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Senate | January 5, 2013 | Chamber | Session

Full MP3 Audio File

From Tuesday February 5th 2013 the following is a replay of ??? radio dot com’s coverage of the daily session in the North Carolina Senate CHANGE SPEAKER Senate will come to order. Sergeant at Arms will close the doors, members will go to their seats. Without objection our prayer will postponed until the 3PM session today. Senator Gunn is recognized for a motion. CHANGE SPEAKER Thank you Mr. President. Mr. President, the Journal on Monday February 4, 2013 has been examined and has found to be correct. I move that the senate dispense with the reading of the Journal and that it stand approved as written. CHANGE SPEAKER Without objection the journal from February 4, 2013 stands approved as written. Senator Meredith is recognized for a motion. CHANGE SPEAKER Mr. President I move that the Senate now be recess subject to introduction of bills and resolutions, the receipt and reading of messages from the House and . the Governor, and the receipt and referral and re-referral of the bills and committee reports to reconvene this afternoon at 3PM. CHANGE SPEAKER You sound like me. {laughter} Without objection the Senate stands in recess subject to the stipulations stated by Senator Meredith until 3PM today. CHANGE SPEAKER Senators come to order. Sergeant at Arms will close the doors; members will go to their seats. All members and ?? ?? ?? CHANGE SPEAKERS ?? pray ?? to us almighty ?? not be anxious about your life, you say to us in scripture, Do not be anxious about your life or what you’ll put on, or what you’ll eat, or what you will drink, nor about your body, or what you’ll ?? great news. That’s great news, Lord, great news, so we ?? up at our community that are sick in body, mind, spirit, to those that have fallen, those that are struggling, ?? As they deliberate, give them wisdom, and prudence and self-control, give them sound minds and pure reason ?? Reminding each of them that the height of reason is to recognize reasons ?? place such as this to have political conversation and debate, gives us such great hope that you have gathered us together, ?? and that these ordinary means of grace will move us forward as a state, thank you for being our provider, thank you for this day, and we ask you again to bless this time together ?? Christ sake, Amen. CHANGE SPEAKER A leave of absence is granted today for senator Hartsell. We do have a nurse of the day with us today; our nurse of the day is Debra Azell from Wilmington, North Carolina, Debra thank you for being with us, and thank you for your service. {Applause} Members were going to jump into the calendar, we are on the third reading of Senate bill 4 and the clerk will ?? read CHANGE SPEAKER Senate bill 4 no NC exchange, no Medicaid expansion. CHANGE SPEAKER Any further discussion or debate on the bill? Senator ?? what purpose do you rise? CHANGE SPEAKER Thank you Mr. President, speak briefly on the bill CHANGE SPEAKER You have the floor senator CHANGE SPEAKER Thank you Mr. President

...President and to the leadership of the Senate, we truly appreciate you giving us this additional day on the bill and it was so gracious of you to do that, but we intend not to keep you here long on this bill today, in return. I think we had a very good debate on this last night. I think by handling it yesterday and today we've given the public a little bit more time to dwell on this bill. The problem is when they don't know what's going on in this building. And that applies to when we're in power or you're in power or anybody's in power. We got to go at such a pace that the public can at least be informed as to what we're doing here. I think we found some salient points for you yesterday to think about and I heard Senator Berger loud and clear that we have until the end of this session to continually deal with this matter. This bill doesn't preclude making whatever decision the General Assembly decides to make governing the expansion of Medicaid. And hopefully, some of the members on the other side of the aisle will have time to talk to your folks back home, especially these rural hospitals. We are truly concerned about them and we think that they will be in peril if we don't do this and certainly you need to listen to the Governor. I know it's hard sometimes, but you just need to do it. He's got a job to do over there and I think I heard the other day through the grapevine that Kasick had been able to negotiate with the Feds and get some flexibility on how they handle Medicaid and was able to go ahead and expand his. So maybe if the Governor has some time that'll happen. I think we need to look at the fact that if this bill passes and becomes law we cut off the opportunity to use that $73 million that we got. The case was made to us by the insurance department that once you say we absolutely are not going to do this there may be the possibility that we can not continue to access that money because we wouldn't be acting in good faith. It was given to us in consideration of I'm not sure. Either going ahead with the exchange or going ahead with Medicaid expansion. Probably the exchange. And I think the Governor's concerned about that money getting gone. But with that said, we still encourage you not to pass this bill and when it passes here today, if it finds a resting place to let it rest and let's get all the information before we jump off this ledge. I think this will be, we think this is one great opportunity for this State and for the people of this State and all ways. It's good for the economy. And we would encourage you not to support the bill but if you do, give it some time. Thank you. [SPEAKER CHANGES] Is there any further discussion or debate? [SPEAKER CHANGES] Mr. President? [SPEAKER CHANGES] Senator Apodaca, for what purpose do you rise? [SPEAKER CHANGES] Speak on the bill reluctantly, please? [SPEAKER CHANGES] Senator, you have the floor. [SPEAKER CHANGES] Thank you, Mr. President. Members, Senator Nesbitt, I do appreciate your comments and always in Raleigh we talk about slowing things down when we don't want them to happen. I understand that. I guess other folks understand that, too, but that really isn't how things work. So we're going to move this on, but one good thing we were able to do was overnight I had staff look up a few things for me. And all I've heard about the Affordable Healthcare Act was that it was going to be good for everybody. It was going to make things better. And last night we limited our debate to that difference, those folks between 100%, 135% of Federal poverty rate. And it sounded to me like they were going to be left out in the cold. Just without any kind of insurance whatsoever. So, that's not the case. Let's talk about it a moment. Let's take a hypothetical question. Say we have a family of three with one bread winner making $24,000 a year. Now that's 133% of the Federal poverty level.

