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Senate votes to send cannabis research bill to Biden (Newsletter: November 17, 2022)

Interstate marijuana commerce suit; Biden: cannabis moves are “top” achievements; Reps want banking data; GOP Congress legalization plan; MD hearing

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/ TOP THINGS TO KNOW

The Senate approved a House-passed marijuana research bill—marking the first time in history that standalone cannabis reform legislation has ever been sent to the president’s desk.

Just before the vote, Senate Majority Leader Chuck Schumer said on the floor that he’s holding “productive talks” about “moving additional bipartisan cannabis legislation in the lame duck.”

The White House is touting President Joe Biden’s move to pardon people for cannabis and initiate a review of its scheduling status as one of the administration’s “top accomplishments”—saying it will remedy the U.S.’s “failed approach to marijuana.”

Reps. Barbara Lee (D-CA) and Earl Blumenauer (D-OR) sent a letter asking the Treasury Department’s Financial Crimes Enforcement Network to provide marijuana banking data—including a demographic breakdown that they say can “inform federal efforts around equitably ending the racist cannabis prohibition.”

Rep. Nancy Mace (R-SC) spoke to Marijuana Moment about her plans to advance marijuana reform in a Republican-controlled House of Representatives next year.

“The only place that cannabis is controversial is in D.C.”

An Oregon marijuana business filed a federal lawsuit seeking to overturn the state’s ban on cannabis exports and imports to and from other states—arguing that it violated the U.S. Constitution’s Dormant Commerce Clause.

The Maryland House Cannabis Referendum and Legalization Workgroup held its first hearing since voters overwhelmingly approved legalization on the ballot. Lawmakers now need to craft legislation regulating the market, and this latest meeting focused on taxes.

Three subcommittees of the Louisiana Employment and Medical Marijuana Task Force met to discuss issues related to workplace protections for medical cannabis patients.

/ FEDERAL

Former President Donald Trump, in his reelection campaign announcement speech, said he would “wage war on the cartels” and reiterated that he would ask Congress for legislation “ensuring that drug dealers…who are responsible for death, carnage and crime” would receive the death penalty.

Sen. Steve Daines (R-MT) said he is open to including expungements provisions in a package of marijuana reforms alongside banking access.

Former House Speaker Newt Gingrich (R-GA) said he will be watching to see how Sen.-elect John Fetterman (D-PA) evolves and changes “in between periods of marijuana and whatever else it is he does.”

Rep. Alexandria Ocasio-Cortez (D-NY) tweeted, “President Biden sent an important signal when he pardoned citizens with federal charges for simple marijuana possession. But there’s still a lot more to do: 1 Expungement. A pardon ends a prison sentence, but it doesn’t erase the charge from your record. People with simple marijuana possessions are still being blocked from accessing housing, employment and other resources. We must expunge records in addition to providing pardons. 2 Pardon immigrants. President Biden’s pardon only applied to citizens with federal marijuana charges. Many immigrants applying for citizenship could continue to face deportation or other adverse consequences for possessing a substance that is now legal in many states.”

Rep. Ayanna Pressley (D-MA) tweeted, “Black folks have been disproportionately locked up for marijuana offenses. Now, we’re being locked out of the growing legal cannabis industry. We need a cannabis policy that centers equity and the people most impacted by the failed War on Drugs.”

Former Rep. Greg Walden (R-OR) tweeted about the participation of the Coalition for Cannabis Policy, Education, and Regulation, for which he serves as co-chair, in a congressional hearing, saying, “Today’s hearing was a step in the right direction to creating a legal, regulated market for cannabis through federal guidelines.”

/ STATES

South Dakota Gov. Kristi Noem (R) said her reelection effort was “tough” because marijuana and other issues were on the ballot.

The Pennsylvania House of Representatives voted to impeach Philadelphia’s district attorney through a resolution that criticizes his decision not to prosecute certain marijuana and drug paraphernalia cases.

Kansas’s House minority leader wants an interim committee on medical cannabis to have additional meetings.

A Missouri senator-elect who currently serves as a representative said he would file a proposed constitutional amendment to steer legal marijuana tax revenue toward eliminating the personal property tax.

Florida has a new top medical cannabis regulator.

Indiana’s State Police superintendent said he doesn’t support legalizing marijuana but that he hasn’t seen an increase in enforcement near the borders with states that have enacted reform.

Ohio regulators said it doesn’t appear that the state can enter into a medical cannabis reciprocity agreement with Kentucky under the limited provisions of an executive order on the issue that Gov. Andy Beshear (D) issued this week.

New York regulators are being accused of violating the Constitution with guidance that says recreational marijuana “dispensaries, their true parties of interest, passive investors, and any management service providers cannot have any interest in any business anywhere that cultivates, processes, or distributes cannabis.”

Oklahoma regulators are accepting public comments on proposed medical cannabis rules through December 15.

Vermont regulators posted an update on the first six weeks of the state’s legal adult-use marijuana market.

Arizona regulators will begin accepting applications for nonprofit medical cannabis dispensary certificates on December 16.

Washington State regulators will host a conversation to explore ideas for modernizing rules for cannabis plant canopy on November 29.

