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Carolina Journal Radio No. 727: House tackles hog farm nuisance lawsuits

Carolina Journal Radio / Donna Martinez and Mitch Kokai
The Truth Network Radio
April 24, 2017 12:00 am

Carolina Journal Radio No. 727: House tackles hog farm nuisance lawsuits

Carolina Journal Radio / Donna Martinez and Mitch Kokai

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April 24, 2017 12:00 am

The N.C. House has approved legislation that would limit the amount of damages neighbors could collect in nuisance lawsuits against hog farms and other agricultural operations. But a key amendment stopped the bill from applying to the hundreds of lawsuits already filed against the world’s largest pork producer, Smithfield Foods. Carolina Journal Editor-in-Chief Rick Henderson analyzes the debate over new limits on nuisance lawsuits. North Carolina has seen dramatic improvements in recent years in the libertarian Cato Institute’s report ranking Freedom in the 50 States. The report’s co-authors are William Ruger, vice president for policy and research at the Charles Koch Institute, and Jason Sorens, program director at the Political Economy Project at Dartmouth College. Ruger and Sorens recently visited North Carolina to brief lawmakers on the reasons for North Carolina’s climb to its current No. 19 ranking. They also offered ideas for state policy changes that could raise that ranking even higher. North Carolina needs a full-scale rewrite of its criminal code. That’s the argument from Jessica Smith, professor at the UNC-Chapel Hill School of Government. During a recent public forum, Smith explained how recodification would clarify and simplify the state’s current system for identifying crimes. Prospective charter schools would get more time to amend their applications and secure state approval, under a policy change North Carolina education officials debated this year. Alex Quigley, head of the state Charter School Advisory Board, explained to the State Board of Education that the existing charter school approval timeline had created unnecessary obstacles for some prospective charters. State education board members signaled support for changes that would help more worthwhile charter school proposals move forward. Four Republicans in the N.C. House have filed a bill called Carolina Cares that would expand the state’s Medicaid program. It’s based on ideas Indiana employed to expand Medicaid when Vice President Mike Pence was Indiana’s governor. Katherine Restrepo, the John Locke Foundation’s director of health care policy, assesses the Carolina Cares proposal and offers alternative ideas for improving health care access in North Carolina.

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From Cherokee to current and the largest city to the smallest and from the statehouse into the schoolhouse Carolina Journal radio your weekly news magazine discussing North Carolina's most of public policy events and issues welcome to Carolina Journal radio amateur coca during the next hour, Donna Martinez and I will explore some major issues affecting our state. North Carolina ranks number 19.

In a recent state-by-state assessment of freedom why and what can the state do to rank even higher will ask the authors who compile the rankings. North Carolina's criminal code is so confusing it needs a complete rewrite.

That's the assessment of a professor from the UNC school of Government. You'll hear her argument you learn how an up-to-date criminal code could benefit normal law-abiding people speaking of rewrites, advocates for public charter schools of argued for a change in the charter approval process. They want to ensure the timeline for approvals doesn't trip up worthwhile charter school plans and some North Carolina Republicans have joined the chorus supporting Medicaid expansion in the state hear an assessment of their proposal. It's called Carolina cares the John Locke foundation's top healthcare expert offers her critique.

Those topics are just ahead.

First, Donna Martinez joins us with the Carolina Journal headline is playing out as a tug-of-war between lawmakers who say they're trying to protect North Carolina farmers and other lawmakers who say they are trying to protect the rights of property owners at the center of this debate.

Hog farming in North Carolina and those who say that there impacted by it in a negative way.

Rick Anderson is the editor-in-chief of Carolina Journal. He's been reporting on this fascinating story legislation making its way through the Gen. assembly, Rick welcome back. Thank you. All right, let's get a layout for our listeners what what the debate is here. Those folks who are say their supporting farmers.

