A few weeks ago I wrote about the simmering battle between the uber-conservative State Treasurer Dale Folwell and his Republican compatriots in the legislature. One might assume that they would be lockstep in their goals, but then one would be incorrect. HB184 is sailing through the NC House.

Over the past few weeks their differences have become prominent, attracting the attention of our papers of record and particularly conservative bloggers, Brant Clifton specifically. Clifton has focused on the issue for weeks and depicts it as an abrogation of conservative principles.

As I wrote two weeks ago in the Salisbury Post,

Folwell is responsible for managing, among other things, the State Health Plan, which amounts to $3.3 billion annually and covers 700,000 North Carolinians. As it works today, the state does not actually know how much certain visits to the doctor or hospital costs. To correct for that lack of transparency, Folwell is proposing that hospitals are paid 177 percent of what Medicare would have paid for the same trip.

The hospitals, of course, are outraged. The North Carolina Healthcare Association has been the lead opposition to Folwell’s proposal. They posit that Medicare has traditionally underpaid and that hospitals are not able to negotiate prices with the federal government. They have a point.

And pushback has not only come from NCHA, but from some of Folwell’s party members in the General Assembly. Numerous Republicans are openly concerned about the way Folwell is approaching negotiations, or, more correctly, how he isn’t negotiating at all. The proposed changes to the State Health Plan would cost North Carolina hospitals around $450 million per year, according to NCHA. What Folwell does not seem as interested in is where those cuts are being transferred.

Folwell is upset with the way hospitals charge the state, and the process is truly opaque. House Republicans are putting a bill on the fast track that would take away the power for Folwell to negotiate and give it to a study committee.

HB 184 made it through the House Committee on Health Tuesday and is apparently on its way to Rep. David Lewis and the House Rules Committee. If it makes it through the Rules Committee the next stop is the floor and a vote.

Conservatives may be rightly upset with their leadership in Raleigh. Folwell, for all his faults, seems to truly believe in the fiscal restraint he preaches. Legislative leaders, not so much, apparently.

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