Year in Review: Abortion, Medicaid laws stir passions

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(The Center Square) – Sides marched and rallied on Jones Street at the Legislative Building well into the summer ahead of the Dec. 1 implementation of a new abortion law in North Carolina.

The decision, coming more than a year after the U.S. Supreme Court reversed Roe v. Wade, topped the state’s 2023 impactful health care developments. Medicaid expansion followed close behind, as did the battle for women’s spaces in athletic competitions and significant surgeries on minors.

Abortion

The Care for Women, Children and Families Act stops abortions after 12 weeks of pregnancy with limited exceptions, down from 20 weeks under the old law. There are exceptions through 20 weeks for rape and incest, and through 24 weeks for “life-limiting” fetal anomalies. There is also a medical emergency exception.

Forty-two states, as of Dec. 1, have “restricted abortions beginning at specific stages of pregnancy,” according to Ballotpedia. Eight states and Washington, D.C., do not. North Carolina, with more than 32,000 legal abortions in 2021 before the Supreme Court decision, is among 16 states at 12 weeks or less.

Medicaid

Long a hard no by Republicans since earning majorities in both chambers of the General Assembly at the 2010 midterms, this was the year for a change in position on Medicaid. It wasn’t easy, either, after GOP leadership implemented the new budget separate from the enabling legislation Democratic Gov. Roy Cooper has championed since his first winning campaign in 2016.

The law went into effect Dec. 1, automatically enrolling nearly 300,000. Bill supporters had said the expansion could make eligible about 600,000 North Carolinians. Nearly $2.6 billion went to 102 hospitals in late November.

North Carolina is a recipient of $1.6 billion from the federal government. Because of the expansion, the state budget has a historical investment in health care – a $7.33 billion appropriation in the first year that swells to $7.76 billion in the second.

Gender surgery

Rules for medical professionals related to performing gender transition surgeries or prescribing puberty blockers or cross-sex hormones to minors became law in August when the General Assembly overturned a Cooper veto.

Medical professionals are prohibited from performing gender transition surgeries or prescribing puberty blockers or cross-sex hormones to minors, mirroring legislation adopted in 20 other states.

Women’s sports

Males who say they are female are not allowed to compete in athletics against girls and women.

The Fairness in Women’s Sports Act had the support of national advocate and Kentucky 12-time All-American swimmer Riley Gaines, former women’s college basketball national champion coach Sylvia Hatchell and Payton McNabb.

The latter played volleyball at Hiwassee Dam High School in Murphy until a boy saying he “identified” as a girl on an opposing team spiked a ball into McNabb’s head, leaving her with partial paralysis on her right side, chronic headaches, learning challenges and impaired vision.

The new law prohibits public middle and high schools, colleges and universities from allowing males to participate on female sports teams. Before going to the governor’s desk, amendments in the Senate had removed restrictions on women playing on men’s teams and references to collegiate intramural sports.

Hospital litigations

Dozens of Atrium Health facilities in North Carolina are no longer suing patients over medical debt following a policy change, a move state Treasurer Dale Folwell believes is “a little too little.”

Atrium Health revised its billing and collection policy to end its practice of pursuing small claims for medical debts to $5,000, and suing patients who owe more than that. Atrium Health said it made the decision nearly a year ago when it merged with Advocate Aurora Health to create Advocate Health, a massive six-state network of 67 hospitals with $27 billion in annual revenue.

Unrelated, state Attorney General Josh Stein in December filed suit on behalf of the state saying HCA Healthcare had not lived up to its end of a 2019 agreement when it purchased Mission Hospital in Asheville. If successful, the court would compel HCA to improve staffing levels and services to what they once were to maintain certain emergency, trauma and oncology services until 2029.

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