What is it that they want what they want is they want a provision in state law that would limit the amount of damages that could be paid under certain nuisance lawsuits mainly in this case, narrowly targeting all hog farmers and what happens when they spray the link. The waste lagoons when, for instance, the during the hottest part of summer. If flies or other critters else. It is where you have a good you have four beautiful flies and insects that go cross off the property lines and can affect your neighbors and what they want to do is I want to say you can sue for a nuisance, but you can only recover actual damages equal to the value of the property for the nuisance and instead of suing for other sorts of damages such as will see if there are health issues involved with this if someone is is if their asthma condition is worsened symptomatically because of the because of the smell the odor the pollution.

Whatever the water quality is damaged and limited in damages in this case you can't get to fuel punitive damages compensatory damages for those of us who maybe watch Judge Judy. It sounds sort of like you're describing almost the pain-and-suffering type aspect of recovering damages. Okay, so that's what they're wanting to tell us what those who say that they are supporting property rights want out of this.

What they would like to do is to have no there there are several arguments or making the immediate argument with this bill is that there should be a respect of the common law principle that a nuisance can involve mortgage damage to property that can involve making your home unlivable. It can damage or quality of life in a very perceptible and measurable way.

And so they want the current set of limits to stay in place which allows collection punitive damages in the else think that they also argue that if you're wanting to enact something like a tort reform provision which is what this is. You said shouldn't just single out what industry you should have this comprehensive you shouldn't pick winners and losers as this particular bill would do so before you get into the other aspect will, which is the litigation that inspired this what they're saying is if you want to set limits it to tort claimant's damages. Let's not say only for this industry and offered every other industry now hog farming in North Carolina. No matter how long you've lived here. You probably already realize that this is huge. Yes, that big industry. In fact, one of the largest pork producers in the in the world and the company that's involved at the center of this dispute.

Smithfield Foods, which is the largest pork producer. There is litigation that involves Smithfield firm. Tell us why this legal case is even become part of the conversation as it relates to this debate in the Gen. assembly first lawsuit was filed against Smithfield and some other small farmers, some of whom contract with Smithfield 2014 involve seven lawsuits initially. Now it's up to 26 separate lawsuits in more than 540 plaintiffs involved and cases have all been consolidated in federal court, even though there suing under state nuisance law been consolidated in federal court and the interest in getting this particular bill passed as originally written, was to have it apply to the case that's now in court, so it would interfere with existing litigation.

The reason for this is decided by the supporters of the hog farmers is that cases sort of stuck right now because the judge Earl Britt federal judge involved in the case is said that North Carolina statute is unclear about how damages should be provided and what is what what the defendant Smithfield's writing is a temporary nuisance. Others are saying this is not something that bothers you all the time. This is something that happens under certain weather conditions during certain seasonal cycles of the hog production process, and that this should not be considered a permanent nuisance if it were permanent. Nuisance law is very clear about that, but the laws from silent on how to handle temporary nuisance is. So that's why hog farmers want to reach into this lawsuit in place of damages really interesting in your reporting on this because you were there and that your listing to some of the debate among the legislators and there was some comments that I thought were particularly fascinating. From my state representative Joe John who talked about whether or not the legislature should really try to do something involving litigation current litigation right. Joe John is a former member of the US chorus you North Carolina Court of Appeals who recently will in the legislative seat.

I wake County and in representative.

John said this is a set. This is potentially separation of powers dispute because what were actually having is the legislature stepping in and trying to weigh in on one side of another of a judicial matter. That's actually ongoing right now and we got similar sorts comments from that from Republicans are represented John Bloss of Guilford County representative Hugh Blackwell from Burke County who both were saying that we only get involved in a situation like this because there is this concern that we are trying to pick winners in an ongoing lawsuit. What they also said by the way as other Democrats joined this argument, saying that when Judge Britt said in his water North Carolina statute is not clear about what role damages should play here. He was simply stating facts. He was saying the law doesn't have clarity now hog farmers and their supporters in general simply said Judge Britt was saying you need to give us guidance you I know which way to go here and there was. I know he was simply saying it's not clear so Rick in the hog farming industry obviously very powerful, influential forces them hog farming is is a huge part of the North Carolina economy. Yet we also have a general assembly where you have a lot of legislators who are really committed to preserving and protecting property rights of every North Carolinian so it's a really interesting tug-of-war. I think that that is going on. Is there any way for folks to meet in the middle on this. What happened to make this to resolve this issue for now, anyway, was that representative Bloss to I mentioned earlier, proposed amendment which would simply say, this law cannot affect ongoing litigation and he said he essentially said if you want to.