—
Marijuana Moment is tracking more than 1,500 cannabis, psychedelics and drug policy bills in state legislatures and Congress this year. Patreon supporters pledging at least $25/month get access to our interactive maps, charts and hearing calendar so they don’t miss any developments.

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—

/ LOCAL

The San Francisco, California Board of Supervisors voted to suspend the city’s cannabis business tax until the end of 2025.

/ INTERNATIONAL

The Colombian Senate First Committee approved a report attached to a marijuana legalization bill, with a vote on the legislation itself expected next week.

Bavaria, Germany’s health minister is urging European Union officials to block his country’s marijuana legalization plans.

/ SCIENCE & HEALTH

A review concluded that “CBD is a well-tolerated and safe natural compound that exerts analgesic effects, decreasing hyperalgesia, and mechanical/thermal allodynia in several animal models of pain and patients” and that “using CBD seems to be a promising strategy to overcome the lack of efficacy of conventional treatment for chronic pain.”

A review highlighted the “diversification of clinical trials on cannabinoid-based medications in the past 21 years,” underlining “the increased interest in conducting clinical studies on new cannabinoid administration methods such as topical applications and on the investigation of emerging phyto- and synthetic cannabinoids” and showing that “more clinical trials have been designed to explore the potential therapeutic benefits of cannabinoids in areas such as mental, behavioral, or neurodevelopmental disorders and skin diseases.”

/ ADVOCACY, OPINION & ANALYSIS

A poll of Scottish adults found that they support ending prosecutions of people for possessing small amounts of marijuana, 65 percent to 18 percent, and support enacting the same policy for heroin, 42 percent to 36 percent.

The Kentucky Democratic Party tweeted, “Thanks to Gov. @AndyBeshearKY’s executive order, medical cannabis can be legally used starting Jan. 1, providing a lifeline to Kentuckians in pain. This is huge — while GOP lawmakers continue to ignore the will of an overwhelming majority of Kentuckians, Gov. Beshear listened.” The party also criticized the state’s agriculture commissioner, saying, “After Ryan Quarles tried to ban Delta 8, a state court ruled that this hemp derivative — which is not a controlled substance under state or federal law — is legal in Kentucky. Yesterday @GovAndyBeshear announced official regulations to ensure it can be sold and purchased safely.”

ASTM International’s cannabis committee developed a new practice for supplier lifecycle management.

Oklahoma Southern Baptists adopted a resolution opposing marijuana legalization.

The director of Americans for Prosperity Montana spoke about efforts to build support for psychedelics policy reform in the state.

/ BUSINESS

SHF Holdings, Inc., d/b/a/ Safe Harbor Financial closed its acquisition of Rockview Digital Solutions, Inc, d/b/a Abaca.

Charlotte’s Web Holdings, Inc. received a $56.8 million investment from a subsidiary of BAT.

Payments provider Zotto is being accused of withholding money from several CBD companies.

WM Technology, Inc. has a new chief marketing officer.

Michigan retailers sold $209.4 million worth of legal marijuana products in October.

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November 19, 2022

Senate passes marijuana medication bill

The Senate passed a bill on Wednesday night time that will grow exploration into the likely health care added benefits of cannabis and CBD.

The Medical Cannabis and Cannabidiol Research Growth Act was handed on Wednesday by means of unanimous consent by a voice vote and will now head to President Biden’s desk to be signed.

The invoice, passed by the Property in July, establishes a new registration method for exploring cannabis and its derivatives. Under the provisions of this legislation, the Drug Enforcement Administration (DEA) will be directed to register entities who carry out cannabis study and those people who offer the marijuana.

The registered entities will be permitted to manufacture, distribute, dispense and possess cannabis or CBD for clinical analysis applications.

“There is substantial proof that marijuana-derived prescription drugs can and are giving major well being gains. Our monthly bill will make it much easier to review how these medications can take care of a variety of conditions, ensuing in much more patients becoming capable to easily obtain harmless medicines,” mentioned Sen. Dianne Feinstein (D-Calif.), who introduced the monthly bill alongside with Sens. Chuck Grassley (R-Iowa) and Brian Schatz (D-Hawaii).

Until eventually this 12 months, the Nationwide Centre for the Advancement of Purely natural Products at the University of Mississippi was the only accepted provider of marijuana for study reasons in the United States. The marijuana at the Mississippi facility was solely grown for research conducted by the National Institute on Drug Abuse.

Having said that, the DEA mentioned in 2021 that it would prioritize efforts to develop cannabis analysis. The agency authorised six new entities this yr to mature cannabis for analysis, which include the Scottsdale Study Institute in Arizona and Royal Emerald Pharmaceuticals in California.

“At a time when much more than 155 million Individuals reside wherever adult-use of hashish is legal at the point out or neighborhood stage and there are four million registered health-related marijuana consumers with several extra likely to self-medicate, it is necessary that we are in a position to fully research the impacts of cannabis use,” stated Rep. Earl Blumenauer (D-Ore.), co-chairman and founder of the Congressional Cannabis Caucus, in a assertion.

At the second, 37 U.S. states and Washington, D.C., permit for the healthcare use of cannabis. And following voters handed ballot steps in several states in the modern midterm elections, virtually 50 percent of all states also now permit grownup recreational use of the drug.

