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Good morning to you. In some statewide news this morning, the North Carolina State Health Plan. Announced on Wednesday the reinstatement of its long-standing exclusion of transition-related treatments typically sought by transgender patients. This announcement from the state health plan arrived on the same day a court case challenging the exclusion officially returned to a federal trial court from the 4th U.S. Circuit Court of Appeals.
The Fourth Circuit issued a September 23rd order in the case known as Caddell versus Falwell, that is referring to previous state treasurer Dale Falwell, vacating a trial judge's 2022 decision to block that exclusion. The trial judge had requested that the state health plan provide coverage for the disputed treatments. The mandate from the appeals court, however, orders the orders order rather reached the trial court on Wednesday. The decision reinstates the state health plan's exclusion of transition-related treatments, according to a news release from state treasurer Brad Breiner's office. Breiner oversees the state health plan as his predecessor in Dale Falwell did, hence why his name was on the court case.
According to the news release, it reads in part: the exclusion dates back to the 1990s, and while litigation has been ongoing and has continued to appear in the annual list of exclusions for plan members, even though it was inactive. The release also goes on to say: the court's decision to vacate the district court's earlier ruling means that the exclusion becomes active once again. The plan communicated this anticipated action to its patients or to its members rather in the month of June. The news release explained, generally, the exclusion does not prevent the treatment of any infection, injury, disease, disorder, or complication that has been caused by or exacerbated by the performance of gender medical, transition medical or pharmaceutical procedures. Additionally, in 2021, the plan's board of trustees affirmed continued coverage for psychological assessments and psychotherapy treatments in conjunction with a diagnosis or connected to gender dysphoria.
The re-implementation benefit exclusion does not exclude some of those psychological assessments or treatments in these cases. The release from, again, the state treasurer's office wrapped up by saying plan staff is now working with our third-party administrator and health care providers to make sure this decision. Is fully communicated to all members affected by its reinstatement.
So as we've been covering, and there's been a little bit on this story over the last year or so, U.S. District Judge Loretta Biggs issued a 2020 injunction, which forced the state health plan to provide some of that disputed coverage, which as we learn from the treasurer's office, has been on the exclusion list going back to the 1990s.
However, a split-fourth U.S. Circuit Court of Appeals voted 8 to 6 to affirm Biggs' decision in 2024.
However, the United States Supreme Court issued an order in June vacating the Fourth Circuit's ruling. The High Court called on the Fourth Circuit to revisit this case, Cadell v. Falwell, in light of the Supreme Court ruling in another case that coming out of the state of Tennessee called United States v. Skermeti. In that case, justices upheld a Tennessee law banning things like puberty blockers and hormone therapy for transgender teens.
So, due to the case in Tennessee and its close proximity to what has been ongoing here in North Carolina, it has reopened the door for the state health plan to add back some of those long-standing exclusions. You can read some additional details on this story this morning by visiting our website, CarolinaJournal.com. That headline story: State Health Plan responds to recent rulings in transgender care case. Again, those details over at CarolinaJournal.com, where it's now 509, News Talk 1110, 993, WBT. Early voting in over 300 municipalities across the state of North Carolina kicks off on this Thursday morning to walk us through what some of those details look like.
Teresa Opeka, CarolinaJournal.com, joins us on the news hour. Teresa, municipal elections, they roll around every two or four years here in North Carolina. What is the latest that you're tracking as it relates to early voting? Sure. Good morning, Nick.
Thanks as always for having me.
So, yeah, so that begins today for voters in 380 North Carolina municipalities ahead of the November municipal elections.
So, to break it down, there's 447 cities, towns, and villages in 88 counties that are conducting elections. And of these, 67 municipalities have chosen not to use early and absentee voting. They're only going to be allowed to vote on Election Day, which is Tuesday, November 4th.
So, just want to make the listeners aware of that as well. And, you know, the early voting sites and schedules are available at the State Board of Elections early voting site search on their website. and also at early voting sites for the november fourth, twenty twenty five municipal elections page that they have.
So statewide, there's about one hundred forty four early voting sites that will be open for the November elections. Teresa, before we get into some of these other early voting locations and some of those details, those 67 municipalities that are not using early voting, in my research of that, these seem to be very small communities, just a couple of hundred people registered in some small towns and villages across the state.