If you want to narrowly pass a tort reform bill affecting only form hog farmers. Okay, I'm not crazy about it.

But if we do that, then let's make sure that were not getting involved with lecture that were not deciding a case for one on one side or another. Right now, that's what they did. It was a very narrow vote of 59 to 56. But the all the underlying legislation then passed and it's not exactly clear if Gov. Cooper will sign it if it ever gets to his desk while it is a fascinating story for sure, and Carolina journal has been covering this quite extensively. Rick Anderson has been reporting on it. He's been our guest here of course is the editor-in-chief of Carolina journal and Carolina journal.com stay with this much more Carolina journal radio to come in just a moment government plays a key role in your life affecting your paycheck the way you educate your kids the way you do business. How can you tell if government is doing a good job making the right choices. Spending tax dollars wisely. Carolina journal.com tackles those questions every day.

The John Locke foundation publishes Carolina journal in print each month and on the web each day@carolinajournal.com you'll find exclusive investigative reports on topics. No one else is covering what else a rundown of the best new stories, editorials and opinion columns in North Carolina. John Hood's daily Journal news stories and important public event set Carolina journal.tv and the voices of the newsmakers themselves. Carolina journal radio and print on the air and on the web. You can find the information you need@carolinajournal.com welcome back to Carolina journal radio I Michiko got fans of the John Locke foundation know that this think tank is promoting the goal. First, in freedom, that is, making North Carolina the freest state in the nation. There's some good news on that front.

Courtesy of the libertarian Cato Institute joining us now with the tales are the authors of a new report from Cato that offers that good news William Ruger is vice president of policy and research at the Charles Coke Institute Jason Sorensen is a lecturer, and program director of the political economy project at Dartmouth College. Welcome to both of you thank you thank for having us so that some good news on the front of freedom for North Carolina and that is thanks to this of report that Cato puts out freedom in the 50 states tell.

So tell us what it says about North Carolina well. North Carolina is not one of the very top states on freedom that we do show increased since 2010, so we look at freedom in three different areas. Fiscal policy, which has to do with taxes and government spending regulation which has to do with restrictions on business, especially, and personal freedom which has to do with lifestyle freedoms as well as things like educational choice we find the North Carolina has improved specifically on fiscal policy taxes have fallen over the past few years and in educational freedom. When you look at the various states and how they're going up and down on these rankings did North Carolina's improvement to stand out to you to. I think it does. So you North Carolina's estate that had declined some from 2000 to 2010, so it had fallen little behind a number of other states, especially in the region and so North Carolina sticks out as a state that has improved on several policies across the board. Since then, however we do know that there are some areas were North Carolina does stick out for still being much less free than the average state yes oh. One of those one big he is, occupational licensing, which really is not really talking about whether medical doctors are license are talking of the whole range of things in which people have to get government approval to actually earn a living and make their lives better for them and their families and North Carolina has way too many of those and really could improve by limiting many of these a lot of times these occupational licenses really are ways in which people in those professions can keep out new entrance, which audit which essentially is a way of what economists call rent seeking is a way of boosting their profits at the expense of others who are able to get into that profession and compete. That is the voice of William Ruger. You also heard from Jason Sorensen.

You looked obviously in putting together this report at all of the 50 states.

This of general trends that you saw either good or bad. Well, we didn't definitely see that the federal government has generally played an adverse role in freedom at the state level federal courts of played a good role in increasing personal freedom, but when we look at France's health insurance regulation that used to be an area where states could try different things now have a one-size-fits-all federal law and that has significantly reduced freedom among all 50 states because now they're forced to conform to this one highly regulated model or any other outstanding trends that that that you think the state should pay attention to what one thing I think you pay attention to is the fact that you're roughly in the same general neighborhood of freedom with your neighboring states.

