N.C. State Treasurer Dale Folwell has not been shy in his criticisms this year, from calling out transportation officials dealing with a budget crunch to the state’s major hospitals that held fast against his proposed changes on reimbursements for employees on the state health plan.
 
Folwell, the first Republican to hold the state’s treasurer post since Reconstruction, served four terms in the state House and headed up the N.C. Division of Employment Security. In those roles, he also called for sweeping, and often controversial, reforms to shore up struggling budgets.
 

You recently called for a shakeup at the N.C. Department of Transportation, calling on Gov. Roy Cooper to replace Transportation Secretary Jim Trogdon and moving financial oversight of the department to the N.C.. Office of State Budget and Management. What prompted you to make take that strong of a stance?

“For over 15 months, I have made my stance on the overspending of the DOT very clear. During that time, I told the governor, Council of State and Secretary Trogdon that they were spending money too quickly; and when they eventually did slow down, they didn’t slow down enough.
 
This overspending has now resulted in at least one bond rating agency noting the cash flow issue and a bailout request of the N.C. General Assembly totaling hundreds of millions of dollars.
 
The NCDOT needs to focus on building and repairing roads, but the financial spigot needs to be within N.C. Office of State Budget and Management, which reports to the governor.”

You’ve also this year been outspoken about the need for more transparency in health care costs for the state health plan. You proposed a “Clear Pricing Project” for 2020 that looked to set rates for enrollees’ care based on Medicare rates plus a markup instead of the negotiated rates between Blue Cross Blue Shield of North Carolina and providers. Since it did not have the support of major hospitals in the state, what happened with the proposal? What can the 720,000 state employees, teachers, dependents and retirees in the state health plan expect to see next year?

“We have been outspoken on behalf of those who have been hurt the worse.
 
Those being state employees, retirees and taxpayers like them who don’t consume health care; it consumes them.
 
After offering the major hospitals nearly a 100% profit, even those hospitals who stood to make more money did not sign up.
 
They chose to boycott those who teach, protect and serve.
 
Nearly 25,000 providers did say ‘yes’ and agreed to get rid of secret contracts and push the power to consume to the customer.
 
We will be partnering with these health care providers going forward.”

Do you plan to continue to push for changes to the State Health Plan?

“Absolutely. The State Health Plan costs are going up at a faster pace than the governor’s budget provides.
 
Secondly, the plan has an unfunded liability of nearly $32 billion, which ranks its insolvency right behind the state of Illinois.
 
Lastly and most importantly, the average entry-level state employee that teaches, protects and serves has to work one week out of every month just to pay the family premium.”

Another local issue you’ve weighed in on is the potential sale or management structure change of New Hanover Regional Medical Center. What are your concerns there?

“My concern is that they are trying to solve a problem that doesn’t exist.
 
New Hanover Regional Medical Center is one of the few examples in the U.S. of a large medical center providing accessibility, quality, lower cost and profitability.
 
That is just the kind of medical facility that should be serving the public.
 
The vast majority of U.S. studies show these types of mergers reverse all of those positive benefits resulting in increased cost and worse patient outcomes to the detriment of the eight counties served by NHRMC.”

Are you concerned the continued budget impasse might affect the state’s AAA bond rating? Why or why not?

“The governor’s veto of the state budget is mainly offset by the fact that North Carolina has a law that allows state government to function past the end of the fiscal year.
 
This is different than what people experience when the federal government has to shut down.
 
North Carolina earns the benefit of the doubt because of our conservative budgeting that produces surpluses and rainy day fund reserves.
 
Nearly 98% of the vetoed budget has been passed into law through other pieces of legislation.
 
As state treasurer and keeper of the public purse, I’m making sure the nearly $50 billion in public service workers’ unfunded health care and pension liabilities remains front and center as the real threat to North Carolina’s financial future.”