Medicaid

A picture of a woman with a bathtub balance seat.
Richard Duncan / CDC

North Carolina's population is aging quickly, increasing the demand for personal caregivers. But a report from a poverty advocacy organization says elderly people might have trouble finding reliable care unless caregivers' wages increase.

The North Carolina legislative office building
Wikipedia

State lawmakers passed a temporary spending measure this week to keep North Carolina’s government running for 45 days.

The move allowed lawmakers to avoid the midnight deadline tonight that marks the end of the fiscal year. Legislators to continue to debate differences over tax structure, education spending and Medicaid. 

Host Frank Stasio talks with WUNC capitol reporter Jorge Valencia about the latest. 

A picture of a dctor holding a stethoscope.
Alex Proimos / Flickr

North Carolina lawmakers have chosen to not expand Medicaid eligibility under the Affordable Care Act.

Republican state leaders, including Senate Leader Phil Berger and House Speaker Tim Moore, have said that, even if the federal government initially subsidizes new people enrolling in Medicaid, the program would eventually cost the state more than it saves.

Medicaid illustration: A Caduceus symbol and a dollar sign
Neff Conner / Flickr

The North Carolina House of Representatives approved a plan Tuesday to allow non-profit groups of hospitals and doctors to manage care for most of the state’s 1.8 million Medicaid health recipients, formally setting the stage for a clash with the Senate over how to revamp the program.
 

The House plan, which lawmakers have discussed since at least 2011 when Republicans took over a majority in both chambers, would allow state health officials to pay the non-profits a predetermined amount of money for the medical care of each patient and would be phased in by as early as 2020.

Photo: The North Carolina seal in front of the state legislative building
Jorge Valencia

Lawmakers take up the state's budget with a month-end deadline looming. Senate leaders passed their plan this morning. It increases pay for new teachers but cuts back on teaching assistants. 

The $21 billion plan also puts Medicaid under the control of an outside agency. But the Senate plan differs greatly from the House proposal and the Governor's plan. Lawmakers need to reconcile the differences before June 30 or pass a continuing resolution to keep the government funded.

NC General Assembly; State Legislature.
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The North Carolina Senate gave preliminary approval on Wednesday afternoon to a two-year budget that would cut funding for thousands of public school teaching assistant positions, and would make significant policy changes to the state's tax code and Medicaid program.

The proposed $21.5 billion budget, which represents an almost 2 percent increase from the current year and was approved by Republicans along a party-line vote of 30-19, is scheduled for a final vote on Thursday.

North Carolina legislative building
Dave DeWitt / WUNC

State Senate leaders held a news conference Monday to discuss details of their $21.47 billion budget proposal. The proposal is smaller than the state House’s budget plan released almost a month ago, and  would create a separate state agency to administer North Carolina’s Medicaid program.

WUNC Capitol Reporter Jorge Valencia said the Senate has only given a general idea of its budget proposal, and includes increasing the starting salary pay for teachers to $35,000 a year, a $2,000 increase.

Medicaid illustration: A Caduceus symbol and a dollar sign
Neff Conner / Flickr

A North Carolina House committee has approved a plan to remake the state’s costly Medicaid program by allowing hospitals and physicians to manage the money spent to care for each patient.

The plan, which would shift much of the financial risk of growing Medicaid costs to provider-led entities, was approved after more than two hours of heated debate in the House of Representatives health committee. The bill is expected to be scheduled for a hearing in the appropriations committee on Thursday morning.

Image of tools in doctor's office
Morgan / Flickr/Creative Commons

The Affordable Care Act is still attracting big enrollment numbers in North Carolina.

Nearly 500,000 people in the state have coverage, but premiums could rise by as much as 40 percent next year for some health plans.

   

And the Obama administration says more than 300,000 people still are not covered because the state did not expand Medicaid. 

Medicaid reform is at the forefront of the state's legislative agenda this session, but legislators are still debating how to design the reform. 

The Senate wants to privatize administration and let commercial insurance companies control the market while the House and Governor McCrory want state health care providers to be in charge. A new report from Wake Forest University argues for a hybrid strategy.

Illustration: Cadeceus
Flickr user takomabibelot

North Carolina lawmakers got the first granular look at the state’s Medicaid program in 20 years, showing the program’s improving financial condition but continuing major debts to medical providers.