States like Virginia and South Carolina, but compared to Tennessee you perform a lot less well.

So Tennessee is one of the freer states in the union. It's a top-five state and having that competitive edge in your neighborhood is something that Allstate should try to take advantage of you so you don't do so have to be the freest state in the union, which would be great if you try to push towards that. But even if you could be in Indiana say in the Midwest which is freer than states like Illinois, or you could be in New Hampshire, which is freer than the states like Massachusetts, Vermont and Maine, or even be Arizona, Nevada, in a territory where your near California which is one of the least free states in the country so is our folks here North Carolina are looking for ways to improve on freedom you mentioned occupational licensing.

Another thing they might want to do was see what Tennessee is doing and see what works there that might work here exactly.

I mean, not to mention the fact that you can just look across the 50 states and use the data we have in our study to compare yourself off so something I used to tell people in Texas a lot when I lived there was. Look, you'd be surprised.

But Vermont which is very liberal or blue state right Bernie Sanders territory has better gun laws when it comes to gun freedom in Texas to us and they say no no no no way you look at the date it was very clear that Vermont was doing better than Texas and that puts you know, the onus on a state that cares about freedom or claims to care about freedom to say maybe we need to do things a little bit better here. You brought up something that's a very important point, and that is that states that are looking to become more free can look at this report and find easy substitute things they could do that would make themselves more free.

It's not just this sort of floating in the ether idea of more freedom. You could actually find policies in other states emulate them and see your own state become freer rightly so. Justice Brandeis talked about how the state circuit of laboratories for democracy in a lot of ways he's talking about. You know them experimenting with progress reforms, but I think the people care about freedom can also look to different states in our data and just kind of our our confederal system that we have in this country allows us to see what other people are doing to improve in a freedom enhancing direction and you can just look around because a lot of times people might say, well, that won't work. How could that work wakens I will look at is working in Oregon or it's working in New Hampshire or it's working Tennessee tickly when you're close to that area. So Tennessee or South Carolina or Virginia would be good examples for North Carolina .2 because these are relatively similar states in certain ways yeah I'm in the other point I would make is that there's no policy in this study that is crazy extreme, you know, beyond beyond the pale. Because they're all policies that at least one state has been trying so you know it. If you simply became as free as the freest date on all the dimensions that we look at EB vastly ahead you all the other states and you wouldn't be some sort of libertarian utopia eats, it would just be the most free market state on all these dimensions and that would be enough to make you really stand out and it really matters, so this isn't just us saying that we like free and therefore you should adopt these policies.

I hope you would love freedom enough that you want to adopt freer state regimes, but the fact is that it also affects other kind of consequences. So, for example, it affects economic growth. It affects whether citizens leave and pick up and go to other states or whether you're there or you're attracting other citizens and their jot those jobs in those businesses and that matters a lot when you state like New York, for example, lost more than 10% of its 2000 population over the last 15 years. What that means is that that means that if your cute you are raising your kids in upstate New York. They're more likely to leave the estate and move to a freer state, and there's nothing wrong with that for their own kind of in a life project, but the fact is, is when we like to have opportunities for people in our own communities and we can do that through attracting the kind of people and jobs that will allow us to flourish yet surprised us a little bit. Actually when we first started this we thought well maybe people move for jobs and so maybe economic freedom would attract people simply because it creates a better economic environment that does seem to be true about. We also found that people seem to move for personal freedom so people are moving from states with less personal freedom to states with more personal freedom and no matter what we control for this comes out in the statistics outside. It's really interesting finding.

That's not just the people are moving to the places that have better weather. I mean certainly North Carolina benefits from that. When you even control for that statistically you're seeing that people are voting with their feet for more free states will North Carolina ranks number 19 in this latest of reports, the Cato freedom in the 50 states report that does mark improvement, but there's also room for even more improvement. We thank William Ruger and Jason swords. The authors of this report. Thanks for joining us for having us will have more on Carolina journal radio interest among are you looking to make North Carolina more free the John Mott foundation is in here are three things you can do today to help us make it happen.

