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I'm Nick Craig. Good morning to you. We start off with some statewide news this morning as it relates to healthcare and healthcare policy. Hospital leaders are warning that North Carolina's rural health care system is on increasingly unstable footing. This is as state officials push forward a $213 million plan to stabilize and transform care in those rural areas across the state of North Carolina.
Earlier this week, at a meeting of the Joint Legislative Oversight Committee on Health and Human Services, officials from the North Carolina Department of Health and Human Services, that's NCDHS, and executives from First Health of the Carolinas highlighted the financial fragility of rural hospitals. Leaders from First Health of the Carolinas, a system of four nonprofit hospitals in North Carolina, warned lawmakers that rural health systems remain on unstable footing both in North Carolina and nationwide. They cautioned that federal policy changes tied to the federal government's one big beautiful bill could push rural hospitals into negative operating margins by 2032. State Representative Hugh Blackwell, the Republican out of Burke County, questioned whether hospitals are overtly dependent on government decisions. With Blackwell asking during the meeting, the way you have presented this today means that you are total victims of whatever the state and federal government does, and there's nothing you can do independently of us to improve your margins.
Is that what you're telling us? asked Blackwell. Autumn McFawn, who is the chief financial officer for First Health of the Carolinas, said that hospitals can make adjustments, but their options are limited and often very unpopular. With McFan telling the committee, not completely. We definitely can intervene with certain actions, but they would not be popular.
Closing service lines that are not profitable, looking at staffing models, but to make up the financial gap that HR1 or the One Big Beautiful Bill creates is going to be very difficult. McFan added that administrative burdens also contribute to some of the financial strain that these rural health care systems are dealing with, estimating that between 10 and 20 percent of rural hospital revenue is consumed by administrative tasks related to regulatory reporting. According to their presentation, more than 700 rural hospitals nationwide, which rounds out to about one-third of all rural hospitals, are at risk of closing due to financial strain. Of those, more than 300 rural hospitals are considered to be in immediate danger of closing. In addition, approximately half of all rural hospitals are currently operating at a loss.
and access to care continues to diminish as facilities close or eliminate certain inpatient services. State Senator Gail Adcock, the Democrat out of Wake County, said that those financial pressures can force hospitals into difficult decisions. With the state senator saying during the meeting, at the 11th hour, if it looks like you may close, other options would never be considered that would begin to look attractive, like selling to private equity or larger hospital systems and consolidating services. Decisions that we make can put rural hospitals in untenable situations. It's close or sell to private equity.
It's close or stop delivering babies. According to hospital officials, services most at risk of cuts due to revenue losses include a variety of oncology services, behavioral health, and some areas of emergency services as well. Hospital leaders also cautioned lawmakers against policy decisions that could worsen some of the financial strain that these systems are feeling. These include Medicaid rate cuts, loss of tax exemptions, or changes to certificate of need laws. Medicare and Medicaid pay nearly 70% of their patients' hospital bills.
Senator Amy Gailey, the Republican out of Alamance County, pushed back on the request to maintain certificate of need protections for those rural health care systems, saying during the committee meeting, what's your basis for saying that it will have a negative impact on rural care? Many people say that there's no demonstrative link between certificate of need repeal and the closure of rural hospitals. That you will end up with more providers overall, especially in urban and suburban areas. When asked for examples of how repealing certificate of need laws has negatively impacted rural care, hospital leaders were unable to cite any cases tied to recent changes. Mitch Kokai from the John Locke Foundation, who will join us coming up a little bit later on in the program this morning, said in an article over at CarolinaJournal.com, it's disappointing but unsurprising that hospital leaders continue to defend policies that promote their bottom line as businesses rather than the best interests of their patients and taxpayers.