So it's safe to say it's probably just a logistical situation when you've only got maybe a couple of hundred voters that are even eligible to vote. I would think so. And like you say, they're such small communities, they probably maybe don't have enough people to come out and maybe be there of the times that are needed as well.
So yes, it's not a significant portion of those areas that have that. As we look at what we are going to see unfolding over the next couple of weeks, there are some major races that are, of course, being watched. The city of Charlotte, the municipal elections there, Teresa, are probably going to be ones that are being watched not only across the state, but the nation. As Charlotte has gotten so much negative attention over the last couple of months, a couple of murders just in the last few days. Of course, the horrific murder of Irina Zaruska on the Charlotte light rail.
Teresa, these elections are really important. And unfortunately, voter turnout seems to be always so incredibly low when you don't have a big ticket name or a big ticket race like a senator, a governor, or a president on the ballot. Right, right. Yeah, it's not a presidential year like last year. You know, like you said, we don't have the U.S.
Senate race that's coming up next year.
So, this is kind of an in-between year where you don't see a lot of activity at the polls. It will be interesting to see how voters in Charlotte turn out, especially with everything you just mentioned, you know, and ongoing crimes, you know, murders going up and things of that nature. Other areas that have races too. We've got Durham in the Triangle, Fayetteville in the Sandhills, and I believe also what, in Wilmington, out in the eastern part of the state. All different areas have elections going on.
But in particular, it will be interesting to follow Charlotte and see if voters will be motivated to go out to the polls now more than ever since there's so much going on. And right now, it's just not a good direction that things are going in. And of course, we'll keep a running tab on some of these early voting totals. We won't have the results, but we will have a pretty good idea of the actual number of individuals that have gone out and voted. We'll keep you up to date with those details right here on the Carolina Journal News Hour.
Something that I do want to mention, Teresa, and we've talked about it in the past, is due to some ongoing lawsuits with the Department of Justice, about a decade or so, if not more, of questions over voter registration practices in North Carolina, individuals who do not have the required HAVA federal information on file in North Carolina. There will be a different process for them as well. Right. If you don't have that information, you can vote provisionally. They do give you a provisional ballot to fill out and fill out a form with your North Carolina driver's license or DMV ID number or the last four digits of their Social Security number.
And then after the election day, the county boards of elections will meet to determine whether that voter provided the required identification for their ballot to be counted. And also, of course, want to mention the registration repair project that was an initiative launched by the Board of Elections earlier this year that's aiming to alleviate some of these issues by collecting driver's license numbers or the last four of their socials from registered voters who do not have one of these numbers in the voter registration database. They can also check that out on their website as well. But yeah, they can vote provisionally in case they don't have that information. Mm-hmm.
Yeah, and of course, helpful that this is happening during a municipal election where, yes, there is a shorter and smaller turnout and in some cases, a shorter early voting window ahead of the big midterm elections that will be heading to North Carolina early next year with the primary. And then, of course, wrapping up with a general or a full on-general election in November of next year.
Now, early voting, three, so there's been some discussion in years past about the length of early voting as we talk about what's going on here this morning. October the 16th, early voting does begin in many areas, and it goes on for a significant period of time, all the way until the 1st of November. There's really no excuse for folks not to get out and vote if they're eligible. That's right. They've got plenty of time.
And of course, too, you can mention absentee voting. That's also begun in the participating municipalities and eligible registered voters. They can request a ballot online. Again, we've got all the details in the article on CarolinaJournal.com, but they have to do that until I believe it's 5 p.m. on Tuesday, October 21st.
That's a little bit shorter to request an absentee ballot. Yeah, but there's definitely no excuse. You've got plenty of time to get out and vote either on Election Day or early voting, which starts today. We will keep an eye and keep a track on some of these numbers and details as this early voting period takes place across the state. We appreciate the details this morning.
And as Teresa noted, you can get some more information by visiting our website this morning, CarolinaJournal.com. Teresa Opeka joins us on the Carolina Journal News Hour. It's 22 minutes past the hour. Welcome back to the Carolina Journal News Hour, News Talk 1110, 993, WBT, and some other statewide news that we are tracking this morning. More than $6.5 billion in medical debt has been eliminated for more than 2.5 million North Carolinians in the past year, according to a recent announcement from Governor Josh Stein, who announced that on Monday, alongside the North Carolina Department of Health and Human Services and the Secretary there.
