Partisan split on pushing HCA to sell Mission Health? NC, US legislative candidates

ASHEVILLE - A partisan split looks to be forming over a new effort to push the for-profit HCA to sell Mission Health to a nonprofit.

All six Democratic incumbents or challengers for Buncombe County congressional or North Carolina General Assembly seats said they supported Reclaim Healthcare WNC . The coalition of doctors, elected officials and other community leaders announced Reclaim's formation July 24, saying the goal is to replace HCA because it has badly mismanaged Western North Carolina's biggest health care provider.

"I support this effort and think it's one of the ways we can reclaim our hospital and get better care around here again," said Caleb Rudow, Democratic candidate for WNC's 11th Congressional District in response to a July 25 Citizen Times query.

Of the five Republicans in races for U.S. House and the N.C. state House and Senate, two responded. Both said health care has deteriorated since HCA's 2019 purchase of Mission. But 11th District Congressman Chuck Edwards and N.C. House candidate Ruth Smith declined to endorse the idea of compelling a sale. They blamed the problem on Democratic policies and said more competition was needed.

"Hospital consolidation resulting from the Affordable Care Act has unfortunately claimed another victim - our mountain community," Edwards said in a July 26 statement.

The Citizen Times reached out to Mission/HCA.

Democratic N.C. state Sen. Julie Mayfield, a Reclaim organizer, said she had not reached out yet to Republicans.

"Until now, our efforts have been to pull in people who had already been outspoken, and none of my Republican colleagues have," she said. Mayfield's GOP opponent for the 49th state Senate District, Kristie Sluder, did not respond to the query.

After buying Mission for $1.9 billion, HCA used "systematic playbook-driven cuts" to staffing, services and resources in search of profits, Reclaim has said, adding that such tactics undermined public trust and diminished a system that once provided best-in-class medical care.

As a nonprofit, Mission was granted special state permission in 1995 to buy competitor St. Joseph's and form a regional monopoly. The state added special rules limiting Mission on revenue and the number of doctors it could hire. In 2015, the GOP-majority General Assembly voted to revoke those controls and four years later HCA bought the untethered health care system.

Former N.C. state Sen. Tom Apodaca of Henderson County engineered the revocation, characterizing it in an interview last month with the Citizen Times as being aligned with his support of free markets.

Edwards, another Henderson County Republican, who is running for a second term in Congress, also pointed to competition as a possible fix.

"It has been my mission as a member of the House Appropriations and Budget committees to promote funding and policies that disincentivize this kind of consolidation and promote greater choice, affordability and quality health care," he said.

Smith, the Republican north Buncombe resident running for the 115th N.C. House District, said she was glad to see AdventHealth building a hospital northwest of Weaverville.

"I think that's a wonderful thing − to allow competition, to allow alternatives, good alternatives to a bad alternative," she said.

The 115th District incumbent, Democratic N.C. state Rep. Lindsey Prather of Candler, said she was "absolutely" in favor of pushing for a sale.

"Time and time again, ever since HCA bought Mission, they have shown that they are not the right fit for this community," Prather said.

Like some other states, N.C. restricts the number of some types of health care facilities and services by requiring that would-be providers apply for a Certificate of Need. The nonprofit AdventHealth wants to expand its planned hospital by 26 beds and has applied for a CON. But Mission/HCA and the Winston-Salem nonprofit Novant Health have also applied for the 26 acute care beds with their own facility plans. The state, which will choose one applicant, is taking public comments through July 31.

Mayfield said increasing competition is a key factor that Reclaim will encourage − and if the General Assembly lifts the CON law that could bring a flood of new providers. Barring that, any meaningful competition with the large Mission system is "years away," the Asheville resident and 49th District state senator said.

"That may help as HCA thinks about its long-term financial prospects in the region, but we would like movement sooner than that," she said.

What candidates said

All six Democratic candidates for federal and state legislative seats covering Buncombe said they support pushing HCA to sell to a nonprofit. Of the two Republicans who responded, both said they did not support that approach. Instead, they pointed to more competition as a fix.

U.S. House, 11th District (15 WNC counties, including Buncombe)

• Republican Chuck Edwards (incumbent): "It has been my mission as a member of the House Appropriations and Budget committees to promote funding and policies that disincentivize this kind of consolidation and promote greater choice, affordability, and quality health care."

• Democrat Caleb Rudow : "All the folks who've been in this fight, we really tried so many avenues to try to find ways to collaborate and work with and cajole HCA to make a better decisions. So, I support this effort and think it's one of the ways we can reclaim our hospital and get better care around here again."

N.C. Senate, 46th District (east, north and west Buncombe. Also, McDowell and Burke counties)

• Democrat John Ager : "Dr. Mike Messino, a personal friend, came to me just after the sale to warn about what was likely to happen. My niece, a nurse at Mission, is attending 'strike school.' The corporate deniability from HCA is maddening. They have failed our people all across the region, and HCA needs to pack up and leave town."

• Republican Warren Daniel (incumbent) did not respond.

N.C. Senate, 49th District (central and south Buncombe, including Asheville)

• Democrat Julie Mayfield (incumbent): "Increasing competition is a key factor And certainly something we support and will work to encourage. But any meaningful competition, and even any not meaningful competition, is years away."
• Republican Kristie Sluder did not respond

N.C. House, 114th District (south and east Buncombe, including south Asheville)

• Democrat Eric Ager (incumbent): "HCA has not been good for the people of Western North Carolina though they seem to do well for their shareholders. I think a non-profit hospital that is less focused on financial returns would be a better fit for our community."

• Republican Sherry M. Higgins did not respond.

N.C. House, 115th District (west and north Buncombe)

• Democrat Lindsey Prather (incumbent): "Every constituent who has reached out to me about this issue speaks about the decline in quality of care or in the quality of the workplace environment. An effective, high-quality healthcare system that prioritizes patients over profits is essential to the health of our region."

• Republican Ruth Smith : "I think anything we can do within the bounds of the law to encourage competition, to encourage improvement of health care here in WNC, to undo the mistake of selling Mission − and that is what it was − we should be exploring those options."

N.C. House, 116th District - no incumbent (Central Buncombe, including much of Asheville)

• Democrat Brian Turner : "The community knew Mission was focused on the people of WNC just like the community now knows that HCA is focused on the bottom-line. HCA’s treatment of nurses, physicians, staff, and most importantly patients has only underscored this difference."

No Republican is running.

More: Asheville nurse strike? Mission/HCA 'gave some ground'; groups support nurses with fund

More: Mission/HCA suit: county can't sue for $3M in EMS costs; NC AG Stein fights deposition

Joel Burgess has lived in WNC for more than 20 years, covering politics, government and other news. He's written award-winning stories on topics ranging from gerrymandering to police use of force. Got a tip? Contact Burgess at jburgess@citizentimes.com, 828-713-1095 or on Twitter @AVLreporter. Please help support this type of journalism with a subscription to the Citizen Times.

This article originally appeared on Asheville Citizen Times: Partisan split on pushing HCA to sell Mission Health? NC, US legislative candidates