Job #1 for the 2023 General Assembly: ending easily preventable deaths

Published January 12, 2023

By Rob Schofield

Republicans in North Carolina are also pursuing “election integrity” legislation.

State government has scores of vitally important roles to play in modern North Carolina. The list of agencies and missions is a long one.

At a basic level, however, government’s most important task is – or at least ought to be – protecting the lives and health of the state’s residents. And so, while state lawmakers obviously have numerous priorities to weigh and debates to have during the 2023 legislative session that convenes tomorrow, one extremely efficient path for prioritizing their work, fulfilling their most basic duty, and making the state a measurably better place would be this: ending easily preventable deaths.

Here are five simple and straightforward policy steps legislators can pursue to save the lives of North Carolinians in 2023:

1 – Expand Medicaid to cover more than a half-million uninsured North Carolinians – There’s no longer any real debate about the wisdom of this action. As the national news site Stateline reported last week, the state’s arch-conservative Senate President Pro Tem, Phil Berger, believes strongly that the three top concerns long voiced by Republicans regarding expansion – that it would disincentivize work, that the federal government would stop paying its 90% share of the cost, and that it would make state Medicaid expenditures too unpredictable – have all been thoroughly allayed.

What’s more, as numerous experts have testified repeatedly, expansion will save lives – lots of them. The state Department of Health and Human Services reports researchers have determined that expansion would save 1,200 North Carolinians per year. This means the state’s nine-year delay in acting has likely already caused more than 10,000 preventable deaths.

2 – Preserve and strengthen state gun safety laws – Gun deaths have surged in North Carolina in recent years, growing by 35% from 2011 to 2020. Gun homicides were up 88% during that same period. With 1,699 gun fatalities in 2020, the CDC reported that our state had a gun death rate of 16 per 100,000. That was almost five times the rate in the state with the lowest rate, Hawaii.  As WRAL reported last fall, “Firearm deaths were the leading cause of injury death in 2021 for children in North Carolina.”

At such a moment, state leaders could save scores of lives each year by making guns less easily accessible to children and individuals inclined to violence. Simple and obvious steps include: preserving and strengthening the state’s pistol permitting system, following the lead of numerous other states by enacting a “red flag law” that would allow for judges to issue temporary “extreme risk protection orders” to remove firearms from individuals shown to be a danger to themselves or others, and embarking on an aggressive campaign to distribute free gunlocks.

3 – Address the state’s workplace safety crisis – As North Carolina’s McClatchy newspapers reported in the aftermath of a disastrous scaffolding collapse in Charlotte last week, workplace deaths remain outrageously frequent in our state and well above the national average. Meanwhile, workplace safety inspections are way down – thanks in part to the fact that “More than a quarter of the state’s 109 workplace safety officer positions are currently unfilled.” Providing the necessary funding to attract and support more inspectors is an obvious step for the 2023 legislature to pursue in order to reverse this trend.

4 – Stop the cheapskate penny-pinching on youth mental health – As Policy Watch reported this week, North Carolina schoolchildren have experienced a terrifying rise in mental health troubles in recent years. Among the many shocking numbers reported: more than one-in-five North Carolina high school students (and nearly half of LGBTQ students) say they seriously considered attempting suicide during the past 12 months. Thirty percent report it would take them less than an hour to get and be ready to fire a loaded gun without a parent or other adult’s permission

How any responsible elected official can read such disturbing figures and still approve a state budget that leaves the number of school nurses, counselors, psychologists, and social workers at pathetically inadequate levels is truly remarkable.

5 – Fund recommended improvements to maternal and newborn health – Infant and maternal mortality rates in North Carolina remain scandalously high – especially for Black mothers and newborns. Late last year, the state Child Fatality Task Force recommended enactment of a modestly priced package of improvements that would raise pay to health care workers who provide maternity services to people enrolled in Medicaid, reimburse for doula services, and increase payments to providers of group prenatal care. Enactment ought to be a no-brainer.

This list is, of course, anything but exhaustive. Dozens of other obvious and eminently affordable actions – from improved regulation of dangerous PFAS “forever chemicals,” to tackling the state’s chronic homelessness problem, to better enforcing highway safety laws – could easily save hundreds more North Carolinians each year.

The bottom line: It’s hard to imagine that there is a North Carolinian – all 170 state lawmakers included – who wouldn’t, at least indirectly, benefit from such an agenda. Surely, that’s reason enough to give it a try.