The state's medical debt relief program, which is being facilitated by undue medical debt, was started in July of 2024 by then-former Democrat Governor Roy Cooper and the former Secretary of NCDHHS, as medical debt does remain a big issue for many American families. A West Health Gallup health survey revealed that up to 12% or approximately Approximately 31 million Americans reported borrowing an estimated total $74 billion in the past 12 months to cover health care costs for themselves or a household family member. A majority of Americans, some 58%, shared concerns that they would experience medical debt if they faced a major health event.
However, Joseph Harris, a fiscal policy analyst for the John Locke Foundation, says the issue is not quite as simple as debt forgiveness. He told the Carolina Journal, quote, The medical debt forgiveness may appear compassionate. But it's built on the same unstable taxpayer-provided shell game that the federal government is now trying to fix in the One Big Beautiful Bill. Under the Debt Forgiveness Plan, hospitals erase patient debt in exchange for higher Medicaid payments from the state. Those higher payments trigger greater federal matching funds, which the state then uses to cover the extra reimbursement.
The state itself also collects a provider tax from these hospitals to offset some of the share of those payments. Harris concluded by saying, in effect, unpaid medical bills are being shifted from patients to federal taxpayers through a circular funding scheme. The North Carolina Department of Health and Human Services asked the United States Center for Medicare and Medicaid, which has the acronym CMS, no relation to Charlotte, to approve a set of conditional hospitals that they must meet in order to be eligible to receive an enhanced amount of Medicaid funds. And under the new agreement, hospitals are required or will be required, I should say, to implement the following policies, including relieving all medical debt deemed uncollectible dating back to January 1st, 2014 for any individuals not enrolled in Medicaid with an income that is at least or below 350% of the federal poverty level or whom is That total debt exceeds 5% of annual income. They must also relieve all unpaid medical debt dating back to January 1st, 2014, for individuals who are enrolled in Medicaid, not on any sort of private insurance.
Provide discounts on medical bills of between 50 and 100% for parties with incomes at or below 300% the federal poverty level, with the amount of the discount varying based on the patient's income. Automatically enrolling people in financial assistance known as charity care by implementing a policy for presumptive determination eligibility for financial assistance through a streamlined screening approach process. And then, two final things that these hospitals must follow: not selling any medical debt for customers with incomes at or below that 300% federal poverty level to a debt collector, and not reporting a patient's debt covered by these policies to any credit reporting agencies. Hospitals that agreed to the requirements would be eligible for enhanced payments under the Health Access and Stabilization Program known as HASP. The conditions include relieving some $4 billion, which was exceeded by $2.5 billion in existing medical debt for 2 million low- and middle-class income North Carolinians, and establishing some of those policies to prevent further accumulation of medical debt.
The governor said in an announcement earlier this week, quote, medical debt is a tremendous weight keeping so many families from financial security, and unlike most other forms of debt, it's not a choice. Today's announcement will free people from the financial stress so that they can focus on getting healthy. I thank Governor Roy Cooper, DHS Secretary Cody Kinsley, and the hospitals that partnered with the state of North Carolina to make these life-changing change this life-changing news possible. I urge the General Assembly to keep this momentum going by coming back to the table and fully funding Medicaid. The program does not utilize state funds.
It is important to note, and eligible individuals do not need to take any other additional action. That debt will just be admonished by the hospital, and you'll likely receive some sort of communication from the hospital that that debt has been washed away. People across the state have begun receiving letters from hospitals letting them know that their debt has, in fact, been forgiven. Additionally, undue medical debt is sending letters to thousands of North Carolinians, letting them know that they had some or all of their debt relieved. At least 255,000 letters are being sent this same week as that announcement was being made, with additional letters to follow in the coming months and years.
It's definitely a very interesting story from the governor, announcement, a big announcement, $6.5 billion in medical debt, no small sum of money. And this will affect more than 2.5 million North Carolinians.
However, as Joseph Harris from the John Locke Foundation, Notes. It's kind of a circular funding model, and where now federal taxpayers are picking up some of those medical tabs here in the state of North Carolina. We've got some additional coverage this morning on our website, CarolinaJournal.com. You can read that story and check out a full press conference from the governor. The headline there: NC program wipes out $6.5 billion in medical debt for 2.5 million residents.