In Oct, Biden also requested the secretary of Health and Human Companies and the legal professional basic to overview marijuana’s position as a Routine I drug. This status areas cannabis in the identical class as heroin and LSD, designating it as a substance with no health-related price and a higher potential for abuse.

November 18, 2022

GOP takes indirect aim at Fetterman’s health in Pennsylvania Senate race

The perfectly-wishing is above. Now Pennsylvania Lt. Gov. John Fetterman’s stroke is formally a campaign concern in the swing state’s U.S. Senate race.

But instead than instantly criticize Fetterman more than his health and fitness, Republicans are taking a unique strategy: bashing the Democrat for not remaining far more clear about the stroke that hospitalized him four times before he handily gained the May possibly 17 primary.

The Fetterman marketing campaign waited two times to disclose his hospitalization, issued a assertion that puzzled cardiologists and later acknowledged that he had a earlier undisclosed coronary heart problem that led physicians to set up a pacemaker with a defibrillator previous thirty day period. He was unveiled from the clinic numerous days immediately after the election.

On Thursday, the National Republican Senatorial Committee, or NRSC, unveiled a world-wide-web advertisement that featured news protection of pundits and reporters talking about the Fetterman campaign’s evolving explanations of his wellness and hospitalization, inquiring, “Does John Fetterman Have a Difficulty Telling the Real truth?”

The advertisement, from the campaign arm of Senate Republicans, was a marked departure from current remarks by Fetterman’s opponent, celeb Tv set doctor Mehmet Oz, who wished him well when he was initially hospitalized.

It is also the very first time Fetterman’s overall health has been raised — although indirectly — by Republicans, who program a compensated Television set media invest in to tarnish the brand of a Democrat who designed a standing as a much larger-than-lifestyle straight talker, in accordance to an NRSC consultant who was not approved to explore marketing campaign strategy publicly. The guide claimed the NRSC also plans to goal Fetterman more than how he has talked over a 2013 incident when he pulled a gun on Black guy he suspected of prison functions.

Pennsylvania Democrats, meanwhile, have expressed worries about how the Fetterman campaign has dealt with both of those the stroke and discussion of the gun incident. But a spokesman for the lieutenant governor claimed the GOP criticisms will not operate with voters.

“Pennsylvania voters know and have faith in John Fetterman. Who they never believe in is Mehmet Oz, who is a fraudster and a scam artist who isn’t even from and does not know Pennsylvania,” Fetterman spokesman Joe Calvello reported, obliquely referring to a Democratic Senatorial Campaign Committee world-wide-web advertisement assault on Oz, whose campaign wouldn’t remark.

Fetterman’s wife, Gisele Fetterman, insisted in an NBC Information interview that aired Wednesday that her household and the marketing campaign had been open about his issue as they ended up just striving to “navigate these pretty personal and hard points quite publicly.”

“We have finished a superb career on transparency,” she reported.

On Election Working day, Gisele Fetterman instructed her husband’s situation wasn’t so poor, calling the stroke “a minimal hiccup.” She said he’d be “back on his ft in no time.” But Fetterman remained in the hospital for 9 times, and his campaign says he’s nevertheless resting and could possibly not be back again on the trail until July.

It was not until finally very last Friday that Fetterman, in a assertion issued by his medical professional, disclosed that he experienced been diagnosed in 2017 with “atrial fibrillation, an irregular heart rhythm, alongside with a decreased heart pump.”

Fetterman, who is 6-ft-8 and weighed 418 lbs at the time of his analysis, when he was the mayor of Braddock, immediately went on a eating plan just after the diagnosis, and a 12 months later he touted his new wholesome way of living, telling the Pittsburgh Tribune-Assessment he had misplaced 148 lbs .. He failed to mention his coronary heart trouble in that job interview, nor was he getting his heart drugs or viewing his health care provider at the time.

“He possibly thought to himself: ‘I lost 150 pounds. I’m working all around. I’m nutritious now. I never have to have to convey to any one or see my health care provider or take my prescription drugs.’ Properly, that was dumb. Now he’s bought a pacemaker, and individuals are inquiring issues,” said Neil Oxman, a Pennsylvania Democratic strategist.

Oxman said the Republican assault on Fetterman’s transparency was the only way to broach his health with no seeming cruel. But he reported it would have minimal salience with voters mainly because of the timing and since Fetterman is anticipated to be again on the marketing campaign path.

“If he’s up and functioning 3 months from now, no a single will treatment,” Oxman mentioned.

Republican guide Charlie Gerow, who ran unsuccessfully for governor in final month’s GOP main, agreed with Oxman that the attack is “not a match changer,” expressing Fetterman will be bogged down more by the toll of inflation and other headwinds experiencing Democrats in the midterm elections.

But Gerow explained that in a carefully divided swing condition, everything issues.

“When candidates really don’t talk straight, it doesn’t engage in nicely,” Gerow stated.

Marc Caputo is a senior countrywide political reporter for NBC Information.

June 10, 2022

NC Senate Republicans float Medicaid expansion bill

By Rose Hoban and Rachel Crumpler

It finally happened.

In a move that many health care advocates have been pushing for years, the state Senate introduced a bill on Wednesday that would expand the state’s Medicaid program to some half million-plus low-income North Carolinians.

