Health Care Issues Among Flurry of Last-minute Bills
Wednesday’s regulatory and reform committee meeting showed how political maneuvering can get special interests sneaked into an omnibus, vaguely described bill during the short session, which is supposed to focus on the state budget and bills leftover from last year.
By Hyun Namkoong
Just when political observers thought the short legislative session would be a pure numbers game with the budget, “sprawling” bills are jumping out of the woodwork at the N.C. General Assembly.
Senate Bill 493, originally a bill to prohibit “glaring and dazzling lights” on cars, turned into a 46-page regulatory reform bill overnight, with several policy changes and amendments unrelated to the disturbance caused by flashy headlights.
During a meeting of the House Regulatory Reform committee, legislators made a mad rush to get their amendments into the bill. Proposals were made so fast that the meeting was halted several times as lawmakers struggled to keep up with the flurry of papers distributed by House pages.
Bills such as SB 493 are emerging even as the House and Senate have claimed that they are only focusing on the budget and leftover legislation from last year.
The strategy of tacking on last-minute pieces of legislation into ambiguous and relatively innocuously titled bills raises concerns on transparency and public discourse.
“I think that legislators ought to think twice, and maybe three times, about whether they risk the credibility of their own institution when they patch together bills full of unrelated actions,” said Ferrel Guillory, a UNC-Chapel Hill professor of political journalism who also spent 20 years as a reporter and columnist at the News & Observer.
Guillory said he understands legislators’ desire to move quickly during the short session, but that, “You can make the case that big, sprawling, ungainly bills make it more difficult for citizens, the press, the lobbyists [and] interest groups to follow and influence what is going on in the legislature.”
The most notorious example from last year’s legislative session is SB 353, which drew wide criticism from women’s-health advocates for inserting restrictive abortion coverage and regulation language into a motorcycle safety bill with no advance notice.
“The question is not whether or not they can do it,” Guillory said. “The question is whether they should do it.”
In addition to health care provisions, the bill includes sections addressing public availability of mug shots, regulations on fraternities and sororities, animal-euthanasia standards and laws governing locksmiths.
Youth skin cancer prevention
If passed, SB 493 would also make it unlawful for minors to have a bronzed glow – that is, if the tan is from soaking in the UV rays of a tanning bed. The tanning bed language also comes from a bill that was passed by the House last March and has been sitting in the Senate without action since then.
According to the Centers for Disease Control and Prevention, indoor tanning has been linked to several forms of cancer. And young people in particular have a higher risk of acquiring melanoma.
The bill also requires consumers over 18 to sign a document acknowledging receipt of a warning statement that informs them of the “potential hazards and consequences of exposure to ultraviolet radiation.”
“We’ve got tanning beds into the budget; we’ve got it in this regulatory reform bill,” said Christine Weason, lobbyist for the American Cancer Society, acknowledging that backdoors remain open for lobbyists and lawmakers to get their interests onto the floor of the House or Senate during this short session.
“We’re doing what everyone else is doing, trying to see what sticks,” she said.
Tanning bed language also appeared in the House version of the budget, a move that drew criticism from members of the Senate.
“Don’t put policy in the budget,” said Sen. Ralph Hise (R-Spruce Pine), co-chair of the Appropriations on Health and Human Services Committee, during a Senate review of the House budget.
Autism health insurance coverage
Included in section three of SB 493 is an expansion of autism health-insurance coverage, a bill that passed the House during the 2013 session.
Autism health advocates have been fighting to require insurance companies to provide coverage for the screening, diagnosis and treatment of people with autism. The insertion of autism health insurance into SB 492 keeps the legislation alive and hopes high for advocates.
“We’re pleased that the House is continuing their support of this legislation,” said Jennifer Mahan, director of advocacy and public policy for the Autism Society of North Carolina. “We’re hoping the Senate will do the same.
“I was hopeful about the legislation the whole time. This makes it look like we have another opportunity for the Senate to consider this legislation.”
Pharmacy benefits management regulation
Provisions in SB 493 also change the way in which insurers or third-party administrators manage costs and prices for prescription drugs in pharmacies.
Language regulating the maximum cost that insurance companies can set for prescription drugs is included in the bill’s language, requiring insurance companies to set maximum allowable cost prices so that the cost of prescription drugs remains “consistent with changes in the national marketplace for prescription drugs.”
Insurance companies are also prohibited from providing incentives to policyholders that encourage them to get their prescription medication from a mail-order pharmacy.
On this, and other parts of the bill, some legislators had questions about why some of the sections were in the bill.
“[Could] a staffer or a bill sponsor give us an explanation of what it is we’re trying to achieve here,” asked Rep. Larry Hall (D-Durham), House minority leader, at one point during the committee meeting.
Tagged abortion, American Cancer Society, autism, Autism Society of North Carolina, Centers for Disease Control and Prevention, pharmacists, pharmacy benefits management, Rep. Larry Hall, retail pharmacies, Sen Ralph Hise, tanning beds