RALEIGH, North Carolina — The controversial implementation of a new abortion law in North Carolina has ignited a fierce battle between opposing sides. Demonstrations and rallies have taken place on Jones Street at the Legislative Building throughout the summer. Set to go into effect on December 1st, the law marks a significant development in the state’s healthcare landscape, following the U.S. Supreme Court’s decision to reverse Roe v. Wade over a year ago.
Under the new law, known as the Care for Women, Children and Families Act, abortions will be prohibited after 12 weeks of pregnancy, with limited exceptions. This is a significant reduction from the previous limit of 20 weeks. Exceptions will still be allowed for cases of rape and incest up to 20 weeks, and for “life-limiting” fetal anomalies up to 24 weeks. The law also includes a provision for medical emergencies.
North Carolina is not alone in implementing restrictions on abortion. As of December 1st, 42 states have imposed limitations on abortions at specific stages of pregnancy, according to Ballotpedia. However, eight states and Washington, D.C. have no such restrictions in place. Prior to the Supreme Court decision, North Carolina had more than 32,000 legal abortions in 2021, and it now joins 16 other states in prohibiting abortions at 12 weeks or earlier.
The issue of Medicaid expansion has also gained significant attention in North Carolina. Republicans, who have held majorities in both chambers of the General Assembly since the 2010 midterms, had previously been staunchly opposed to expansion. However, this year saw a shift in their stance. The expansion, which went into effect on December 1st, is expected to automatically enroll nearly 300,000 individuals. Proponents of the expansion estimated that it could make approximately 600,000 North Carolinians eligible for Medicaid. In late November, 102 hospitals received nearly $2.6 billion in funding as a result of the expansion. The federal government will provide the state with $1.6 billion. The state budget has allocated a historic investment in healthcare, with a $7.33 billion appropriation in the first year, increasing to $7.76 billion in the second year.
Further healthcare developments in North Carolina include the enactment of rules regarding gender transition surgeries and the prescription of puberty blockers or cross-sex hormones to minors. These rules were passed in August, overturning a veto by Democratic Governor Roy Cooper. Similar legislation has been adopted in 20 other states. The law prohibits medical professionals from performing these procedures or prescribing these treatments to minors.
Another contentious issue centered around women’s participation in sports. In North Carolina, the Fairness in Women’s Sports Act has gained support from notable figures, including Kentucky swimmer Riley Gaines, former basketball coach Sylvia Hatchell, and Payton McNabb, a volleyball player who suffered serious injuries during a game against a player who identified as female. The act prohibits males who identify as female from competing in female athletic competitions. Amendments made in the Senate removed restrictions on women playing on men’s teams and references to collegiate intramural sports.
The healthcare sector has also witnessed ongoing legal battles. Atrium Health facilities in North Carolina recently announced an end to their practice of suing patients over medical debt. However, critics argue that this change is insufficient. Atrium Health revised its billing and collection policy last year, ceasing to pursue small claims for medical debts up to $5,000 and initiating lawsuits for larger amounts. State Treasurer Dale Folwell has expressed reservations about the policy change.
Additionally, the state’s Attorney General, Josh Stein, filed a lawsuit in December against HCA Healthcare for allegedly failing to fulfill obligations stated in a 2019 agreement. The legal action seeks to compel HCA Healthcare to improve staffing levels and maintain certain emergency, trauma, and oncology services until 2029.
As North Carolina grapples with these significant healthcare developments, their impact on women’s reproductive rights, healthcare access, and gender equality continue to be fiercely debated. The state finds itself at the forefront of these contentious issues, navigating the complex intersection of law, medicine, and social perspectives.