Until this point, Medicaid has been reserved mostly for children from low-income families along with a small number of parents in those families, poor seniors and people with disabilities. Since 2012, the possibility to sweep in many low-income workers has been on the table as a result of the Affordable Care Act, but Republican leaders in the state senate have been staunch opponents.

Now, after years of saying no, powerful Republicans in the state Senate are saying yes.

“Why now? Why this? First, we need coverage in North Carolina for the working poor,” said state Senate leader Phil Berger (R-Eden), who admitted during a press conference Wednesday that he has likely been the most outspoken person in the state about his opposition to Medicaid expansion.

“Second, there is no fiscal risk to the state budget moving forward with this proposal,” Berger added, noting that the bill includes pay-fors that would have hospitals largely on the hook to pay the 10 percent of the costs for the expansion population not covered by an enhanced federal payment. There’s also a federal incentive that would total some $1.5 billion in extra funds that would flow to North Carolina over a two-year period.

Finally, he argued that since the state has moved Medicaid from being a state-run fee-for-service program to one managed by commercial insurance companies, the program has been “reformed and transformed.”

“Medicaid expansion has now evolved to a point that it is good state fiscal policy,” Berger continued. “But again, I cannot emphasize this enough: Expanding Medicaid needs to happen with additional reforms.”

Those reforms could make the bill to be titled Expanding Access to Healthcare in North Carolina a hard pill for many to swallow. One aspect of the bill would set up a work requirement for the new beneficiaries, something that’s been repeatedly struck down in other states by federal judges.

What really might jeopardize passage of the bill is that it contains provisions that already are raising hackles in some powerful health care lobbies, including those that advocate for the state’s physicians and hospitals.

Resistance from doctors

One reform proposed in the 33-page bill would make it possible for advanced practice nurses such as nurse practitioners, nurse midwives and certified registered nurse anesthetists (CRNAs) to practice without having a contract with a physician for their supervision.

Physician and nursing groups have been divided over the so-called SAVE Act for years, with medical providers — led by the North Carolina Medical Society — usually being able to stop the nurses from having more leeway in their practices. At a Senate Health Care Committee hearing held after the press conference, several Democratic lawmakers also expressed reservations over this part of the bill.

Chip Baggett, head of the North Carolina Medical Society, also spoke out about the nursing practice language in the bill at the committee. He had a number of problems with the changes.

“The first is the foundational education that is received by APRNs, many of which are receiving online education right now, and we do not think that provides the foundation necessary for independent decision making,” Baggett added after the meeting.

Several decades of research, though, bolster the nurses’ contention that their practices are safe, and that patient satisfaction with advanced practice nurses is often better than for physicians.

Joyce Krawiec, a Republican state senator from Kernersville, noted that 137 health care facilities across North Carolina only have CRNAs to deliver anesthesia services and that 34 other states have already loosened the rules around nursing practice.

“My husband had a colonoscopy recently, and they can do it with the supervision of a physician,” Krawiec said. She recounted how she asked the physician leading the procedure if he was overseeing the anesthesia. He responded, “Heavens, no, I don’t supervise her. He said I haven’t looked at anesthesiology since I was in medical school. I wouldn’t know what to do. She does it all on her own.”

Sen. Ralph Hise (R-Spruce Pine) argued that making it easier for nurses to practice, particularly in rural burgs, needed to be included in any bill that would make it easier for more people to see those providers.

“Finding nurses in this state is becoming more and more impossible,” Hise said. “And so this bill, allowing the nursing profession to expand its scope, to have more upward mobility in the nursing program is what ultimately I think will allow us to provide a lot of health care that we currently just don’t do.”

Rep. Gale Adcock (D-Cary), who is also a nurse practitioner, said that increasing access to health insurance would require adding providers.

“The majority of folks clearly understand these things all need to happen at the same time, and I’m excited to see that it might happen soon,” she said.

Hospitals, House objecting?

One of the big obstacles to Medicaid expansion that Republican lawmakers have raised for years has been where the 10 percent of the expansion cost not covered by the federal government would come from. For years, lawmakers have argued that hospitals would be the main beneficiaries of more federal dollars for Medicaid flowing to the state, so hospitals could foot much of the bill in the form of an additional assessment.

Hospitals have said they lose so much on uninsured patients that they were willing to pay for some of the cost, but not the whole tab. In Medicaid expansion bills in other years, this cost was also borne by a new tax on commercial managed care companies providing coverage under the “transformed” Medicaid program.

Rep. Tim Moore (R-Kings Mountain), speaker of the North Carolina House of Representatives, told reporters on Wednesday afternoon that he didn’t think members of his caucus had an appetite for Medicaid expansion this year. Photo credit: Rachel Crumpler

Hise contended the proposal will definitely help hospitals’ bottom lines, with more federal money flowing into the health care systems than they’ll have to put out to cover the rest of the Medicaid expansion population.

A spokesman from the NC Healthcare Association, which represents the state’s hospitals, told NC Health News that his organization was reviewing the new bill and would wait to offer comment on its potential impact.

The other big obstacle to passage of the bill may come from the other side of the General Assembly building in Raleigh, in the House of Representatives. Leaders there have expressed hesitation about making such a big policy change during this year’s short legislative session.