First, know the facts visit John Mott data work for data analysis, interviews, and more and read Carolina journal.com to learn what government is doing with your money.

Second, influence the debate invest in the John Mott foundation's work with a tax-deductible donation you can get it done in lessthan92@johnlocke.org and third make North Carolina more free by sharing the message of freedom. It's easy when you visit John Locke.org.

Click on shareable's download past messages to freedom. Dear friends, print the messages and mail them, or if your savvy computer user share the message of freedom on Facebook and Twitter know the facts influence the debate and share the message three things you can do today to help us make North Carolina more free. Get started today@johnlot.org North Carolina is changing not just day-to-day but outward to our minute to minute and 2nd to 2nd, how can you keep up with the changes, especially the ones that affect you, your family, your home, your job, make the John Locke foundation and Carolina journal part of your social media diet on Facebook like the John Locke foundation like Carolina.

Journal follow us on Twitter at John Locke in the sea and at Carolina journal news, insights and analysis you'll find nowhere else. Thanks to the experts at the John Locke foundation and thanks to the first-class investigative reporting of Carolina journal. Don't wait for the morning newspaper. Don't wait for the evening news if it's happening now it's happening here the John Locke foundation and Carolina journal. Have you covered with up to the second information like us on Facebook the John Locke foundation and Carolina journal follow us on Twitter at John lock NC and at Carolina journal did you know you can now advance freedom and free markets just by shopping with Amazon it's true online shopping is now a great way to support the John lock foundation just shot using the Amazon smile program and designate the work foundation to receive a portion of your purchase amount that's right you shop and Amazon donates money to ask the John lock foundation. So here's how it works long time to smile.amazon.com Amazon smile.

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Don't forget log on to smile.amazon.com today by something nice and help defend freedom. Support the John lock foundation will go back Carolina radio amateur coca some North Carolina legal reformers or focusing on a concept called mens rea meeting that people need to have a guilty mind to be convicted of a crime, but during a recent forum on the topic, you would see Prof. Jessica Smith raised a larger issue or problem. North Carolina streamlined comprehensive quarterly principal because of the number one efficiency in the system which drives up off for every body in the system also needs for opportunities for unfairness and I think actually the criminal law so I streamlined comprehensive principal chapter 14 North Carolina Gen. statutes that is entitled are criminal, criminal, most of the codified offenses in North Carolina by Alan E offenses can be found in 53 separate chapters errors can be found in one country. Separate chapters on law we delegate authority to create criminal law to a ministry boards and mountains.

So for example, the Board of dental examiners is allowed to create by regulation services without specifying whether he is a generalist or specialist.

In addition to administrative North Carolina law authority to see counties, politicians create some North Carolina population just over 5000 has a local ordinance that will allow chickens to be at large. A person who allows chickens to be at large, class III misdemeanor. Under North Carolina law patient had asked our close department is codified.

We dealt with a host of principles that are sensual to criminal law that's you and see Prof. Jessica Smith. She's making the case for reform of North Carolina's overly complicated criminal code reform would require action from the Gen. assembly will return with more Carolina journal radio. Are you tired of fake news. Well you won't find it here at Carolina journal. We don't make things happen and we don't presume or assign motives.

