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Health Insurance

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Citizens and families in Alexander, Ashe, Watauga and Wilkes Counties who don’t have employer provided health insurance or who can’t get it because of prior conditions or can’t afford private health care insurance now have a possible option. On January 1, 2009, for the first time North Carolina will begin to offer health insurance opportunities for those unable to find coverage of prior conditions. An arrangement known as a “High Risk Pool” has been created. This represents a major development in the health insurance landscape of North Carolina as thousands of North Carolinians will now have access to more affordable coverage. The North Carolina Health Insurance Risk Pool, Inc. is offering three plans under the brand name of Inclusive Health. While the pool will only cover a small portion of the estimated 1.4 million people in North Carolina who are uninsured, it will provide help to those who are afflicted by the worst case situations. About three dozen other states already offer such plans. The state will pay for the program with a tax on health insurance premiums and an annual cash withdrawal from the State Health Plan for public service workers. It is starting operations with a $5 million grant from Health and Wellness Trust Fund. (Raleigh News and Observer, December 30, 2008) Established by the 2007 North Carolina General Assembly, the program is designed primarily for individuals with medical conditions that cause them to face higher health insurance premiums in the individual market. Eligible individuals will pay premiums that are set at 175% of an average of the individual insurance market rate. For many individuals who have been deemed high risk, this rate level will be considerably less than they would face from commercial plans. This is because the Legislature has placed a ceiling on premiums, with the state subsidizing the difference between what you would expect to pay under a commercial plan and what Inclusive Health will charge you. To quickly determine your Inclusive Health premium rate, visit www.inclusivehealth.org and follow the “Applicants” link to the “Premium Rate Calculator.” There are multiple ways individuals can qualify, with many people qualifying due to a pre-existing medical condition. The second group of potential Inclusive Health enrollees are federally qualified HIPAA eligible individuals who meet several complex criteria. (Call the toll free number cited below for information about the requirements.) The third group are those individuals eligible for the Health Coverage Tax Credit, which includes individuals who qualify under the Trade Adjustment Assistance Reform Act and who have lost their job because they have been shipped overseas. People with access to group employer coverage or who have Medicare or Medicaid do not qualify for Inclusive Health. To quickly determine if you may be eligible, visit www.inclusivehealth.org and follow the “Applicants” link to the eligibility worksheet. Inclusive Health offers three different benefit plans with annual deductibles of $1,000, $2,500 and $5,000 respectively. Their rates and benefit plans have been reviewed and approved by the North Carolina Department of Insurance. Benefits details can be found at www.inclusivehealth.org under the “About Us” link. If you or someone you know may be eligible, the Legislature created an incentive to enroll by June 30, 2009. Anyone who enrolls by then will have any pre-existing condition exclusion waiting period they face reduced from a maximum of 12 months to not more than 6 months. If you have any questions or would like additional information you may also contact Inclusive Health directly during business hours at (866)665-2117.

The Senate and House have both passed the state budget, and Governor Perdue has signed it into law — on time and in place for the start of the new Fiscal Year for the first time since 2003. I believe the budget is a thorough blueprint for our state as we come out of this awful recession and keeps us on track for the recovery. It helps small businesses, protects classroom teachers, supports our community colleges and universities, and prepares us for the future.

First, let me tell you what’s not in it: no pay cuts or pay raises, no mandated furloughs, no mass layoffs, and no new tax increases. In the aftermath of the Great Recession and historic budget shortfalls, that was quite a feat.

CUTTING SPENDING
This budget takes us back to 2006-2007 levels at under $19 billion. We have made difficult cuts — we’ve cut spending by $800 million in this budget and we’ve identified another $518 million in cuts if Congress does not come through with their federal health care matching funds. In all, the budget has been cut by around $3 billion over the last two years without even taking into account the federal recovery funds that helped us protect education and health care for the needy.

SUPPORTING SMALL BUSINESSES AND CREATING JOBS
The budget includes a tax credit for 125,000 small businesses (most of which have less than 10 employees) that employ 500,000 people in our state. It lowers the cost of maintaining and adding jobs in North Carolina for the next two years by allowing a refundable income tax credit to a small business equal to 25% of the amount it paid in unemployment insurance tax on wages paid to employees.

The budget also includes:
• Loans to help small businesses keep their doors open and funds to help small businesses leverage federal entrepreneur grants
• Restores funds for Small Business Centers at 58 community colleges, which supports the development of new businesses and the growth of existing businesses by being a community-based provider of training, counseling, and resource information
• Builds the “In-source NC” database to help NC companies find and use other NC companies for supplies and services

PROTECTING EDUCATION

The budget works to protect classroom teachers and minimize cuts to K-12 education. We were able to protect an estimated 1,700 teaching positions by adjusting the Education Lottery receipts budgeted for classroom teachers.

It also:

• Provides funding for handheld diagnostic devises, giving teachers a high-tech tool for measuring student progress.
• Preserves recurring funding for dropout prevention grants
• Fully funds enrollment growth at community colleges, which has grown by over 30,000 students this year alone
• Fully funds enrollment growth at universities, and removes any proposed cap on enrollment
• Provides $33 million for community colleges to purchase vital health, science, engineering, and technology equipment

PROVIDING FOR THE PEOPLE OF OUR STATE
• Helps working families with health insurance costs; adds 2,750 more kids to Health Choice for a total of 137,789 children
• Restores damaging cuts to the mental health system
• Continues North Carolina’s landmark per year investment in cancer research
• Statewide expansion of CJLEADS, a new data system to track probationers

We have worked well with our counterparts in the House, and this is truly a compromise budget where, in most cases, we met in the middle. In North Carolina, we have a long tradition of being a state where people want to live and work, to raise their families, and to retire. The priorities we fund help shape that quality of life. Even in the toughest of times, we have come together to craft a budget that is, I believe, a strong and appropriate plan to lead our state into brighter days.

The full budget is here:
http://www.ncleg.net/Sessions/2009/Bills/Senate/PDF/S897v8.pdf

The spending and reduction summaries:
http://www.ncleg.net/sessions/2009/budget/2010/SB897_Joint%20Conference%20Committee%20Report%2006-28-10.pdf

As always, please don’t hesitate to let me know your thoughts on the budget or any other issue you feel is important and thank you for the opportunity to serve you in the Senate.

Authorized and Paid for by Steve Goss for NC Senate