The Khan law, in particular, has no defense given other than giving hospitals a mean of keeping competitors out of their market. We have spent a lot of time over the last couple of years talking about certificate of need and the major issues that are created by Khan. And, well, the situation, if you're not familiar with certificate of need, is based right into the name. Hospital and healthcare systems across the state of North Carolina have to go to the state and request a certificate of need, requesting a certain piece of equipment, requesting additional hospital beds, and they can only purchase that equipment or build out those additional beds if they receive that certificate from the state. The state has a very lengthy process.
You normally have multiple health care systems and healthcare providers all trying to get those certificates at the exact same time, and there's no question about it. It severely limits competition. And as we have seen in recent studies, just over the last 12 months, Months or so, healthcare in North Carolina remains one of the most expensive anywhere in the nation, with many political observers and experts pointing to certificate of need and the bureaucracy and bloat associated with it for one of the reasons for rising healthcare here across North Carolina. During the meeting, the North Carolina Department of Health and Human Services Secretary and other officials updated lawmakers on North Carolina's Rural Transformation Program, which is a federally approved initiative aimed at strengthening rural health care systems. The program is backed by more than $213 million in federal funding, including six major initiatives focused on expanding access, stabilizing providers, and modernizing care.
The largest share, about $87.6 million, will fund the creation of regional roots hubs designated to coordinate care and services across rural areas. rural communities. Other key investments include primary and prevention, nearly $9.7 million to expand chronic disease management, diabetes prevention, and mental and maternal health services. Behavior Health is also on the list as well. More than $33.8 million To expand mental health services, crisis response, and substance use treatment, workforce development, about $38 million for recruitment initiatives, training programs, and new care models.
And then finally, digital health, over $35 million to expand telehealth, data sharing, and technology infrastructure. The proposal drew skepticism from some state lawmakers who questioned whether it serves as a workaround for the state's decision not to continue funding the Healthy Opportunity Pilots Program beyond June the 30th of this year. As I was just mentioning, this discussion over healthcare in North Carolina does remain a very hot topic of conversation, whether it's a certificate of need, whether it's rural hospitals, talking about some of the Medicare and Medicaid reimbursement rates. It remains a top conversation for lawmakers in Raleigh. We are getting very close towards the end of April where the Medicaid Rebase is scheduled to go forward.
State lawmakers are back in Raleigh in a couple of weeks. If you're not familiar with that, there was a pretty big blow-up late last year as the governor's office and DHHS officials cut some of those Medicaid-based payments, claiming the system was out of money. Lawsuits forced the governor and other officials to reinstate them, with state lawmakers claiming they had until April to get a plan passed. We will be keeping an eye on that as lawmakers do make their way back to Raleigh here in just a couple of weeks. We'll keep you up to date with all of it right here on the Carolina Journal News Hour.
Uh It's 5:21. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk 107.9 FM, WBT, keeping our attention this morning on the North Carolina Legislature. The North Carolina House Oversight Committee has once again called the Chapel Hill-Carlborough City School System to testify as part of the legislature's ongoing review of material available in public school libraries. In a letter sent to Superintendent Rodney Trice, the House Select Committee on Oversight and Reform has directed him to appear before the committee coming up here in just a couple of weeks on April the 23rd at 9 a.m. Lawmakers say that Trice is quote uniquely qualified to address concerns about books currently available in elementary school libraries across the district.
The request reads, as the superintendent of the Chapel Hill Carborough City Schools, you are uniquely qualified to discuss books currently on the shelves and otherwise available at CHCCS Elementary School Libraries. The request references a list of 155 titles that legislators claim are, quote, in direct conflict with North Carolina's parents' Bill of Rights, which was enacted back in 2023. The letter goes on to say, we implore you to familiarize yourself with the attached lists of 155 books currently embedded across your elementary schools in direct conflict with the Parents' Bill of Rights, Senate Bill 49. That legislation outlines parents' rights as it relates to their child's education, including access to instructional materials and limits on certain content. Committee members argue that library materials fall under the status definition, the statute's definition of curriculum, which includes supplemental material and other resources used to support instruction.