There's no simpler way to put it then that were proud to say that honest, factual, rigorous journalism is the Carolina journal way our reporting team is focused on accountability in government and policymaking. No matter which political party is in power, and regardless of the person taken to task in the story, Carolina journal where beholden to the truth and to transparency. Unlike fake news lies, innuendo, questionable sourcing all meant to create controversy not inform the debate. So the next time you're confronted with fake news log onto Carolina journal.com or pick up the latest print edition you'll find compelling news reporting from a team that knows what it means to be real journalists committed to truth Carolina journal. You can count on us for the facts. Look back Carolina journal radio amateur coca to new North Carolina charter schools need more time to address regulators concerns Alex Quigley think so. The head of the state charter school advisory board recently explained why during a presentation to the state school board part of this buildup of last summer when we had some recommendations that came back that were denied at at the state board level was very late in the season so you have schools that have been approved as early as February or approved or recommended at the charter school advisory board level sent to the state board but then the denial came in August we get the rent. Final recommendations to you all until June and July was a called meeting and wanted to make those decisions that so we want to avoid this because time is of the essence when you're opening school and the sooner a school can begin laying the groundwork, even if they haven't been formally approved by the state board, but they are beginning to put things in place and then once they get that approval from the civil we want to want to empower the schools that have that recommendation and have been approved have as much time as possible select one so we are working really hard on our side to get the recommendations to you as soon as possible so that all decisions by this by the state board he made by G what would happen in June or June meeting you would give give us a recommendation for you. It made your final decision based on our recommendation and if in the case of the denial we are asking that you would send that school back to us for us to have another opportunity to review again and send another recommendation forward.

So there are so in that situation. A school will be snow in June. Hey you're actually in a different situation than the schools that had been formally approved by the state board in June. So were kind of trying to move this process more quickly. I sat through three days of applicant review meetings just a couple weeks ago so we're working really hard to get everything to you and plenty of time for you to make informed decisions and I think this will most importantly equip schools to have successful openings state school board member Becky Taylor had a question.

Just make sure that we are going get these goals at the time any if they come to us in many yes to 11 AM. We disagree with a recommendation that would go back to the things that they come back to probably be July or August, but at least then that school knows in June.

Hey, there's a strong possibility that you might not get move. You might not get charter. At that point and so I think it's it's you're basically moving out by two months or more. That that decision for them and even though we would need to meet again. We also have necessary no can do everything we can do a called meeting set to expedite retrying applications or do you were just kind of children time to have that happen have another opportunity before the charter school advisory board.

What is the mindset around this. The mindset is or is the Churchill advisory board. It does an extensive amount of deep research and time and energy. We now have a two-step interview process that were implementing this year where we have folks before us for 30 minute clarification interview followed by us then invited back for all formal hour-long board interview after we've made it scored in the application.

Whether or not we believe each section is a pass or fail the wish from the board is that if we were if we disagree. I understand that there will be times and that happens around the application process that we have a chance to step back review again and then send a decision forward to the to the charter school advisory board or to the state board on this yesterday. I do think that certainly I know that applicants would be okay with. If they were that they would rather have a denial in June and then another chance with the deceased and then another quote from the S state board working rather have that obviously the gist of our right to die with no second chance from the state board. I think the one of the keys here is you have a number of applications it will come forward with either unanimous or very high threshold of votes in the affirmative that were recommended to move forward one move those folks was high flyers as quickly as possible. Want to reward them for putting together an Apple housing application and outstanding board when expedite the process as quickly as we can. That's Alex Quigley, chairman of the North Carolina charter school advisory board speaking to the state Board of Education about tweaking the charter school approval process state board chairman Bill Kobe mentioned a hypothetical case is probably split birds majority of charter school would drive through board recommends and then we this know even though you recommend were were working about two than I and this is actually happened is this more about when it goes back being able to address the questions that were raised absolutely give the board one pressing the board members on this year to do this year is that if we sense that it's going to be a split vote are going to be a close vote on asking board member's estate for the record in the minutes. The reason I'm making a decision so it's exquisitely clear to all of you where the board members fell on the decision and wider voting away their voting so that you have that information before you also it does it gives us an opportunity or if there are questions I want to questions last year was I don't I don't understand why this was not sent forward or this one was it in the other one wasn't. And so that if it's in you do not you did deny that he would give us an opportunity to have a conversation clarify that. Also, we know we had about it was it Stephen type because we had some board members absent and so we we will be able to rectify that situation as well so I think this just builds an extra step in the process. In the in the situation where things are not just exceedingly clear. Which is it also will help us prevent a protracted argument with applicant or protracted, where they feel like they were given no a fair shake. You know, I feel very very confident the decisions we make are fair, clear, equitable, and we've done tons of due diligence I know is in Appleton.

