Monday News: Rolling the health care dice


NC SWITCHING MEDICAID TO MANAGED CARE MODEL: North Carolina is shifting most Medicaid programs from traditional fee-for-service coverage to those in which companies or medical networks get flat monthly amounts for each patient covered. Instead of paying doctors and hospitals for every test and procedure, Medicaid would allow these "prepaid health plans" to keep whatever's left over after medical expenses and activities. While keeping patients healthier could boost plan profits, sicker patients could mean losses. The alterations should influence the debate over whether it makes sense at the same time to bring another 300,000 to 500,000 new low- and middle-income enrollees on board through expansion. Democratic Gov. Roy Cooper and party allies, who made legislative seat gains last November that gives them more negotiating leverage, are making expansion a top priority this year. Legislative Republicans have blocked it for years.

MCCREADY READY TO ROLL ON NEW ELECTION, HARRIS NOT SO MUCH: Democrat Dan McCready would have a commanding head start over Republican Mark Harris if there’s a new election in North Carolina’s 9th Congressional District, according to new finance reports. McCready has $338,000 in his campaign account compared with just over $19,000 for Harris, according to reports filed Thursday with the Federal Election Commission. The reports also show that Harris wound down his campaign after November’s election while McCready has begun rebuilding his. The result of their 2018 election has been clouded by allegations of absentee ballot fraud. Although Harris leads McCready by 905 votes in unofficial returns, the State Board of Elections twice declined to certify his election. The board has since been investigating irregularities centered in Bladen County.

TRUMP CAMPAIGN MOVES TO ENTRENCH POWER WITHIN THE GOP: Worried about a potential Republican primary challenge, President Donald Trump's campaign has launched a state-by-state effort to prevent an intraparty fight that could spill over into the general-election campaign. The nascent initiative has been an intense focus in recent weeks and includes taking steps to change state party rules, crowd out potential rivals and quell any early signs of opposition that could embarrass the president. Trump's campaign has deployed what it calls an unprecedented effort to monitor and influence local party operations. It has used endorsements, lobbying and rule changes to increase the likelihood that only loyal Trump activists make it to the Republican nominating convention in August 2020.

DESPITE INTELLIGENCE REPORT, PENTAGON SENDS 3,750 MORE U.S. MILITARY TO BORDER WITH MEXICO: The Pentagon said Sunday it will send 3,750 more troops to the U.S.-Mexico border to put up another 150 miles of concertina wire and provide other support for Customs and Border Protection. The additions will bring the total number of active-duty troops on the border to 4,350. Members of Congress have question whether the border mission is distracting troops from their main work of fighting extremists abroad and training for combat. “What impact does it have to readiness to send several thousand troops down to the Southern border? It interrupts their training. It interrupts their dwell time,” Rep. Adam Smith, D-Wash., chairman of the House Armed Services Committee said at a hearing on Tuesday. Vice Adm. Mike Gilday, the director of operations for the Joint Staff, told the panel that he does not believe military readiness has been significantly affected. He said some units have missed training opportunities because of the deployment and others have seen less time at home between deployments than the military likes to provide.

TRUMP WANTS TO USE USE U.S. TROOPS IN IRAQ TO "WATCH IRAN," WHEN FIGHTING ISIS IS WHAT THEY'RE SUPPOSED TO DO: “I want to be able to watch Iran,” Mr. Trump said in an interview aired Sunday on CBS’s “Face the Nation.” “We’re going to keep watching and we’re going to keep seeing and if there’s trouble, if somebody is looking to do nuclear weapons or other things, we’re going to know it before they do.” Mr. Trump’s comments come as the United States has quietly been negotiating with Iraq for weeks to allow perhaps hundreds of American commandos and support troops now operating in Syria to shift to bases in Iraq and strike the Islamic State from there. But senior American officers and diplomats said Mr. Trump’s comments could undercut the delicate negotiations in Iraq by inflaming fears among the Iraqis that the moves would be a guise to check Iran, potentially straining ties with Baghdad and weakening the ability of the United States to respond to Islamic State remnants in Syria.