5 Things NC: COVID relief bill, ACA subsidy expansion, Q&A w/Dr. Rajesh Davda

Welcome to our inaugural edition of 5 Things We’re Watching in North Carolina health care and health policy. Our goal is to provide a unique level of coverage on five items we think are worth tracking for senior health care executives and health policy leaders.

Our goal is to provide you one or two unique things that you may not have known about which will help support your leadership and decision making. So, if we can ever focus on one area or another, I’d welcome your feedback. Thanks for reading our stuff.





With help from Emily Boerger

1. Legislation, process and deadlines

There are currently 9 bills in the House Committee on Health, including legislation related to telehealth, prescription drug costs, and the occupational therapy interstate compact. Yesterday, the committee referred HB 144, which would establish tele-dentistry standards, and HB 180, which would designate August 31 as Overdose Awareness Day. Last week, the committee passed two organ donation-related bills.

There are two bills in the Senate Committee on Health Care, but no bills in either chamber’s Health and Human Services Appropriations Committees. The deadline for bills to pass out of their house of origin is still two months away. The deadline for new bills to be introduced into the House is April 20, while the deadline for new bills in the Senate is April 6.


2. Q&A: Dr. Rajesh Davda, Cigna

Dr. Rajesh Davda is the Market Medical Executive for Cigna’s Carolinas market. In this Q&A, Davda discusses the importance of addressing the social determinants of health to positively impact patient health outcomes. As a nephrologist, he has witnessed firsthand how issues like food insecurity and transportation can be detrimental to patient success.

Davda says caregiver support, developing value-based systems, and data sharing will all drive improved quality of care. “We have built different systems that don’t talk to each other. When you get into preventative care, we need a national interoperable system and I don’t think any states or private entities can build that by themselves… When we have interoperability, we will know what gaps in quality exist so we can manage that and improve.”


3. Federal Detailed Agenda coming Thursday

On Thursday we will release the Detailed Agenda for the 2021 State of Reform Federal Health Policy Conference. This is a curated list of over 100 speakers set to be with you on April 7-8th. This will be perhaps the single best way to interact virtually with some of the key actors shaping federal health policy in both Congress and the Biden administration. We’ll also have a state learning lab focused on elevating the most prominent lessons from health reform in various states. North Carolina’s innovative model will be one of our case studies to teach the nation.

Be sure to check out the Topical Agenda to get a feel for the two-day event and take a look at our Convening Panel to see some of the folks who helped put the agenda together. If you haven’t registered to be with us yet, we’d be honored to have you join us! And, because we’re new to your inbox, readers of this newsletter will get a 50% off of registration for this event for the next two weeks.


4. Legislature passes COVID relief bill

The General Assembly unanimously approved a $1.7 billion COVID response and relief spending package on Thursday, setting aside about $1 billion for DHHS to combat the spread of the virus. The spending package allocates federal funds received through the Consolidated Appropriations Act.

The package includes $47 million in mental health grants, $11 million for substance abuse prevention, and $600 million for COVID testing, tracing, and prevention. The bill comes after Gov. Cooper signed a $2.2 billion bill in February assigning federal funding to reopening schools, vaccine distribution, and rental assistance.


5. Health reform in federal COVID bill

Over the weekend, the US Senate approved the $1.9 trillion COVID federal relief package. The House is expected to vote on the amended legislation early this week. In a recent piece, State of Reform columnist Jim Capretta outlines the health measures in the bill that “will be significant for policy debates in the years ahead.”

Among the list of changes is an increase in premium tax credits for households receiving insurance through the ACA exchanges. The bill would fully subsidize coverage for households below 150% FPL, it would increase subsidies for those up to 400% FPL, and it would remove the 400% FPL cap, allowing any household to get coverage through the ACA exchanges with a premium of no more than 8.5% of annual income.

A recent analysis estimates that for an enrollee in North Carolina at 430% FPL, the expanded subsidies would decrease monthly premiums from $742 to $64 (lowest-cost bronze), $1,095 to $390 (benchmark silver), and $1,101 to $395 (lowest-cost gold). While the subsidy increase is set to expire after 2022, Capretta reasons that once in place, Congress will make the changes permanent.