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Governor Expresses Dissatisfaction with Senate Budget Writers' Medicaid Plan


Governor Pat McCrory held a news conference yesterday at the executive mansion to talk about one thing in particular he doesn’t like in the Senate budget proposal- turning Medicaid services over to a managed care organization. The governor, the Secretary of Health and Human Services, hospital organizations and physicians are against the idea.

Governor McCrory held the news conference in a secluded garden at the executive mansion. Dozens of doctors wearing their long white coats gathered on the brick steps behind him.

"We need both the House and Senate to come together and start taking progressive action. This is not a Republican or Democrat issue because I’m looking for both solutions from both Republicans and Democrats. What we can’t afford is for people to sit on the sidelines and delay reform," said McCrory.

McCrory was referring to the Senate’s budget proposal, which passed late last Friday night. It seeks to place Medicaid services for low-income residents under managed care. But that’s not the plan the governor and the Department of Health and Human Services have been working on all year long. That plan would create hospital and physician networks that would work together to find Medicaid savings and share in cost overruns:

"I welcome other ideas. But I don’t welcome people just saying what they’re against. I wanna find out what people are for and present the detailed plans so we can have that debate, have that discussion and make the tough decisions."

The managed care plan the Senate proposed to treat Medicaid patients was an unwelcome surprise for the McCrory administration. On Friday night, as Senate lawmakers were discussing the budget proposal they would later pass, Republican Senator Louis Pate gave one reason why he supports the managed care model.

"Every year, it seems like we have to come up here and find 400 million dollars per year in overruns to make up for the budget in Medicaid," said Pate.

Medicaid cost overruns are a familiar refrain for lawmakers, who say that’s what has busted their budget for the last several years. Earlier this week, Secretary of Health and Human Services Aldona Wos and state Budget Director Art Pope announced there would be a 60 million dollar bill they’d need to pay- they had expected to get that money back from local mental health agencies serving Medicaid patients, but they discovered that federal regulations prevent them from doing so. Still, Secretary Wos says the managed care model is not what physicians and health care providers across the state want.

"What everyone has requested during these last 16 months- that our reform is North Carolina specific. And it is. It is doable, it is reasonable, and it is what can work on the ground in North Carolina right now," said Wos.

The plan that’s being discussed expands on North Carolina’s community care model, which is nationally recognized for its cost savings and high quality of care given to Medicaid patients. The plan makes network providers more accountable for cost savings. Medical organizations across the state support it, and there’s a reason why, says Secretary Wos:

"We listened to the entire health care industry and to all our stakeholders. We know that this reform can work and it can work because of the innovation and passion of the people behind me."

It’s hard to say exactly why Senate budget writers decided to propose a completely new plan for Medicaid patients, despite the general consensus of everyone from the governor to physicians in small rural practices. The House is now working on its version of the budget. And it could be that the Senate wanted a bargaining chip in negotiations to create a final budget.  


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