Again, those details at CarolinaJournal.com. It's 5:36. Welcome back to the Carolina Journal News Hour, News Talk 1110-993 WBT. If you miss any portion of our show weekday mornings here live on WBT, you can check out the Carolina Journal News Hour podcast. It's available in Google Play, Apple Podcasts, Spotify, anywhere you get your shows.
Search for the Carolina Journal News Hour, tap the subscribe or follow button, and you'll take a new program with you each and every weekday morning. It's the Carolina Journal News Hour podcast. Download and subscribe now. We've been covering a couple of pretty big lawsuits that pit the Republican-led General Assembly against Democrat Governor Josh Stein. In one of those cases, a major update this week to let us know about that case and its future implications.
It's my pleasure to welcome Mitch Kokai from the John Locke Foundation back to our airwaves this morning on the Carolina Journal News Hour. Mitch, these lawsuits have been going on now for quite some time. Pretty big break in one of them. What's going on? That's right.
Some of these cases, in fact, predate Governor Josh Stein coming into office. They go back to the closing days of Roy Cooper's tenure as governor. And that's what happened in this case that we're talking about now: a case that started out as Cooper v. Berger. And by the time it was decided, it was actually called Stein v.
Berger, pits the governor against the Republican-led General Assembly over changes to appointments to seven different state boards and commissions.
Now, basically, the gist of it is that the governor challenged changes in state law to change the way that the appointments were done to all seven state boards and commissions. This case went before a three-judge trial court panel, and that court issued basically a split decision. The judges were unanimous, but they split on what they decided. They basically said that the General Assembly was within its rights to make changes to five. Of the boards and commissions, but overstepped and violated the separation of powers in changes to two.
The different commissions.
So it was five wins for the General Assembly, essentially, two for the governor. This case got to the State Court of Appeals and it went before a three-judge panel at the State Court of Appeals, all Republicans. And basically, the upshot is that the Court of Appeals ruled instead of 5-2, 4-3, that the General Assembly was within its power to. To make four of the changes that were made to boards and commissions, but got it wrong on three of the boards.
Now, basically, the ones where the governor wins are the Economic Investment Committee, which is a group that decides on targeted tax incentives, the State Board of Transportation, which deals with transportation issues, as you might expect, and the one in which the governor gets the win at the Court of Appeals, where he lost at the trial court level, is the Commission for Public Health. Basically, there are a lot of details here, but the appeals court says the way the General Assembly went about making the changes overstepped its bounds and encroached on the governor's authority.
Now, while the governor gets wins on all three of those, the General Assembly wins at the Appeals Court on the Environmental Management Commission, the Coastal Resources Commission, the Wildlife Resources Commission, and also changes that move the Building Code Council to this new Residency Code Council.
So, kind of a split verdict on this. And this also has implications for another ongoing fight that you and I have talked about, because just after this ruling came out. On Wednesday morning, the panel overseeing another fight between Stein and legislative leaders issued an order saying. Hey, the Court of Appeals, our court just issued this ruling. We want you to tell us how this case affects our case.
And this is a case that deals with an appointment to the State Utilities Commission. It also deals with the Building Code Council in another respect, and it deals with judicial vacancies. This ruling won't really have any impact on the judicial vacancies piece, but it certainly could have an impact on the fight over the Utilities Commission appointment and the Building Code Council. And basically, one of the main arguments that came out of this that will essentially affect the Utilities Commission appointment is that the general the appeals court did not buy the governor's argument that shifting an appointment from the governor to another elected member of the Council of State. Was a violation of the separation of powers.
The court order was specific in saying that. The executive branch, whether it's the governor or the Or, in this case, the Insurance Commissioner or the Agriculture Commissioner. And in the case of the Utilities Commission, in a separate case, it would be the state treasurer. If those bodies together have the majority of appointments, that means the executive branch has the majority of appointments.
So that could really be interesting moving forward if the General Assembly wants to do this in other cases where they take an appointment that is now in the hands of Josh Stein and hand it off to another member of the Council of State. At least in this case, the Stein v. Berger ruling, the Court of Appeals says that's okay. That's not a violation of the separation of powers. And it's kind of interesting, Mitch.
