Wake County leaders on Monday voted to let a proposed merger between WakeMed and Atrium Health move forward after a tense moment with protesters who opposed the merger.
The 5-2 vote in favor of allowing the merger to move forward came after a meeting that lasted for more than five hours on Monday.
Other WRAL Top Stories
"I believe that this action will make WakeMed stronger in the face of growing demands, workforce pressures, rising costs, and the real headwinds facing healthcare today," said Wake County Commissioner Don Mial.
In a joint statement sent to WRAL News, representatives for the healthcare providers said the vote would be a "historic milestone" for both.
"The amended Transfer Agreement includes a strengthened charity care commitment establishing a higher minimum threshold for caring for patients in need, providing additional assurance around a level of support that already exceeds that threshold today and helping ensure access to care regardless of a person's ability to pay," the statement said.
The merger is still not complete, as it still needs approval by the Federal Trade Commission and the United States Department of Justice.
"As the proposed combination now moves to the regulatory review process, we look forward to fulfilling our commitments," WakeMed and Atrium representatives said. "We recognize that trust is earned, and our focus now is to follow through on what we've outlined, continuing to listen to the community and demonstrating, through our actions, the values this combination will create for the people of Wake County and beyond."
Tense exchange with protesters ahead of vote
The vote was not without disruptions. Deputies with the Wake County Sheriff's Office cleared the room at the Wake County Justice Center of protesters who were shouting and interrupting the commissioners as they began to vote. The commissioners then called a five-minute recess after clearing the room. After the recess period, some audience members were allowed back into the room for the vote.
The merger required approval from county commissioners. Critics ahead of the meeting raised concerns that combining the systems could lead to higher healthcare costs.
“WakeMed belongs to our community, not corporate boardrooms," said Aliyah Manigault with the North Carolina Black Alliance to the commissioners. "It was created to ensure people could receive quality care, regardless of their ability to pay.”
The public comment portion of the meeting featured more than a dozen speakers, several of whom raised cost and access concerns.
In a statement provided to WRAL News, The Patients Union, an organization advocating for more affordable health care, said it is "heartbroken and angry" by the commissioners' decision to move the merger forward, but added that the last few months showed that improvements were made in the deal because of patients speaking out against it.
"The last few months showed how powerful patients are when we claim our role in these moments," said Jamila Headley, executive director of The Patients Union. "The more we got involved and raised our voices, the better the deal got."
Ardis Watkins, the executive director of the State Employees Association of North Carolina, was present at the meeting. Although she wasn’t there to protest, she said she’s against the deal.
"This process has been such a mess," she said. "The citizens have had it. So they ended up with complete chaos, but that’s fitting because this entire process has been nothing but chaos."
Wake County commissioners raise concerns
Ahead of Monday's vote, Vickie Adamson and Tara Waters, the two commissioners whom voted against allowing the merger to move forward, felt they didn't have enough time between last week's revisions and Monday afternoon to absorb the documents and make a decision.
Commissioner Adamson, who represents District 7, told WRAL in a statement Sunday:
After much consideration and prayer, I intend to vote no on the proposed amendment to the transfer agreement that would allow WakeMed to move forward in becoming part of Atrium Health. In the very short time I've had with the documents, it's not clear to me that the changes address the concerns Wake County residents have about the substance of the agreement. I am very concerned about costs increasing if WakeMed merges with Atrium. I don't have confidence that amending the transfer agreement in this way won't directly lead to increased health care costs. I received the new documents on Thursday night at the same time as the public and the media. These are complicated legal documents that require time to review and discuss together as a County Commission, and for us to engage with questions from the public. This timeline doesn't let us do either of those things. I spoke out on this issue in May because the process felt rushed and undemocratic, and I feel the same about where we stand today. I'm just not comfortable being part of setting a precedent for rushed, undemocratic decision-making in Wake County. I ran for County Commission on a commitment to good governance, and this is not good governance.
“In my eight years on this board, I don’t think I've ever been handed this complicated of legal documents on Thursday night and had to vote on it on that day and that’s just normally not how we do business,” Adamson said.
Waters, who represents District 5, where WakeMed's Raleigh Campus is located, told WRAL that she has heard concerns and feedback from residents about the deal.
Waters said she is concerned that the revised agreement includes complicated legal and health care language that residents may not have enough time to fully understand before Monday's decision.
While not specifying how she would vote ahead of the meeting, Waters said, "It’s an important decision and one that I will do thoughtfully, prayerfully, and with the citizens of Wake County in mind.”
After the vote, WakeMed and Atrium said they spent "countless hours listening to county leaders, community organizations, faith leaders, employees, care providers and residents" who wanted to know how the merger would affect Wake County residents.
"That's a fair question, and we believe the additional commitments included in the final agreement are a meaningful answer," they said.
Gov. Josh Stein 'pleased' with agreement requests
In a statement on Monday, Gov. Josh Stein said he was "pleased" that WakeMed and Atrium agreed to his request to cap price increases at WakeMed for the next five years.
Ahead of the meeting, Stein said he asked WakeMed to cap price increases at not more than 1.5 times the annual increase in Medicare costs over the next five years, saying that the state needs broader health care reform to address rising costs.
"Since my time as Attorney General, I have been urging the General Assembly to give the Attorney General’s Office more authority to review hospital transactions and protect North Carolinians from the increased prices and decreased quality they often bring. Health care costs are too high, and additional oversight and authority would better protect patients," Stein said.
Stein originally raised concerns about the deal after it landed on the county commissioners' agenda in May.
"Because Atrium has addressed a number of concerns about the deal’s impact on North Carolinians, I do not oppose the combination," Stein said.
Union, advocacy groups raise concerns about workers, patients
Before Monday's vote, patients and workers gathered in downtown Raleigh for one final push against the agreement.
The Patients Union held a rally at Nash Square, arguing that despite changes to the deal, it still does not include enough protections against potential increases in what patients pay.
The revised agreement limits certain WakeMed price increases for five years, strengthens charity-care commitments and includes the $150 million community benefit fund.
After the rally, the group planned to deliver a petition signed by more than 1,500 Wake County residents.
The Triangle Central Labor Council also raised concerns about the proposed transfer.
"The Triangle Central Labor Council, a democratically elected body representing more than 20,000 union members across the Triangle, continues to have serious concerns about the proposed transfer of WakeMed Health & Hospitals to Atrium Health," the group wrote in a statement Sunday.
On Friday, advocacy groups told WRAL they remained concerned that Atrium's growing size could lead to higher costs.
"Atrium is already the biggest. When they become even bigger, they're going to take that and squeeze more money out of us," one advocate said.
