As state treasurer, Folwell promoted a controversial "Clear Pricing Plan" contract initiative, attempting to move State Health Plan participants to a pricing model that would tie all payments to Medicare, rather than negotiating reimbursement rate with health care providers. The plan would save money for the plan, but would also cause providers to be reimbursed for their services at lower, but still profitable, rates. The North Carolina Healthcare Association opposed the plan, while the State Employees Association of North Carolina supported it. Folwell ultimately lost a battle with the state legislature over his proposal.