All’s well that ends well. 

 

This morning when the NorthCarolina General Assembly’s House Health Committee met to discuss Senate Bill 228 we were greeted with a Big Hospital Lobby-backed amendment that was loaded with poison pills. 

 

If passed, it would have added billions of dollars to the state’s healthcare system, eroded all of the cost savings and quality improvements provided in the original bill, and dramatically increased the rate of surprise billing in North Carolina. 

 

Thankfully, many on theCommittee urged that we pump the breaks and carefully review what the BigHospital Lobby was pushing. 

 

It didn’t take long for the members to realize just how bad the amendment was. 

 

A few short hours later, theHealth Committee reconvened and passed Senate Bill 228 in its original form. It then went to the House floor where it passed by a vote of 97-6.

 

The bipartisan bill, which passed the Senate unanimously, allows Exclusive Provider Organization (EPO)insurance plans to be offered to small businesses and individuals in NorthCarolina. 

 

Currently,EPO plans are offered in North Carolina, but current regulations only allow them to be offered to businesses who “self-fund” or pay their own medical claims. 

 

Of course, with healthcare being as expensive as it is, businesses that can afford to pay their workers’ medical claims are almost always multi-million-dollar corporations. 

 

Senate Bill 228 updates these regulations so that small businesses and individuals also have the option to buy EPO plans if they chose to do so. 

 

EPO plans could save small businesses, workers and their families, up to 20 percent on their premiums while also improving the quality of care-coordination.

 

It’s important to know these are not so-called “junk plans.” 

 

EPOs are subject to the same consumer protections, pre-existing condition coverage requirements, and network adequacy standards as other ACA health insurance plans. 

 

They are already being used in North Carolina by large corporations, and insurers and partnering with major health systems like Atrium, Wake Forest Baptist and Duke Health to offer the plans. 

 

Rather than skimp on benefits, EPOs deliver cost-savings by limiting in-network coverage to an exclusive provider. Since a provider knows they will get nearly 100 percent of the plans business, they offer lower rates, which in turn means lower premiums.

 

39 other states allow businesses, workers and their families to buy EPO plans. 

 

SB228 would make NorthCarolina the 40th.

 

The members of the HouseHealth Committee should be commended for their work today. 

 

Instead of passing an amendment that would have dramatically increased healthcare costs and sent surprise billing into overdrive, they discussed, carefully deliberated, and then passed a bill that will mean big health premium savings to businesses, workers and their families. 

 

In the end, it was a good day for healthcare consumers at the NCGA.

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