of the angst this announcement has caused with staff, with community leaders and with patients, and will say at the outset I completely understand.”

“When first presented with the possibility, our executive committee felt the same thing. But after two years of due diligence, we came to see the pure beauty of it,” McDonald said, as The N&O previously reported.

On the two-year process, Burgin said “they’ve done a really good job, they kept it quiet. Almost everybody that works for WakeMed didn’t know anything about it.”

“A lot of their key people didn’t know anything about it. None of their doctors knew anything about it,” he said.

Approval of what will happen with the WakeMed and Atrium merger will first fall on Wake County commissioners and could draw scrutiny from the Federal Trade Commission, along with the North Carolina attorney general’s office, as The N&O previously reported.

Burgin’s bill — Senate Bill 978 — would give the state the power to review and potentially block any deal worth more than $5 million where hospital assets are sold or taken over. The state attorney general, auditor and treasurer would need to be notified and would have up to 90 days to review the deals. Public hearings would be required, and they could sue to stop a deal.

Asked about Burgin’s bill, Senate leader Phil Berger told reporters last week that the merger “does bear some digging into.”

“We’ll see what the county commission does, as far as review is concerned. I also understand that there are other folks who have expressed concerns that may conduct their own review,” Berger said.

“Consolidation in the healthcare industry is fairly rampant. It happens on a regular basis. It sounds like the Atrium folks, the WakeMed folks, and maybe even the county commissioners, have been involved in conversations about this for some time,” he said. And so “hopefully in the days and weeks ahead, we’ll find out a little bit more about the background and the merits.”

Headlines you won’t want to miss

• ‘Modernize’ NC’s liquor laws? A group is pushing for change after others failed
• GOP health leader targets NC’s laws on pot, hemp and tobacco. Will it pass?
• Why NC’s Rep. Valerie Foushee is introducing a bill to end the war in Iran
• A super PAC is making a major investment in North Carolina’s Senate race
• Top coronavirus researcher Ralph Baric will retire from UNC-Chapel Hill

Thanks for reading Under the Dome

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Kyle Ingram contributed to this report.

Luciana Perez Uribe Guinassi

The News & Observer

Luciana Perez Uribe Guinassi is a politics reporter for the News & Observer. She reports on health care, including mental health and Medicaid expansion, hurricane recovery efforts and lobbying. Luciana previously worked as a Roy W. Howard Fellow at Searchlight New Mexico, an investigative news organization.