House Majority Leader Brendan Jones, the Republican from Columbus County, who also serves as the committee's chairman, highlighted the recent request on social media saying, quote, due to their continued defiance of the parents' Bill of Rights, we have called back Superintendent Rodney Trice to explain why there are 155 books currently in their elementary school libraries in direct violation of state law. Also, bill filing starts in 19 days with the I emoji. The letter also cites Chapel Hill Carborough City School's own library mission, which aims to provide materials that, quote, enrich and support the curriculum and meets the needs of students and faculty served. In addition to Trice, the committee has also called Al MacArthur, the district's library media director, to testify at the hearing. The committee did not specify which books are at issue in the letter, but indicated that the titles are distributed across the district's elementary schools.
The upcoming hearing builds on a tense and highly publicized December oversight hearing in which Republican lawmakers sharply confronted CHCCS leadership over alleged non-compliance with the parents' Bill of Rights. During that nearly two-hour hearing, Representative Brendan Jones and other Republicans accused the district and its officials of attempting to circumvent state law. Jones opened that earlier hearing by reading aloud passages from children's books available within the district, at one point calling the material trash and throwing the book aside in frustration. Republican lawmakers also presented video and email evidence that showed school board leadership discussing ways to disregard portions of the law, particularly provisions related to parental notification and gender identity policies. During that hearing, which happened just back a couple of months ago, lawmakers repeatedly pressed the superintendent in Trice on whether the district was selectively enforcing the law.
Trice maintains that the district was compliant, though Republicans challenged that claim and accused him of misleading the public. The hearing grew very heated, with lawmakers warning of potential consequences for the district and others that failed to comply, with Representative Jeff McNeely, the Republican from Iredale County, suggesting that legislative action, including possible reductions in state funding, could follow. Jones closed the December hearing with a stark warning, telling district officials that the General Assembly would use, quote, every tool available to enforce compliance with state law. The upcoming hearing reflects broader legislative scrutiny of school library content across North Carolina, particularly in the wake of recent debates over age-appropriate material and parental oversight. The Chapel Hill Carborough City Schools has not yet publicly responded to the committee's request.
They are not. Required to do so, but that hearing is coming up now in less than two weeks as state lawmakers continue to kind of rub their hands together and figure out what do we do about this situation when you've got school districts like the Chapel Hill, Carlborough City School District, that have stated in public during their Board of Education meetings, which fall under any sort of open meeting laws in North Carolina. They are recorded, the transcripts are all available for everybody to publicly access. That they are not a fan of the parents' Bill of Rights, that they were in multiple cases attempting to circumvent pieces of the legislation that they claimed they did not agree with. That is really what sparked this very fiery hearing.
That happened back in December of last year. Lawmakers warned at that hearing that if they didn't clean up their act, there could be consequences. And it would appear that one of those consequences is those same officials being called back in front of the legislature coming up here in just a couple of weeks. We will keep an eye on that as we roll through the month of April. We'll bring you the latest coming up right here on the Carolina Journal News Hour.
If you want to read some additional details on this story and read about the December hearing, if maybe you have forgotten about that, we've got all those links as well. Head on over to our website, CarolinaJournal.com. Look for the story with the headline: House Oversight Committee Summons School Leaders Over Library Books. Taking a look at the General Assembly calendar as we roll into next week, lawmakers say there are set to be some level of committee hearings next week. On Tuesday, the House Select Committee on Involuntary Commitment and Public Safety are meeting on Tuesday.
That should be an interesting. To see as that discussion continues to unfold. On Wednesday, the House Select Committee on Property Tax Reduction and Reform is set to meet. That'll be an interesting one to keep an eye on as well. And on Thursday, the House Select Committee on Oversight and Reform, as well as the Select Committee on Blockchain and Digital Assets.
So while the entire General Assembly is not back in session next week, we will see some of these interesting committee hearings. We'll keep an eye on all those, keep you up to date with the details right here on the Carolina Journal News Hour. It's 536. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk, 107.9 FM, WBT. I'm Nick Craig.