I would appreciate the additional opportunity for this he said to review again the Taylor wonders whether charter schools need even more time there. I know it's hard for getting ready to open after just one year. Yes and I mean back it up that they could have their approval. Perhaps I can march.

Yes, you have a much longer time so we would not be Quigley agrees, citing some charter schools problems securing the location facilities is a real issue. We have discussed ways that we could potentially do that and what you know.

One way is having a rolling process. What you don't want to have happen is where you overly savor the schools that have the early interviews so you know they have this huge advantage over schools adjusted scheduling a counter suggested just whoever puts in their application. First gets there there interview first scan rewarding people that are beat the deadline. I think that something that I can take back to the board and say hey we have some support from the state board to consider adjusting the process somehow we could potentially move up the application deadline and start earlier you been listening to highlights from a recent discussion about the charter school application process, potential changes would be designed to help new schools have more planning time will return with more Carolina journal radio in a moment. If you love freedom we got great news to share with you now. You can find the latest news, views, and research from conservative groups all across the state. All in one place North Carolina conservative.com one-stop shopping for North Carolina St. movement North Carolina conservative.com. You'll find links to John lock foundation blogs on the days news Carolina journal.com reporting and quick takes Carolina journal radio interviews TV interviews featuring CJ reporters and Locke foundation analyst plus opinion pieces and reports on higher education. All of that from the Pope Center for higher education policy commentary and polling data from the Tass Institute and news and views from the North Carolina family policy Council. That's right, all of that, all in one place North Carolina conservative.com that's North Carolina spelled out conservative.com North Carolina conservative.com.

Log on today.

Welcome back to Carolina journal radio Donna Martinez.

It's called Carolina cares. It's a bill supported by a bipartisan group of state legislators who want to expand Medicaid in North Carolina and that is something that former Gov. Pat McCrory and the Republican majority in the Gen. assembly have chosen not to do. We should stick with that decision. Says Catherine Restrepo. She is the John not foundation's director of healthcare policy she's joining us now to explain this new push by some to embrace a key provision of Obama care Catherine welcome back thinking, interesting on a number of fronts. But let's start with this. It is a key provision of Obama care, Medicaid expansion, accept Obama care seems to be really on slippery footing right now.

So why would a proposal like this come up at this point time yeah well I think at the federal level. There's a lot of uncertainty going on, you know, as you know, the federal public Republicans in the house and Congress weren't able to get the American healthcare act there proposed Obama care reform, healthcare reform, which is more of a market-based reform passed for a full house though. Before going into the Senate so you there's a lot of uncertainty and within that bill. There is going to be lots of changes with the way Medicaid, which is that health insurance program for low income children, parents on elderly blind, and disabled populations and there is can be a big shift in how that program is to be funded, and so I think that with Obama care is Medicaid expansion. If North Carolina were to expand, we would get so much of it would be paid for with federal funds and if that is going to go away. I think this is pressuring states to expand before there's a deadline on that. Explain to us what this group of legislators has proposed state their calling it Carolina cares, but what is the element to do yet. The key elements at its I mean it's very much representatives that have sponsored this bill will say this is not your typical Medicaid expansion.

This is a unique version of expanding coverage for more low income individuals and what this bill dies is that it expands and expands coverage, but there are certain twists in certain flavors to it that is beyond your traditional Medicaid expansion so there be a work requirement and they would all say I mean you would have to do if you signed on. If the patient decided to sign up, you would have to go to annual you would have to get annual comprehensive physical done. You have to engage in preventive and wellness behaviors on three different wellness programs so there is also a lot of individual mandates.

If I mean if you want to say that and that will be included in this bill so there's there's some characteristics that are different but overall, other states have passed similar bills just like this and the actual enforcement of those things has really not been happy. How many people are we talking about here. That would be added onto North Carolina's night roles yet about 500,000 would be added to the rolls right now if you look at the program. It currently serves about 2 million people in our state and it costs total state and federal funds combined about $14 billion so it's one of the fastest growing line items in our state budget, and with expansion. Yes, they link it would include those people who are currently in the coverage, meaning that they don't qualify for Medicaid and they don't bring enough income to qualify for subsidized private health plan if they don't get health insurance to their job and their working on, but it also would shift a lot of people who are currently receiving subsidies with private plans on exchanges onto Medicaid and Medicaid is a program that has a far inferior track record than most other types of health insurance Emmett, let me make sure I understand because that seems pretty important.

