Various health care-related bills that would impact North Carolinians, from those who are providing care to those receiving it, have been filed in the General Assembly this session. The bills touch on subjects such as reproductive rights, vaping on school grounds, the practice scope of nurses, and paid sick leave.
Reproductive and LGBTQ+ rights
North Carolina lawmakers have brought forward a number of bills that would create or secure protections for reproductive care and the LGBTQ+ community. This comes at a time where the GOP is ramping up its legislative attacks on the LGBTQ community, on both a state and federal level, and where doctors and patients attempt to navigate a post-Roe world in a state with one of the strictest abortion laws.
Since the overturn of Roe v. Wade, North Carolina Republicans have put into law one of the most restrictive abortion bans in the country, moving the period to have an abortion from 20 weeks down to 12 and enacting obstacles such as a 72-hour waiting period and in-person counseling requirements. While the current law is already restrictive some Republicans have shown an appetite for tighter restrictions, with Republican Representative Kieth Kidwell filing House Bill 804, that would make abortion after conception illegal with no exceptions of rape or incest. The only exception in the bill would be to save the life of the mother.
As Republicans try to take away North Carolinians’ right to health care, Democrats have filed legislation that would increase and assure access to health care needs. This includes codifying the right to contraception and in-vitro fertilization, increasing regulation of crisis pregnancy centers, and eliminating sales tax on menstrual products.
Additionally, for the estimated 71,300 adults and 8,500 children (aged 13-17) in the state that identify as transgender, lawmakers have proposed a ban on conversion therapy and the Don’t Tread on Me Act which states that “medical decisions belong to individuals and families, not politicians” and that “no one should have to navigate government red tape to make personal health choices.”
However, as the national Transgender Day of Visibility approached, protestors and advocates gathered in Raleigh with a different bill in the spotlight. Republican Senator Vickie Sawyer filed Senate Bill 516, titled “Women’s Safety and Protection Act,” which is reminiscent of the infamous House Bill 2, also known as the bathroom bill, that cost the state billions in business. Sawyer’s bill calls for the state to recognize only two genders and to require people to use the bathroom corresponding to their biological sex. However, this bill goes further in preventing individuals from changing their sex on their birth certificate or driver’s license after they have had gender reassignment surgery. Democrat Senator Julie Mayfield insists we need to be “done with” the days of HB 2. “We need to be done with that,” said Mayfield. “We need to recognize who people are. We need to allow them to live their lives, and we need to be done with treating people as anything less than full human beings deserving of respect and dignity.”
Vaping on school grounds
Democrat Representative Carla Cunningham has put forward two bills that would prohibit vaping on school grounds. Cunningham’s two bills, House Bill 328 and House Bill 329, differ in a few ways. House Bill 328 explicitly bans DELTA-8 AND DELTA-9 products from school grounds. It also calls for the clarification of banning vaping on school grounds.
Cunningham pointed to Leesville Road High School in Raleigh to show why this is needed. Cunningham said vaping in the school bathrooms has become so frequent it often sets off the fire alarms in the school to the point the school had to close half of their bathrooms.
House Bill 329 aims to “encourage” non-public schools to prohibit the use of tobacco products and “hemp-derived consumables” on school grounds.
Advance Practice Nurses
Nurses in the state are supporting legislation that would allow advanced practice nurses to practice without the supervision of a physician, allowing them to work to the full extent of their educational experience. Lawmakers have put forward such legislation: House Bill 514 and its Senate companion, Senate Bill 537. Some hundred nurses gathered at the legislature to call for support of the legislation, saying it would make healthcare more accessible. Nurses say the bill would elevate the stress they face to retain a supervising physician, which typically includes providing funds to ensure that the physician continues in a contract as they are needed for the nurse to continue their work.
Jamie Gallagher, a board-certified family nurse practitioner, owns Peri and Pause in Fuquay-Varina, a women’s health clinic focused on menopause. Although no physicians see her patients, they are still on the payroll as supervisors to the nurses who tend to patients. Gallagher explains that the legislation would free up funds that could go directly to the nurses who keep the clinic running instead of physicians who only sign off on their work. “It will free me up to pay my nurse practitioners exactly what they’re worth and the money that they earn, rather than having to pay another profession — physicians — to sign a piece of paper, because no physician sees my patients,” she said.
It wouldn’t just save clinics money but also the state itself. The NC Nurses Association proposed that North Carolina could save between $647 million and $6.4 billion in health care costs annually by passing the bills. Although doctors have been fighting similar legislation for years on the idea that care quality would suffer with advanced care nurses leading care, supporters of the legislation point to decades of research proving that no such deficit occurs under the leadership of advanced practice nurses.
Paid Leave
Two companion bills filed in the House and the Senate, House Bill 499 and Senate Bill 480, aim to develop better access to sick and paid leave. The legislation, entitled NC Paid Family Leave Insurance Act, calls for the creation of a program that would provide paid family and medical leave insurance for qualifying persons. Roughly 78% of North Carolina’s workforce does not have paid family leave, according to the National Partnership for Women and Families.
The Division of Employment Security of the N.C. Department of Commerce would manage the program as it does state unemployment. Employers and employees can pay into the fund and split the costs. This legislation would benefit not just workers but also employers of small businesses who may not be able to afford to offer paid sick leave to their employees.
Advocates gathered at the general assembly to rally support for the legislation. During a press conference Democrats held for the legislation, many of the speakers talked about times they had to miss work to take care of a new child or an ill family member and how it cost them their income and sometimes their jobs. Senate Minority Leader Sydney Batch (D-Raleigh), a cosponsor of the Senate bill, told the audience the bill would “change the fabric of North Carolina” by expanding access to paid family and medical leave so workers do not have to choose between income and health.
The bills were brought forward by Democrats and have seen support along party lines. However, no Republicans have shown support for the bill, frustrating advocates and lawmakers alike who understand the need for the legislation. “We are just exhausted by the fact that we sit on the floor and we work with colleagues in this building who espouse that they care about families, that they care about women, that they care about North Carolinians —and yet when they can act, they do nothing,” said Batch.