Good Friday morning to you. We have talked a lot about tariffs over the last year here on the Carolina Journal News Hour. Extensive coverage, written content over on our website, CarolinaJournal.com. It has become a major topic of conversation as it relates to the U.S. economy, the North Carolina's economy.
We have a very large global discussion economically. We are keeping an eye this morning on an interesting legal battle that is taking place later today in the federal court system. Multiple states, including North Carolina, joining a lawsuit going after the Trump administration for a variety of tariff policies. To give us a little bit of a preview as to what we can expect in federal court, Mitch Kokai from the John Locke Foundation joins us on the Carolina Journal News Hour. Mitch, should be an interesting morning and afternoon here across the federal court system.
What do you got for us? Yeah, it should be very interesting. You'll remember, Nick, and your listeners will as well, that back in February, the U.S. Supreme Court struck down tariffs that President Donald Trump's administration had enacted under the International Emergency Economic Emergency Powers Act, or IEEPA, saying that the president did not have authority under that legislation to enact tariffs.
So, not very long after that ruling, the president came back and said, okay, if we can't have Trumps under IEEPA, we're going to have tariffs under Section 122 of the 1974 Federal Trade Act. And so he enacted tariffs under that piece of legislation and almost immediately faced additional legal challenges, a couple of which are now heading to a court hearing in New York City in the Court of International Trade before a three-judge panel. Plaintiffs in one suit are 22 attorney generals and two governors, all of them Democrats, including Jeff Jackson, the Democratic Attorney General of North Carolina. They have support from a number of interesting places. The latest filing was a group of economists, including former Fed chair and Treasury Secretary Janet Yellen, a Nobel Prize winner, and a number of other economists from Harvard, the American Enterprise Institute, and other places who have signed on to a brief supporting the plaintiffs in that case.
Another brief that came out earlier had some North Carolina ties, where you had North Carolina economists Ed Lopez from Western Carolina University. Mike Munger of Duke University and former House Republican Speaker Pro Tem Skip Stam, who also was at one point the minority leader for Republicans in the state house. All of them signed on to a different brief that has some other high-profile names who are against tariffs, all of them challenging the president's authority to enact tariffs under this legislation that's now more than 50 years old. This is one of two suits that the Court of International Trade is dealing with on this same issue. The other one deals with businesses.
So you have states that are suing in one suit and businesses suing in another suit. A three-judge panel of the Court of International Trade hearing the case. And the expectation is that there will be a ruling not too long after we hear the case because the court had signaled that it's going to have an abbreviated schedule, wanted to get briefings in from both sides fairly quickly, and then get some sort. Of expedited ruling. We also know that the states.
Have asked the court that once it issues a ruling that it not stay its ruling at all on appeal because this same court dealt with IEEPA tariffs, struck them down, but then stayed its own ruling during the course of the appeal. And so tariffs were allowed to be collected for quite a while. And so the states have said in this Court case. A Court of International Trade, we don't think you're going to like these tariffs under this. provision of the 1974 Federal Trade Act any more than you like the IEEPA tariffs.
And when you strike these down, go ahead and say they have to end. Don't allow for a stay that would be in place while this whole thing goes through the appellate courts. Mitch, you mentioned that you've got a variety of states, whether it's attorney generals or governors, joining in on this lawsuit. Maybe sounds like a stupid question, but let's use the example here in North Carolina. What is Jeff Jackson's reason for jumping into this lawsuit as it relates to these international tariffs that are being implemented out of Washington, D.C.?
Well, the official justification, of course, is the impact on North Carolina, both the consumers and also producers that have to use materials that are affected by tariffs. And so an impact on our economy and an impact on the people of North Carolina and their ability to get the products at the best possible price.
Now, that's part of the justification of why getting involved. But you also see that there's a political angle here that most of the people who are involved in this suit are from blue states or are Democratic officials in purplish states like Jackson. One of the interesting things from the vantage point of the John Locke Foundation is that as Jeff Jackson was announcing his decision to join this suit, he cited research from the John Locke Foundation about the impact of tariffs and the fact that we put out a report earlier this year that suggested thousands of jobs and more than a billion dollars of potential negative impact from the tariffs. Tariffs.