“The position of the House is we have no plans to take up expansion in the short session,” Rep. Donny Lambeth (R-Winston-Salem) said in a text to NC Health News.

Lambeth has been leading a committee with members from the House and Senate since January that has been examining what it would mean for the state to expand Medicaid.

“The work of the committee has not been finished and the committee has made no recommendations,” Lambeth continued.

The line from Lambeth and others on the House side has been that they’d rather come back for a special session on health care access in the fall. That, however, has drawn misgivings from state health leaders.

“I mean, September sounds nice,” Health and Human Services Sec. Kody Kinsley said last week. “But here’s why I’m worried. First and foremost, this $1.5 billion dollar signing bonus that’s on the table right now. Right now, the money that is earmarked for North Carolina is nothing more than, you know, some print on a piece of paper. And it would not be hard for Congress to take that off the table, so they can invest it in other things they need to invest in. We cannot wait.”

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Δ</label> </form></div> </aside> </aside> On Wednesday afternoon, Rep. Tim Moore (R-Kings Mountain), the speaker of the House of Representatives, said he believed that money would be available next year. “All indications are it would,” he said. “If that is going to go away, then that’s a problem with the premise of even doing this.” <h4>Medicaid already expanded</h4> Since the beginning of the pandemic, Medicaid rolls have ballooned to close to 2.7 million beneficiaries, up from 2.1 million enrollees since March 2020. That’s because in one of their early COVID-19 relief bills, the U.S. Congress ordered all the new enrollees who qualified for the program to stay on the program for the duration of the federal state of emergency created by the pandemic. Advocates have pointed out that many of those folks were people who would have qualified had North Carolina already expanded the program. North Carolina likely paid billions more to cover those additional 600,000 people than the state would have if they had already expanded Medicaid, as the Affordable Care Act allowed. Instead of getting the 90 percent match that the federal government would have provided, the state had to make up the difference, paying 27 percent of the cost. “We’re actually looking at a situation where a lot of the expansion population are already enrolled on Medicaid,” Hise admitted. Hise also talked about the anxiety that county social service leaders have around the requirement to “recertify” all of these new Medicaid enrollees once the federal emergency ends. If the state doesn’t expand, at least half of those new enrollees would be purged from the rolls in a time-intensive process that would take up to a year. The process of recertifying these peoples’ eligibility would be much less cumbersome if they end up rolled onto the program via Medicaid expansion, Hise noted. <h4>Political process</h4> After years of waiting for such a bill to come out of the Senate, there was a palpable upbeat energy in the Senate committee room. “Sen. Krawiec, I hate to say I told you so,” quipped Sen. Gladys Robinson (D-Greensboro), an advocate of expanding Medicaid for years. Laughter erupted. That giddy feeling might not last long. Getting the bill across the finish line seems like a stretch, given the resistance from the House and from powerful groups. Catawba College political science professor <a rel="nofollow noopener" target="_blank" href="https://catawba.edu/academics/programs/undergraduate/politics/faculty/bitzer/dr-j-michael-bitzer/">Michael Bitzer</a> said that many details could be hashed out once the House rejects the bill and it goes to a conference committee with people from both chambers. “You know, conference committees are typically called the third chamber of the legislature because that is where the true dealmaking has to occur within the legislative dynamic,” Bitzer said. “With the way the two chambers are, that could become the real power base of any type of legislation that’s gonna get moved from either chamber.” That bargaining will come down to who is willing to give up what from their wish lists during negotiation, Bitzer added. “I think oftentimes with this type of significant legislation, people are probably more willing to say, ‘I can live without this,’ rather than, you know, ‘this is what my final demands are going to be,’” Bitzer said. <section id="republication_tracker_tool-4" class="below-content widget republication_tracker_tool"> <div class="license"> <button on="tap:republication-tracker-tool-modal" name="Republish This Story" id="cc-btn" class="republication-tracker-tool-button">Republish This Story</button> <amp-img alt="Creative Commons License" src="https://www.northcarolinahealthnews.org/wp-content/plugins/republication-tracker-tool/assets/img/creative-commons-sharing.png" width="88" height="31" class="amp-wp-enforced-sizes amp-wp-27d0abf i-amphtml-layout-intrinsic i-amphtml-layout-size-defined" layout="intrinsic" data-amp-original-style="border-width:0" i-amphtml-layout="intrinsic"><i-amphtml-sizer slot="i-amphtml-svc" class="i-amphtml-sizer"><img decoding="async" alt="" aria-hidden="true" class="i-amphtml-intrinsic-sizer" role="presentation" src="data:image/svg+xml;base64,PHN2ZyBoZWlnaHQ9IjMxIiB3aWR0aD0iODgiIHhtbG5zPSJodHRwOi8vd3d3LnczLm9yZy8yMDAwL3N2ZyIgdmVyc2lvbj0iMS4xIi8+"/></i-amphtml-sizer><noscript><img loading="lazy" decoding="async" alt="Creative Commons License" src="https://www.northcarolinahealthnews.org/wp-content/plugins/republication-tracker-tool/assets/img/creative-commons-sharing.png" width="88" height="31"/></noscript></amp-img> </div> <div class="message"> Republish our articles for free, online or in print, under a Creative Commons license. </div> </section> <amp-lightbox id="republication-tracker-tool-modal" layout="nodisplay" role="dialog" aria-modal="true" class="i-amphtml-layout-nodisplay" hidden="hidden" i-amphtml-layout="nodisplay"> <div id="republication-tracker-tool-modal-content"> Close window X <h2>Republish this article</h2> <div class="cc-policy">As of late 2019, we’re changing our policy about reprinting our content. You are free to use NC Health News content under the following conditions: <ul> <li>You can copy and paste this html tracking code into articles of ours that you use, this little snippet of code allows us to track how many people read our story.