You know, we talk a lot about, and you'll hear a lot about the executive branch. And the first reaction, of course, is in Washington, D.C., where you've got the president of the United States who essentially dictates everything that goes on out of the executive branch. Kind of unique setup here in North Carolina. While the governor does sit on the top, and he is, of course, the individual who gets a lot of the media attention, a lot of the things flow to him, the legislation from the General Assembly. There are these other Council of State members who are not only influential in what they do, but they also appeared on a statewide ballot and were potentially elected by tens of millions of voters across North Carolina.
And that's one of the arguments, Nick, that the General Assembly has been making during the course of this: that unlike Washington, which has a unitary executive, all of the power eventually flows to the president.
Now, there are, of course, a lot of executive offices, and the president doesn't actually have a hand in everything that the federal government does. But the buck stops with him when it comes to executive branch decisions. Whereas there is a plural executive and always has been in North Carolina because of the North Carolina founders' fear of having one all-powerful person at the head of the executive branch. And so you have not only the governor, you have the nine other statewide executive branch officials who are elected by voters, as you pointed out, and they make up the Council of State. And so shifting some power from the governor to another member of the Council of State doesn't take the power away from the executive branch.
The governor, in his Arguments in this case and others that have involved transfers from his office to another member of the Council of State has basically said, well, but the governor is really the power, and the governor needs to be able to show that these laws are being put into effect. And at least in this case, the court is saying, well, but that's not exactly how it works here in North Carolina. The General Assembly can shift some of this power to other members of the Council of State and still keep that power within the executive branch. It's not taking the power for itself as the legislative branch.
So one of the interesting things that we've covered in some of these previous cases, whether it's the State Board of Elections or the Utilities Commission, some of the more high-profile cases that we've discussed, Mitch, the power, political structure of those boards have changed dramatically. In many cases, going from Democrat-controlled, most of the time, three to two Democrats to Republicans, to now the other way around, three Republicans, two Democrats. Are we going to see similar things based on this decision from the appeals court? It's entirely possible. I think one of the things that we have seen in recent years is that the General Assembly has been testing out what will work and what will pass muster with the courts.
We saw several different ways of going about it with the case that was decided this week's Dying B. Berger. They took some appointments from the governor, gave them to another member of the Council of State. They expanded one board, allowed the governor to continue to have a majority of appointments, but then gave the General Assembly more appointments and set some changes into the quorum rules. They also Set some different rules about the governor would have more appointments than the General Assembly, but then an outside group had some appointments.
All of those, I think, involved the General Assembly testing. What was not only something that they thought could fly in terms of making the operations work for these various agencies, but what would fly with the courts? And at least with this decision in Stein v. Berger, if it holds up. If there's not no appeal to the Supreme Court and the Supreme Court says something different, that if this decision stands or if it's affirmed by the state Supreme Court, it means that shifting an appointment from the governor To another member of the Council of State is something that's going to stand up under the North Carolina Constitution.
And if that's true, we're likely to see more of it if there are other opportunities to do that. You kind of took the next question out of my mouth here. This is the North Carolina Court of Appeals that made this decision. The higher you can go, the highest you can go is the North Carolina Supreme Court. Mitch, in your experience following these cases, maybe ask you to read between the tea leaves a little bit here.
Do you think either side, maybe both, decides that they can get a better breakdown in terms of who has the appointment authority at the state Supreme Court? Or are they just going to be kind of happy with where things sit right now? It really remains to be seen. I suspect that neither side is particularly happy with how this turned out, largely because both ended up with some losses. And in fact, this is a worse ruling in terms of the ultimate outcome for the General Assembly than what they got from the trial court.
I imagine that they would be interested in seeing whether the Supreme Court would go along with Giving all of the endorsing all changes to all seven boards. The governor, of course, would like to see the four boards where he lost to get a win from the Supreme Court. But I'm guessing that his legal team looks at the current makeup of the Supreme Court and probably is dubious about whether that's going to happen.
So I suspect we'll see some sort of appeal. It might be from both sides, or it might just be from one side. And if only one side appeals, my guess would be the General Assembly just thinking that they might be able to win on all seven boards at the state Supreme Court. But you might see the governor appeal as well, just to make sure that this gets its final ruling from the final court, the one that has the final say on all of these state constitutional issues. We've got a lot more details, detail not only on this story, but some of the other legal challenges that have continued to pit the Republican-led General Assembly against Democrat governors, whether we're talking about Roy Cooper or Josh Stein.
