North Carolina Governor Roy Cooper has signed legislation permitting Blue Cross and Blue Shield of North Carolina (BCBSNC), the state's primary health insurer, and Delta Dental to restructure under a new holding company. This move, effective immediately, allows the transfer of assets despite warnings from state officials about potential oversight limitations.

The bill received significant bipartisan support in the Republican-led General Assembly. Governor Cooper expressed confidence that the legislation, with its consumer protections, would maintain BCBSNC's strength and commitment to North Carolina while aiming for comprehensive and affordable health insurance statewide.

State Insurance Commissioner Mike Causey voiced opposition during the legislative process, citing concerns about reduced regulatory power over the holding company's actions. He questioned whether the new structure would truly benefit consumers. However, given the Republican supermajority in both legislative chambers, Governor Cooper's ability to block the measure, even if he opposed it, was limited.

BCBSNC, a non-profit entity, argued that the restructuring would enhance its competitive edge against for-profit insurers and enable broader service delivery. A spokesperson for BCBSNC praised the bipartisan effort, emphasizing the company's commitment to addressing the evolving healthcare needs of the state. The new law mandates the holding company to invest in initiatives that enhance affordability and contribute to the health of North Carolinians, capping the transferable "admitted assets" at 25%.

Transparency measures include annual audited financial statements submitted to the Insurance Commissioner's office, disclosure of executive compensation, and details of strategic investment activities. Despite these provisions, Commissioner Causey maintains that the law provides BCBSNC with excessive leeway to use ratepayer funds for purposes other than intended.

Commissioner Causey and State Treasurer Dale Folwell made an unusual appeal directly to Governor Cooper during a Council of State meeting, urging him to reconsider the bill and incorporate amendments to safeguard consumer interests. They expressed ongoing public concern and criticized the legislative process, alleging undue influence by BCBSNC, a major political donor and lobbying presence in the General Assembly.