A number of House Republicans expressed concerns with Senate Bill 933, saying they hadn't had time to vet it. The legislation, which would allow statewide nonprofits to create new health insurance plans largely free of state or federal regulation, was heavily debated in the Senate but came to the House without regular committee debate.
Even House Republicans against the Affordable Care Act said the idea to bypass it needs more study. It was voted down 38-53.
"This might be the best idea since sliced bread, but I'm not quite ready to say yes," said state Rep. Donny Lambeth, R-Forsyth, co-chairman of the House Health Committee.
House Rules Chairman David Lewis, who carried the bill in the chamber, declared it dead after the vote, declining to take House Speaker Tim Moore up on an offer to send the bill into negotiations with the Senate as the legislature approaches the end of its session. It's unclear what that will mean for the original bill that the insurance plan legislation was pasted into.
That portion of the bill is meant to entice more psychologists to North Carolina public schools, which have 75 vacancies at the position. It was initially billed a mental health and school safety measure.
The North Carolina Farm Bureau pushed for the insurance provision, saying it wanted to offer members health plans with lower monthly premiums than they face through the ACA's online exchange. They pointed to examples of skyrocketing premiums and deductibles faced by family businesses, something Lewis, R-Harnett, reiterated on the House floor.
Lewis deals farm equipment and said he's heard from farmers who pay $2,000 and $3,000 a month for health insurance just to cover themselves and a spouse.
"I'm just saying there's got to be a better way," Lewis said.
Supporters acknowledged that people with pre-existing conditions could still face higher prices, though, and the North Carolina Health Advocacy Project at the North Carolina Justice Center said the bill would continue to let plans price people out of coverage.
The American Cancer Society Cancer Action Network put out a statement against the bill as well.
"Allowing the sale of unregulated and inadequate health plans risks splitting the insurance market into two," the group said. "Young and healthy people would pay less for inadequate coverage and older and sicker people, like those with cancer, would pay much more for coverage that meets their needs."
The amended bill cleared the Senate 37-7, though Sen. Paul Lowe, D-Forsyth, said he meant to vote for the legislation, as he did Wednesday. Thursday's vote gave the bill support from nearly half the Senate's Democrats, including Senate Minority Leader Dan Blue, D-Wake.
Lowe noted that the legislation wouldn't have taken effect until 2020, and he said a lot could happen between now and then. Among other things, there's an election that could determine the balance of power in Raleigh. Lowe also said that associations, including the Farm Bureau, should be able to offer plans to their members.
"It's going to need regulation (though), no doubt about it," he said.
Lowe said the groups need to offer "some downsized policies, and they're going to have to offer some Cadillac policies as well," but he acknowledged the bill didn't require that.
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