</li> <li>Please do not reprint our stories without our bylines, and please include a live link to NC Health News under the byline, like this: By Jane Doe North Carolina Health News </li> <li>Finally, at the bottom of the story (whether web or print), please include the text: North Carolina Health News is an independent, non-partisan, not-for-profit, statewide news organization dedicated to covering all things health care in North Carolina. Visit NCHN at northcarolinahealthnews.org. (on the web, this can be hyperlinked) </li> </ul> </div> <div class="article-info"> by Rose Hoban and Rachel Crumpler, North Carolina Health News May 26, 2022 </div> <textarea readonly="readonly" id="republication-tracker-tool-shareable-content" rows="5"><h1>Lots of buzz about NC Senate Republicans and their Medicaid expansion bill</h1> by Rose Hoban and Rachel Crumpler, North Carolina Health News May 26, 2022 <h4 id=”h-by-rose-hoban-and-rachel-crumpler”>By Rose Hoban and Rachel Crumpler</h4> It finally happened. In a move that many health care advocates have been pushing for years, the state Senate introduced a bill on Wednesday that would expand the state’s Medicaid program to some half million-plus low-income North Carolinians. Until this point, Medicaid has been reserved mostly for children from low-income families along with a small number of parents in those families, poor seniors and people with disabilities. Since 2012, the possibility to sweep in many low-income workers has been on the table as a result of the Affordable Care Act, but Republican leaders in the state senate have been staunch opponents.  <figure class=”wp-block-image aligncenter size-full”><a href=”https://www.northcarolinahealthnews.org/donate/”><img src=”https://i0.wp.com/www.northcarolinahealthnews.org/wp-content/uploads/2021/04/COVID-Donate-Ad-NEW-April-2021.png?fit=500{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}2C150&ssl=1″ alt=”” class=”wp-image-33559″ /></a></figure> Now, after years of saying no, powerful Republicans in the state Senate are saying yes. “Why now? Why this? First, we need coverage in North Carolina for the working poor,” said state Senate leader Phil Berger (R-Eden), who admitted during a press conference Wednesday that he has likely been the most outspoken person in the state about his opposition to Medicaid expansion. “Second, there is no fiscal risk to the state budget moving forward with this proposal,” Berger added, noting that the bill includes pay-fors that would have hospitals largely on the hook to pay the 10 percent of the costs for the expansion population not covered by an enhanced federal payment. There’s also a federal incentive that would total some $1.5 billion in extra funds that would flow to North Carolina over a two-year period. Finally, he argued that since the state has moved Medicaid from being a state-run fee-for-service program to one managed by commercial insurance companies, the program has been “reformed and transformed.”  “Medicaid expansion has now evolved to a point that it is good state fiscal policy,” Berger continued. “But again, I cannot emphasize this enough: Expanding Medicaid needs to happen with additional reforms.” Those reforms could make the bill to be titled <a href=”https://www.ncleg.gov/documentsites/committees/Senate2021-139/5-25-2022/H149-AMRxfry-32{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}20v1.pdf”>Expanding Access to Healthcare in North Carolina</a> a hard pill for many to swallow. One aspect of the bill would set up a work requirement for the new beneficiaries, something that’s been repeatedly struck down in other states <a href=”https://www.northcarolinahealthnews.org/2019/03/29/medicaid-work-requirement-bill-faces-legislative-legal-challenges/”>by federal judges</a>.  What really might jeopardize passage of the bill is that it contains provisions that already are raising hackles in some powerful health care lobbies, including those that advocate for the state’s physicians and hospitals.  <h4>Resistance from doctors</h4> One reform proposed in the 33-page bill would make it possible for advanced practice nurses such as nurse practitioners, nurse midwives and certified registered nurse anesthetists (CRNAs) to practice without having a contract with a physician for their supervision. Physician and nursing groups have been divided over the so-called <a href=”https://www.northcarolinahealthnews.org/2022/04/12/should-advanced-practice-nurses-in-nc-be-more-independent/”>SAVE Act</a> for years, with medical providers — led by the <a href=”https://ncmedsoc.org/”>North Carolina Medical Society</a> — usually being able to stop the nurses from having more leeway in their practices. At a <a href=”https://www.ncleg.gov/Committees/CommitteeInfo/Senate/139″>Senate Health Care Committee</a> hearing held after the press conference, several Democratic lawmakers also expressed reservations over this part of the bill.  Chip Baggett, head of the North Carolina Medical Society, also spoke out about the nursing practice language in the bill at the committee. He had a number of problems with the changes. “The first is the foundational education that is received by APRNs, many of which are receiving online education right now, and we do not think that provides the foundation necessary for independent decision making,” Baggett added after the meeting. Several <a href=”https://pubmed.ncbi.nlm.nih.gov/27798780/”>decades</a> of <a href=”https://pubmed.ncbi.nlm.nih.gov/30015724/”>research</a>, though, bolster the nurses’ <a href=”https://pubmed.ncbi.nlm.nih.gov/28649737/”>contention</a> that their <a href=”https://pubmed.ncbi.nlm.nih.gov/28162784/”>practices</a> are <a href=”https://pubmed.ncbi.nlm.nih.gov/27606392/”>safe</a>, and that <a href=”https://pubmed.ncbi.nlm.nih.gov/14734943/”>patient</a> <a href=”https://pubmed.ncbi.nlm.nih.gov/25339237/”>satisfaction</a> with <a href=”https://pubmed.ncbi.nlm.nih.gov/31607371/”>advanced practice nurses</a> is often better than for physicians. Joyce Krawiec, a Republican state senator from Kernersville, noted that 137 health care facilities across North Carolina only have CRNAs to deliver anesthesia services and that 34 other states have already loosened the rules around nursing practice. “My husband had a colonoscopy recently, and they can do it with the supervision of a physician,” Krawiec said. She recounted how she asked the physician leading the procedure if he was overseeing the anesthesia. He responded, “Heavens, no, I don’t supervise her. He said I haven’t looked at anesthesiology since I was in medical school. I wouldn’t know what to do. She does it all on her own.” Sen. Ralph Hise (R-Spruce Pine) argued that making it easier for nurses to practice, particularly in rural burgs, needed to be included in any bill that would make it easier for more people to see those providers.  “Finding nurses in this state is becoming more and more impossible,” Hise said. “And so this bill, allowing the nursing profession to expand its scope, to have more upward mobility in the nursing program is what ultimately I think will allow us to provide a lot of health care that we currently just don’t do.” Rep. Gale Adcock (D-Cary), who is also a nurse practitioner, said that increasing access to health insurance would require adding providers.  “The majority of folks clearly understand these things all need to happen at the same time, and I’m excited to see that it might happen soon,” she said. <h4>Hospitals, House objecting?