So it was interesting to see that while Jeff Jackson and the John Locke Foundation would tend to disagree on a lot of policy, the Attorney General was. Willing to rely on John Locke Foundation research to help justify joining this case. It'll be interesting to see. Where the arguments go. The state of Oregon is leading this case, and one presumes that lawyers working for the state of Oregon or working on the national level and hired by Oregon are going to make the case for the states.
Meanwhile, it's the Justice Department working on behalf of the Trump administration that's going to be defending the president's right to issue tariffs under this 1974 law. In reading the federal brief, one of the interesting things that I saw was the fact that an initial argument from the states was that this law That is being used now for the tariffs was basically a dead letter by the time that it became effective. And the Trump administration is saying, well, that's interesting to see that argument, that this law that's been in place for 52 years, now the states are saying there's no validity to it.
So it'll be interesting to see what types of questions come from the judges and whether they are any more inclined to support these tariffs than they were the IEEPA tariffs. Another argument the Trump team made was. When we had the initial tariffs and they were going through the court process, the other side, the plaintiffs who were challenging those tariffs were saying, well, you can't use IEEPA, but maybe you can use Section 122 of the Federal Trade Act. And the Trump team is saying, well, that's what we're doing now. This is exactly what the plaintiffs on the other side said that we could do.
And now they've changed their whole position and are saying, you can't use tariffs under this law either.
So I will be very interested to see what the court decides and what types of questions the judges ask as they're mulling their decision. Mitch, we don't have time this morning to get into a full-blown conversation over tariffs. We've had those discussions with a variety of folks from the John Locke Foundation and the Carolina Journal News Hour talking about the various impacts, whether we're talking about the agricultural industry, steel workers, a whole bunch of different industries affected. It is interesting, though, that once that major decision, as you noted, came down in February, as it related to that IEEPA tariffs or the IEPA tariffs that the administration did go through using these sections 122. And I would presume that we're kind of depending on what the court has to say about 122, the administration will probably look for another way that they could potentially implement these tariffs.
It seems like we're almost trending into a game of whack-a-mole at this point as they will play out any sort of executive authority on these tariffs as the administration seems to think they are a great way to bring trade back to balance or bring free trade back to the discussion and conversation.
Well, there's no question that President Donald Trump supports tariffs. He has supported tariffs for much of his life. If you look back at the statements he's made about tariffs, and throughout his political career, he's supported tariffs. And I think the idea that he's been going for is: okay, what gives me the most flexibility on tariffs? Probably.
From the vantage point of the John Lack Foundation, tariffs are bad. But if you're going to have tariffs, the best way to go about it would be to have Congress. Approve a bill. That either sets tariffs or gives the executive branch some wiggle room saying, We support tariffs, and you can raise tariffs to X amount of level. And here's what you would need to prove to be able to do it, and set out some guidelines so that it's actual legislation.
That's not been the way that President Trump has wanted to go about doing it. He basically looked at legislation that was already on the books and said, Which legislation can I use to get the tariffs I want? He looked first at IEEPA or IEPA. The Supreme Court said, no, you can't do that. And so, second choice was Section 122.
As you alluded to, if the courts strike this down, I think before he finally gives up on tariffs, the president would try to find anything else within existing legislation that would enable him to move forward with his tariffs. If he can't, he'll just then criticize Congress and especially the courts for not being able to or not allowing him to be able to use the tariffs in the way that he wants. Mitch, you mentioned a couple of minutes ago that the court has already signaled that they will be handling this in somewhat of an expeditious manner. We often talk about legal challenges that go on for 20 or 30 years. Over the last couple of weeks, we've talked about the Leandro lawsuit here in North Carolina.
When they say that, realistically, what kind of timeframe are we looking at after these oral arguments take place later today?