You can read those details over at CarolinaJournal.com. We appreciate the information and the insight this morning. Mitch Kokai from the John Locke Foundation joins us on the Carolina Journal News Hour. This is the story of the one. As a maintenance supervisor at a manufacturing facility, he knows keeping the line up and running is a top priority.
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Good morning again. It's 5:53. Welcome back to the Carolina Journal News Hour. News Talk 11:10-993WBT. Early voting across many municipalities in North Carolina kicks off today ahead of the municipal election day coming up on Tuesday, November the 4th for more than 380 North Carolina municipalities.
There are 447 cities, town, and villages in 88 different out of 100 counties across the state that will be conducting elections over the next couple of weeks. Of those, 67 municipalities are not using early or absentee voting. Most of them are very small townships, hamlets, and villages across the state. There's only a couple of hundred residents, so they don't feel the need to do any of the early or absentee voting. All of this, of course, ahead of election day coming up the first Tuesday of November.
Early voting will again kick off today and taking a look at what voters across Mecklenburg County can expect. While there will be a plethora of early voting sites that open starting on Thursday, next Thursday, October the 23rd, between now and then, only one site will be operational today and tomorrow. Closed this weekend, then reopening on Monday and running through the remaining of the early voting period. That is at the Hal Marshall Annex. The address on that, 618 North College Street in uptown Charlotte, that will open up at 8 o'clock this morning.
It runs from 8 to 5 today and tomorrow. Again, closed over the weekend and running 8 to 5 the remainder of next week, plus a plethora of other municipality locations that will open up a list of look, just tertiary looking at this. Close to 20 locations will be opening in the coming days. Most of those start on Thursday, October the 23rd. During the early voting period, eligible individuals who are not registered to vote may register and vote at the same time.
That is called same-day registration. At any early voting site, it is important to note that that is only something that is allowed during early voting. If you are not registered on election day itself and show up and try to vote, you cannot do what is called same-day registration and vote. That is only something that is allowed during the early voting period. Voters must be registered to vote in the municipality where they reside to vote in its upcoming elections, and they can find out if they are eligible to vote by going to the State Board of Elections voter search tool that is provided via the North Carolina State Board of Elections website, and you will see a sample ballot if you do have an election coming up here in early November.
If you do not see a sample ballot attached to your voter registration record, then you are not eligible to vote in any of the contests. Voters in many municipalities will be selecting things like mayors and members of their local governing bodies, whether you're talking about a city council or a county commission. Other areas across the state will be voting on things like water and sewers, sanitary district commissioners, and of course, some ballot bonds are across the state as well, including that big transportation bond coming up here in Mecklenburg County. Sam Hayes, the executive director of the state board of elections, said: Municipal elections are a huge undertaking across North Carolina. We appreciate the hard work of our county officials and poll workers in administering these important elections.
Municipal elections represent another opportunity for voters to make their voices heard in choosing their government leaders. Absentee voting has also begun in participating municipalities. Eligible registered voters may request a ballot online through the North Carolina absentee ballot portal or on paper using the 2025 absentee request form.
However, you do have to have the request, not the ballot in, but the request in conversation. Coming up next Tuesday, October the 21st, and then it can be returned anytime during that early voting period. Also, a quick reminder for those that may have had some issues with their voter registration numbers due to the fact that they were missing either a DMV driver's license number or the last four digits of your social security number. You could deal with some slowdowns at the polls and voting provisional.
So make sure you head on over to our website, CarolinaJournal.com, and check out the registration repair project so you can make sure that you are all set to go for either early voting or election day. That's going to do it for a Thursday edition of the Carolina Journal News Hour. WBT News is next, followed by Good Morning BT. We're back with you tomorrow morning, 5 to 6, right here on News Talk 1110 and 99.3 WBT. Every now and then I rinse it out.
And I need downy rinse tonight and I need it more. I can't put the bed and the smell never means. I don't know what to do. I'm always in the dark. The swecking deck short smells like a tar.
Downy rinse fights stubborn odors in just one wash. When impossible loaders get stuck in Ouch.