</h4> One of the big obstacles to Medicaid expansion that Republican lawmakers have raised for years has been where the 10 percent of the expansion cost not covered by the federal government would come from. For years, lawmakers have argued that hospitals would be the main beneficiaries of more federal dollars for Medicaid flowing to the state, so hospitals could foot much of the bill in the form of an additional assessment. Hospitals have said they lose so much on uninsured patients that they were willing to pay for some of the cost, but not the whole tab. In Medicaid expansion bills in other years, this cost was also borne by a new tax on commercial managed care companies providing coverage under the “transformed” Medicaid program. <figure class=”wp-block-image aligncenter size-large is-resized”><img src=”https://www.northcarolinahealthnews.org/wp-content/uploads/2022/05/IMG_7738-450×338.jpg” alt=”shows a man in a tie talking to reporters about Medicaid expansion” class=”wp-image-39400″ width=”618″ height=”464″ /><figcaption>Rep. Tim Moore (R-Kings Mountain), speaker of the North Carolina House of Representatives, told reporters on Wednesday afternoon that he didn’t think members of his caucus had an appetite for Medicaid expansion this year. Photo credit: Rachel Crumpler</figcaption></figure> Hise contended the proposal will definitely help hospitals’ bottom lines, with more federal money flowing into the health care systems than they’ll have to put out to cover the rest of the Medicaid expansion population. A spokesman from the NC Healthcare Association, which represents the state’s hospitals, told NC Health News that his organization was reviewing the new bill and would wait to offer comment on its potential impact. The other big obstacle to passage of the bill may come from the other side of the General Assembly building in Raleigh, in the House of Representatives. Leaders there have expressed hesitation about making such a big policy change during this year’s short legislative session.  “The position of the House is we have no plans to take up expansion in the short session,” Rep. Donny Lambeth (R-Winston-Salem) said in a text to NC Health News. Lambeth has been leading a <a href=”https://www.northcarolinahealthnews.org/2022/03/11/lawmakers-hear-unvarnished-support-for-medicaid-expansion/”>committee</a> with members from the House and Senate since January that has been examining <a href=”https://www.northcarolinahealthnews.org/2022/02/21/is-medicaid-expansion-coming/”>what it would mean for the state to expand Medicaid</a>.  “The work of the committee has not been finished and the committee has made no recommendations,” Lambeth continued.  The line from Lambeth and others on the House side has been that they’d rather come back for a special session on health care access in the fall. That, however, has drawn misgivings from state health leaders. “I mean, September sounds nice,” Health and Human Services Sec. Kody Kinsley said last week. “But here’s why I’m worried. First and foremost, this $1.5 billion dollar signing bonus that’s on the table right now. Right now, the money that is earmarked for North Carolina is nothing more than, you know, some print on a piece of paper. And it would not be hard for Congress to take that off the table, so they can invest it in other things they need to invest in. We cannot wait.” On Wednesday afternoon, Rep. Tim Moore (R-Kings Mountain), the speaker of the House of Representatives, said he believed that money would be available next year.  “All indications are it would,” he said. “If that is going to go away, then that’s a problem with the premise of even doing this.” <h4>Medicaid already expanded</h4> Since the beginning of the pandemic, Medicaid rolls have ballooned to close to 2.7 million beneficiaries, up from 2.1 million enrollees since March 2020. That’s because in one of their early COVID-19 relief bills, the U.S. Congress ordered all the new enrollees who qualified for the program to stay on the program for the duration of the federal state of emergency created by the pandemic.   Advocates have pointed out that many of those folks were people who would have qualified had North Carolina already expanded the program. North Carolina likely paid billions more to cover those additional 600,000 people than the state would have if they had already expanded Medicaid, as the Affordable Care Act allowed. Instead of getting the 90 percent match that the federal government would have provided, the state had to make up the difference, paying 27 percent of the cost. “We’re actually looking at a situation where a lot of the expansion population are already enrolled on Medicaid,” Hise admitted.  <div class=”wp-block-group has-secondary-background-color has-background”> </div> Hise also talked about the anxiety that county social service leaders have around the requirement to “recertify” all of these new Medicaid enrollees once the federal emergency ends. If the state doesn’t expand, at least half of those new enrollees would be purged from the rolls in a time-intensive process that would take up to a year. The process of recertifying these peoples’ eligibility would be much less cumbersome if they end up rolled onto the program via Medicaid expansion, Hise noted. <h4>Political process</h4> After years of waiting for such a bill to come out of the Senate, there was a palpable upbeat energy in the Senate committee room.  “Sen. Krawiec, I hate to say I told you so,” quipped Sen. Gladys Robinson (D-Greensboro), an advocate of expanding Medicaid for years. Laughter erupted.  That giddy feeling might not last long. Getting the bill across the finish line seems like a stretch, given the resistance from the House and from powerful groups.  Catawba College political science professor <a href=”https://catawba.edu/academics/programs/undergraduate/politics/faculty/bitzer/dr-j-michael-bitzer/”>Michael Bitzer</a> said that many details could be hashed out once the House rejects the bill and it goes to a conference committee with people from both chambers.  “You know, conference committees are typically called the third chamber of the legislature because that is where the true dealmaking has to occur within the legislative dynamic,” Bitzer said. “With the way the two chambers are, that could become the real power base of any type of legislation that’s gonna get moved from either chamber.” That bargaining will come down to who is willing to give up what from their wish lists during negotiation, Bitzer added.  “I think oftentimes with this type of significant legislation, people are probably more willing to say, ‘I can live without this,’ rather than, you know, ‘this is what my final demands are going to be,’” Bitzer said. This <a target=”_blank” href=”https://www.northcarolinahealthnews.org/2022/05/26/buzz-about-nc-senate-republicans-and-medicaid-expansion-bill/”>article</a> first appeared on <a target=”_blank” href=”https://www.northcarolinahealthnews.org”>North Carolina Health News</a> and is republished here under a Creative Commons license.<img src=”https://i0.wp.com/www.northcarolinahealthnews.org/wp-content/uploads/2021/10/cropped-favicon02.jpg?fit=150{fe463f59fb70c5c01486843be1d66c13e664ed3ae921464fa884afebcc0ffe6c}2C150&ssl=1″ style=”width:1em;height:1em;margin-left:10px;”><img id=”republication-tracker-tool-source” src=”https://www.northcarolinahealthnews.org/?republication-pixel=true&post=39394&ga=UA-28368570-1″ style=”width:1px;height:1px;”>