Well, I mean, in theory, because there's been quite a bit of briefing, if the judges already know their answer. They could come up with something even by the end of the day. I mean, because basically all of the arguments are spelled out in documents before them. I would think that would be kind of a quick turnaround, quicker turnaround than I would bet money on. But my guess is this doesn't linger for weeks and weeks and weeks.
This is the type of decision that if it didn't come out today, could come out as soon as early next week. Because the idea is if you think these tariffs are wrong, you want to stop the administration from continuing to carry them out. And regardless, even if you think they're wrong, you would also want to get the legal issues resolved fairly quickly. And as soon as the Court of International Trade comes up with its ruling, whichever side loses can then appeal and try to get this back probably eventually to the U.S. Supreme Court.
And as we mentioned, North Carolina is a party in at least one of these legal challenges dealing with these Section 122 tariffs. We'll keep a close eye on the oral arguments a little bit later on today in New York City. We'll have continued coverage over on our website, CarolinaJournal.com. We appreciate the preview this morning. Mitch Kokai from the John Locke Foundation joins us on the Carolina Journal News Hour.
Good morning again. It's 5:53. Welcome back to the Carolina Journal News Hour, Charlotte's FM News Talk, 107.9 FM, WBT, keeping our attention on some statewide news this morning. Governor Josh Stein opened the April Council of State meeting with a nod to history. But today's most urgent message centered on a present-day threat, wildfires burning across North Carolina.
With the governor saying, We share your enthusiasm about the upcoming anniversary in Halifax County, referencing the approaching 250th anniversary of the Halifax resolves and the significance of hosting a council of state meeting outside of Raleigh and in Halifax County. The sense of the place and timing framed the April the 7th meeting at the historic Halifax Visitor Center. Just days before the anniversary of the Halifax resolves, state leaders gathered on the same grounds where North Carolina became the first colony to officially call for independence from Great Britain. But as the meeting unfolded, the tone shifted from reflection to warning. Agricultural Commissioner Steve Troxler delivered the most direct remarks of the meeting, outlining the scale of wildfire activity and risks facing communities statewide.
With the Agricultural Commissioner telling the group, we have been concentrating on fighting wildfires, noting that state crews have responded to 451 fires in a single recent week, noting that it has been a very busy wildfire season. Even after a statewide burn ban was enacted back a couple of weeks ago, Troxler said 114 additional fires were reported, underscoring the role of human activity and how that continues to play out as it relates to sparking these blazes. Troxler told the group, I just ask the public to remember there is a burn ban in effect. Please pay attention to the burn ban and be careful. Then came some of the starkest warnings of the meeting with Troxler saying these fires, when they get out of control, they burn houses, businesses, and they do kill people.
The remarks highlighted a central concern from state officials. While recent rainfall has been helpful and reduced some immediate risks, the drought condition remains pretty dire across North Carolina, particularly as warmer weather draws more people outdoors. And as we are continuing to look at many days without significant rainfall across the vast majority of North Carolina.
So far, the Agricultural Commissioner and Steve Troxler said that North Carolina has managed to contain most fires before they grow into a large-scale disaster that would require some level of out-of-state assistance. But that success, he suggests, depends heavily on public compliance with restrictions like the burn ban. The urgency of that message stood in contrast to the historic setting, but also reinforced it. Halifax County's role in the American history was front and center throughout the meeting. Back on April the 12th, 1776, North Carolina's 4th Provincial Congress unanimously adopted the Halifax Resolves, authorizing its delegation to the Continental Congress to vote for independence and asserting the colony's right to self-govern.
The document laid out a decisive break from Britain, citing grievances that included destruction of property, interference with colonial governments, and broader abuses of powers. It concluded with the reconciliation with the mother country was no longer possible. You can read some additional coverage of that story this morning over on our website, CarolinaJournal.com. That's going to do it for a Friday edition. WBT News is next, followed by Good Morning BT.
We're back with you Monday morning, 5 to 6, right here on Charlotte's FM News Talk, 107.9 FM, WBT.
