Chiropractors and physical therapists would get a boost from a bill that cleared a House committee Thursday.

The bill would require health insurance companies covering some 2 million people in the state to offer a lower co-pay for chiropractors and physical and occupational therapists.

The bill, sponsored by Rep. Cullie Tarleton, started out as a do-over for a requirement that patients could see chiropractors and pay the same co-payment they are charged for seeing a family doctor.

That benefit was inserted into the budget by former House Speaker Jim Black four years ago. It helped land him in prison when three chiropractors admitted to giving him cash payments while pushing their legislative agenda. It was later rescinded.

Tarleton said the benefit was rescinded because of the circumstances surrounding it, not because it wasn't good policy.

"This is a really a patient's bill, plain and simple," said Tarleton, a Blowing Rock Democrat.

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The House approved the State Health Plan bill.

Members voted 60 to 56 in favor of the bill. House Republicans objected to the final version.

Members cited the increased cost to state employees and the removal of a provision that would convert the plan to a calendar year.

"The only thing the House could have been proud of and stood up for is converting the plan to a calendar year," said Rep. Dale Folwell, a Winston-Salem Republican.

Converting the plan's calendar would put it in line with most other health plans and allow families to better plan for health care costs.

But the conversion would cost the state an additional $60 million over two years. It would cost employees an additional rate increase.

Rep. Hugh Holliman, the bill's primary sponsor and House Democratic leader said the compromise bill was meant to be a short-term fix that will help the struggling plan stay solvent while officials consider a long-term fix.

"I think this is a fair compromise," Holliman said.

* Services for state Sen. Vern Malone, who died this weekend, will be held at noon Thursday at Martin Street Baptist in Raleigh. 

* After a trip to Cuba, U.S. Rep. Mel Watt says he was surprised to find that Raul Castro was "just as outgoing and loquacious" as his brother, Fidel.

* More than any other state, North Carolina is seeing a spike in the number of people without health insurance, up to 25 percent.

* Former state treasurer Richard Moore closed out his gubernatorial campaign account, forgiving himself $1 million in loans. 

Rep. Dale Folwell filed legislation Wednesday that he said fixes a flaw in the State Health Plan that could allow for fraud against the state and municipalities that provide ambulance service.

The flaw: Plan members are cut a check for the cost of an ambulance ride when the provider's not part of the plan's network, Dan Kane reports.

The check is in the member's name, so if he or she pockets it, the ambulance service is out of the money. Each trip costs roughly $500.

At least 24 municipal services are not in the plan's network, including those serving Durham, Forsyth, Mecklenburg and Randolph counties, Folwell said.

He presented anecdotal evidence of ambulance riders failing to pay for the service. In one case, a public school retiree from Forsyth County requested 22 ambulance trips last year, collecting nearly $12,500 from the health plan. The county has yet to be reimbursed for the ambulance service.

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Legislators would hike premiums to fix the State Health Plan.

One proposal currently under discussion in the House includes taking $250 million from the rainy-day fund to cover expenses until June 30 and increasing the premium by eight percent on July 1 and again next year.

Democratic Majority Leader Hugh Holliman said that spreads the burden out and still gives the 667,000 state employees, teachers, retirees and their families a better deal than what some private sector employees are facing.

"If I get a health care premium increase of anything less than 15 percent," Holliman said, "that's a good year."

Erica Baldwin, a spokeswoman for the State Employees Association of N.C., which represents state workers, said it agrees with using the rainy-day fund but worries that higher premiums will drive state workers from the plan.

"It's putting costs more out of reach for families," she said. (N&O)

* Washington political predictor Stuart Rothenberg ranks U.S. Sen. Richard Burr's 2010 re-election race as "narrow advantage for incumbent party."

* Health care consultant Adam Searing suggests one way legislators could cut costs at the State Health Plan: Remove themselves from it's coverage.

* President Obama says he wants to modify "Buy American" provisions in the stimulus bill, presumably including one by freshman Democratic Rep. Larry Kissell.

* State Sen. Neal Hunt takes another run at the windmill with a bill that would call for at-large elections of several seats on the Wake County school board.

The state health plan needs $1.2 billion over the next two years.

State financial officials presented the figure at a meeting this morning on the upcoming state budget, which already faces a $2 billion shortfall.

Directors of the plan have been operating under emergency measures since December.

The plan covers teachers and state employees across North Carolina.

Update: Officials said they will need a special appropriation of $300 million this fiscal year to keep the plan running.

Freshman Sen. Kay Hagan voted for a bill to expand the health insurance program for children, but not before making a symbolic effort to reduce the size of the cigarette tax hike that pays for it.

The Senate vote Thursday night to expand the Children's Health Insurance Program to 11 million low-income children. The $32.8 billion expansion will be paid for by raising the federal cigarette tax from 39 cents per pack to $1 per pack.

Hagan, along with fellow tobacco-state Democrat Virginia Sen. Jim Webb, offered an amendment to raise the cigarette tax instead to just 76 cents per pack. But after offering the amendment, they withdrew it because it was clear that Senate Democratic leadership wanted the bill.

The measure passed by a 66-32 vote in the Senate in a largely party-line vote. North Carolina Republican Sen. Richard Burr voted against it.

Hagan expressed dismay that the health insurance program was funded entirely with tobacco taxes, but ultimately voted for the measure.

"Less than a month into my service here in the U.S. Senate," Hagan told the Senate, "I'm faced with a situation in which the health of thousands of my state’s children are at odds with a key industry in North Carolina."

"But ultimately," Hagan said, "I had to vote on behalf of the 10 million low-income and disadvantaged children this bill helps."

The measure, which had earlier passed the House, now goes to the White House where President Obama is expected to sign it next week. President Bush had previously vetoed the bill.

Sen. Jim Forrester
Gaston County Republican
Ten Terms

What two things would you cut in the state budget? He said the legislature should look at cutting some of the benefits for Medicaid, the health insurance program for the poor.

He said some of the benefits exceed those of other health insurance plans.

He also said there was also savings to be found in the N.C. Department of Transportation.

Are there any taxes you would be in favor of increasing? No. 

— Rob Christensen

Elizabeth Edwards says medical scans taken this week show her health is no worse than when she announced 18 months ago that her breast cancer had returned in an incurable form.

Edwards spoke Wednesday at a health care round-table in North Carolina, the Associated Press reports.

The wife of two-time Democratic presidential candidate John Edwards was first diagnosed in 2004, and later declared cancer-free. Last year, the cancer returned and spread to her bone.

Edwards supports mandatory universal health coverage and has been speaking out against the policies of Republican presidential nominee John McCain.

Her husband, however, has no public events planned until after the election. He’s been in self-imposed exile since admitting this summer that he had an affair.