And we all know that’s almost impossible to live off of. We understand that, but what the Affordable Healthcare Act does do, it provides those folks in that category with a: refundable and advanceable tax credits, and b, and the most important part, is advanceable monies, meaning their premiums will be helped paid for by this. So in this example, they cannot pay a premium more than 3%. That would be $731 for the year. Now just because you’re poor, doesn’t mean you’re stupid, and I think families will take advantage of this, and paying $731 for your whole family is not a whole lot to ask. So I think as we go down this road and we get accused of forgetting the folks that can’t help themselves or are down on their luck or whatever it may be, I can assure you on this side of the aisle we don’t feel that. We care about those folks, but as my son told me today when he was reading some of the articles, money from Washington still isn’t free. That’s our tax dollars. And I did shed a tear, hearing it from him. I never thought he would become a Republican, but anyway, he has. But we care about folks, and I think this plan, and with the current financial shape of North Carolina, this is the best way for us to go, so I encourage you to vote yes. Thank you. [SPEAKER CHANGES] Senator Hise, for what purpose do you rise? [SPEAKER CHANGES] Speak to the bill. [SPEAKER CHANGES] Senator, you have the floor to speak to the bill. [SPEAKER CHANGES] Members of the Senate, I wanted to take just a moment to discuss the arguments put forward about how that prohibiting the expansion of Medicare was quite so devastating to rural health. I’ve spent some time over the evening and I’ve come to quite the opposite conclusion. I looked over the study that Senator Brown referenced yesterday from Harvard, and I quite frankly believe that if we allow Medicaid to expand in North Carolina, we will destroy rural healthcare. The study that was referenced here yesterday indicates if you believe it is a saving grace, you would somehow believe that this expansion from 100 to 133% of federal poverty represents the uninsured. Quite frankly, that income group represents 9% of the uninsured. The breakdown that this study offers of where the new Medicaid recipients would come from indicates that 80% would come from current private insurance coverage, 14% from uninsured, and 6% from other public insurance. Now I talk to rural hospitals quite a bit – that’s what I represent, and their biggest problem right now is their provider mix, what they have of Medicaid recipients, Medicare recipients, neither of which cover the actual cost, and the small percentage they have of private insurers. If you allow this Medicaid expansion to go through, you will reduce their private insurance and expand their Medicaid payer base. It will make operation impossible. However, if we prohibit this expansion and we allow those individuals to purchase as we’re now seeing on a federal exchange program, for a family of four at the top end, you’re looking at somewhere in the neighborhood of 52 dollars a month for insurance coverage, that we can take that same population and add them to the insurance market, which does cover the cost of a hospital and allow them to move forward. By putting this bill in action, we can make sure that we are making a better payer mix for rural hospitals. 11 counties in North Carolina have a median family income lower than 138% of federal poverty. It’s $31,800 is what it’s expected to be in 2014. You cannot operate a hospital when more than 50% of your population and families would be paid for under the Medicaid system. It doesn’t work and it doesn’t continue. That is why I continue to ask for your support on this bill. [SPEAKER CHANGES] Mr. President? [SPEAKER CHANGES] Senator Stine, for what purpose do you rise? [SPEAKER CHANGES] To see if Senator Hise will yield for a question. [SPEAKER CHANGES] Senator, do you yield for a question? [SPEAKER CHANGES] I do. [SPEAKER CHANGES] The Senator yields. You have the floor. [SPEAKER CHANGES] Do you agree

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49 having voted in the affirmative and 0 in the negative, Senate Resolution 41 is adopted. Notices and announcements. [SPEAKER CHANGES] Mr. President. [SPEAKER CHANGES] Senator Brunstetter, for what purpose do you rise? [SPEAKER CHANGES] Two announcements please. [SPEAKER CHANGES] You have the floor Senator. [SPEAKER CHANGES] Members, tomorrow morning at 8:30 in room 643, we will finish the Joint Appropriations budget presentations. We have about ten more minutes of presentation and then we’ll continue the questions, we have quite a few questions this morning and we’ll continue that tomorrow. I expect that to last about 30 to 60 minutes or so. Second announcement, Mr. President. The International Business and Trade caucus will meet tomorrow at 4:00 pm, room 1228, all members are welcome. Thank you. [SPEAKER CHANGES] Thank you, Senator. Any other notices or announcements? If not, the chair recognizes Senator Berger for a motion. [SPEAKER CHANGES] Thank you, Mr. President. I move that the Senate do now adjourn subject to introductions of bills and resolutions, receipt and reading of messages from the House and the Government, and the receipt, referral, and re-referral of bills and committee reports to reconvene tomorrow, Wednesday, February 6th, 2013 at 10 AM. The actual session will be at 2 o’clock. At 10 AM we will open and take a recess until 2. [SPEAKER CHANGES] Thank you, Senator. The motion is that the Senate do now adjourn subject to the stipulations stated by Senator Berger to reconvene Wednesday, February 6th at 10 AM, seconded by Senator Brock. All in favor say aye. [SPEAKER CHANGES] Aye. [SPEAKER CHANGES] All opposed say no. The ayes have it and the Senate stands adjourned. All right, good job.