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Mobilizing to Defeat HB 918 in North Carolina


“I am proud that many of my primary care colleagues took a stance against the NC HB 918, favoring more equitable care and working to eliminate barriers for marginalized communities. This bill threatened to dismantle the foundational family unit, disproportionately affecting families afflicted by systemic racism and poverty. Taking a stance against HB 918 communicates our commitment to achieving a more unbiased and nondiscriminatory health care system for North Carolinians.” – Keyona Oni, MD | North Carolina Cluster AAFP Liaison

On June 18th, leaders in the North Carolina Cluster received word that House Bill 918, a bill criminalizing pregnant people for substance use, moved swiftly through the Committee on Rules and Operations and was poised for a full vote on the Senate floor.  

The North Carolina bill makes positive prenatal drug screening tests grounds to separate newborns from their parents and expedites the termination of parental rights. The threat of family separation and prosecution deters pregnant people from seeking prenatal care and addiction treatment.(1) Local groups like The North Carolina Urban Survivors’ Union, a grassroots harm reduction organization dedicated to protecting the rights of drug users, have played a critical role in amplifying the harmfulness of HB 918 and centering the voices and autonomy of drug users and their families.

HB 918 would be disproportionately weaponized against poor communities of color. A 1990 study conducted in Pinellas County, Florida found that although Black women and white women had similar rates of positive drug tests, Black women were 10 times more likely to be reported to authorities than white women. (2) HB 918 stems from the long and racist legacy in this country of violently prescribing criminal intervention for Black and Brown communities instead of equitable public health initiatives.

North Carolina Cluster members quickly mobilized as HB 918 headed to the Senate floor. Members persistently sent emails to Senators, highlighting their position as medical experts who denounce HB 918 and the criminalizing of medical care. The Cluster listserv was constantly flooded with updates and encouragement from colleagues after receiving responses from Senators who were thankful to hear from clinicians and who planned to vote against HB 918. A contingent of family physicians within the North Carolina Cluster also called upon the North Carolina Academy of Family Physicians to issue an official statement opposing the bill. (3) Unfortunately on June 24 HB 918 passed in the Senate (25 -20) and moved on to pass in the House (59-53). Fortunately, however, after receiving waves of veto requests from North Carolinians, Governor Roy Cooper vetoed the bill on Thursday, July 2nd. (4)

As an Organizer at RHAP, witnessing the mobilization and peer-support of the North Carolina Cluster community was motivating. Seeing how clinicians’ can leverage their positions as medical experts and organize alongside grassroots initiatives reminds me of how inherently connected our reproductive health advocacy in primary care is to other social justice movements.

Showing up for patients in and outside of the clinic brings us closer to a reality where everyone can truly access equitable, person-centered health care.

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