Are you getting that of these 500,000 people that would be added under this proposal. Some of them currently have insurance. Yes, yes, a lot of the media were talking about one third of the exchange population and again exchanges. If you don't have health insurance through your employer, you get it on your own, and depending on your income you can qualify for a subsidy to purchase the health insurance plan. So yes, they will be shifting about one third of the exchange population onto Medicaid. Catherine you also mentioned that to be the idea behind Medicaid was really to be a social safety net for those folks who are very very vulnerable. Can't take care of themselves and as a compassionate, civil society, we would make sure that they were cared for, but as this program expands what happens to those folks who really are qualified for this program and they're trying to get access to healthcare and yeah and I'm so glad you bring up that point that that's really the critical point of all of that that we go back to access and to healthcare costs on when you have more people on a program on this pool and there's there's less of a supply primary care providers.

The other primary and primary care physicians that can take care of these people. I mean that the traditional Medicaid population alone can children on elderly blind and disabled people there going to be competing harder for access adequate access to healthcare and fewer doctors are accepting the Medicaid patient when you simply because Medicaid play pays well below market rates well below what commercial insurance companies reimburse the providers they contract to FN on well below Medicare would state taxpayers be on the hook if this expansion went forward yes and there's some creative financing is going on with with this particular bell. Carolina cares that he has the right now if we expands on while starting in 2020. If we were to expand before then, but starting in 2020 on the state would pick up 10% of the tab of the expansion population so the 5000 500,000 people in the federal government will pick up the rest of the remaining 90%, and how the state portion would be financed is through these premiums that patients will supposedly be paying on hospital taxes and that's the creative financing scheme are talking about here. So essentially what happens is that hospitals agree to be taxed by the state. The state then gives that money back to the hospital and then when they get that money back to the hospitals that triggers more federal funds because that's just the way Medicaid financing works you're making my hair hurt just the whole thing works and you've actually described it as a scheme.

I understand why so complicated, so Catherine, it seems like there must be a better way to simplify this process and help people more people get access to healthcare and be able to perhaps even by an insurance policy that meets their individual needs adverse all these mandates you were talking right yes and so instead of lawmakers. Yes, this is a short-term coverage solution by the end of the day. We should be looking at healthcare. How can we make access better because right now it it's going to be worse for more people on this program who are competing for access on and tardy difficult enough as it is, but how can we make healthcare more affordable and let there's a lot of things that have to be on the federal level for that to really happen on really become widespread. But there's a lot of things that state lawmakers can do to not just increase the supply of healthcare. I mean get rid of certificate of need laws where that basically stifles innovation and stifle the ability for more providers to open up more facilities that offers lower-cost alternatives for healthcare in rural areas especially now let let free up scope of practice laws where mid-level providers can relocate or practice on their own in many rural areas of North Carolina that are currently facing severe primary care shortages, so those are just a few ways in which you can open up the market, you don't need necessarily so much subsidies to provide coverage for people well. It is an ongoing discussion and debate at the federal level and right here in North Carolina. How do we make sure folks have access to care and also address the issue of insurance Catherine Restrepo is the John foundation's director of healthcare policy. You can read all of her analysis on this and she's written quite a bit about this@johnlocke.org and Carolina.com. Thank you for thinking of the time we have for the program this week. Thank you for listening on behalf of my cohost Mitch Cope.

I'm Donna Martinez help you join us again next week for another edition of Carolina Journal radio Carolina Journal radio is a program of the John one. To learn more about the job donations that support programs like Carolina Journal radio send email to development John Locke call 66 jail left 166-553-4636 Carolina Journal radio nation airline is all opinions expressed on this program nearly mentioned on the show or other programs. John foundation is any airline sponsored Carolina radio again


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