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May 26, 2022

Senate narrowly adopts bill affirming access to off-label drugs for COVID-19

TOPEKA — A Kansas state senator amid well being professionals investigated by the Board of Healing Arts for alleged misconduct during the COVID-19 pandemic voted early Thursday for legislation to legalize the prescribing by doctors and dispensing by pharmacists of treatment for off-label use from the coronavirus.

The bill adopted by the Senate on a vote of 21-16 would mandate kid treatment services and K-12 public educational facilities to acknowledge — without the need of inquiry or scrutiny — the spiritual objection of moms and dads or guardians to vaccination of their kids versus a collection of maladies.

Steffen, a Republican from Hutchinson and licensed anesthesiologist, had launched legislation that would retroactively shield him and other health companies who approved ivermectin or hydroxychloroquine in the course of the pandemic from investigation by regulators with the Kansas Board of Healing Arts.

In January, Steffen explained he was below investigation by the BOHA. He has asserted physicians should not be confined in the selection of potential treatment method possibilities in a pandemic linked with a lot more than 8,000 fatalities and 19,000 hospitalizations in Kansans.

“Thousands of Kansans and hundreds of thousands of Americans have died needlessly because mainstream educational medicine’s shutdown of successful therapy protocols,” Steffen stated. “This fearful, greedy, political and incompetent shutdown of early treatment will be considered a nationwide tragedy in time.”

Steffen has waged a protracted war of text with general public health officials and clinical professionals who expressed reservations about alternative therapy of COVID-19. University of Kansas Wellbeing Program submitted testimony opposing the laws on behalf of Ascension Via Christi Overall health, College of Kansas College of Health Professions and University of Kansas doctors.