The audit found the Medicaid fund balance was $350 million in the red for the fiscal year ended June 30, 2014—almost $59 million better than a year earlier.
 

Illustration: Cadeceus
Flickr user takomabibelot

Roughly 480,000 people in North Carolina have signed up or been automatically re-enrolled for Obamacare plans by the end of January using the healthcare.gov system, according to government data released Friday. Almost 7.5 million in total have signed up across the country.

N.C. Attorney General Roy Cooper
N.C. Democratic Party

Attorney General Roy Cooper says he'll continue to criticize Republican policies during the legislative session that begins Wednesday, hinting once again hinting that he might run for governor in 2016.  
 

At a luncheon held by the women’s group Lillian's List, Cooper told a few hundred Democrats that he supports issues such as abortion rights and expanding Medicaid in North Carolina.

He hasn't announced his candidacy for governor, but he’s widely seen as the most likely Democrat to try to unseat Republican Gov. Pat McCrory.

North Carolina is now tracking babies born with alcohol or drug dependencies.
Tulane Publications / Flickr, Creative Commons

A legislative subcommittee has endorsed a measure that would take oversight of the state's Medicaid program away from the Department of Health and Human Services.

The subcommittee approved the measure Thursday.
 

It would place an eight-member board in charge of the state's Medicaid program. The group would run Medicaid with a set amount of funds, given by the legislature every year. That means it would have the power to increase or reduce services for patients.

The head of Blue Cross and Blue Shield of North Carolina is speaking out in support of expanding Medicaid in the state.

Brad Wilson is President and CEO of Blue Cross and Blue Shield of North Carolina.

“As business leaders of North Carolina, you need to help us craft a solution to expand Medicaid," said Wilson.

Wilson tossed out that charge during this week’s Economic Forecast Forum in Research Triangle Park, sponsored by the North Carolina Bankers Association and the North Carolina Chamber of Commerce. 

Ralf Heb / Flickr/Creative Commons

In recent months, Governor Pat McCrory has said he’s considering proposing expansion of the state’s Medicaid program, which would allow more low-income people here to receive health care. Back in 2012, the General Assembly passed a bill blocking expansion and the formation of a state health exchange. The governor signed it into law. But now, many other Republican-led states are moving forward with enlarging eligibility for the program. Yet Republican leaders don’t have a consensus on what to do here.

A picture of a stethoscope.
jasleen_kaur / Flickr/Creative Commons

A Medicaid oversight subcommittee has approved recommendations laying out goals for reform of the state's health insurance program for low-income residents. But support for the measure was not unanimous among Republicans. 

The recommendations approved Tuesday will now go before the full Health and Human Services oversight committee.

Two-pages of findings sketch out general goals for Medicaid reform in the state. Overall, it reiterates the feeling among some lawmakers- including Senator Ralph Hise- that the primary goal in reforming Medicaid should be to cut costs.

Pat McCrory
Dave DeWitt

Governor Pat McCrory has filed a suit against House Speaker Thom Tillis and Senate Leader Phil Berger, saying he's trying to stop them from usurping executive powers.

The lawsuit, filed in Wake County Superior Court, alleges violations of the separation of powers, executive power, and appointments provisions of the state Constitution, the Raleigh News & Observer reported. Former governors Jim Hunt, a Democrat, and Jim Martin, a Republican, joined McCrory in the filing.

Image of tools in doctor's office
Morgan / Flickr/Creative Commons

State health secretary Aldona Wos says North Carolina would likely need to change some of its Medicaid rules to expand the program under the Affordable Care Act. 

The health care law offered to pay for expanded Medicaid through 2016, but North Carolina was one of 24 states that rejected the expansion last year.  Gov. Pat McCrory said the state's Medicaid program was broken, and was not confident the federal government would cover the costs. 

But Wos says Medicaid is now more stable, and she plans to present the governor with options for expanding Medicaid. 

Aldona Vos, DHHS
North Carolina Department of Health and Human Services

    

North Carolina’s Medicaid program covers 1.7 million people at a cost of $14 billion per year.

The program for low-income and disabled residents has had a turbulent past. Last year, computer glitches created a long backlog of applications and payments for providers. And Medicaid has been a question mark in the budget, causing cost overruns for several years.

But health officials say the system is improving enough that the state could reconsider expanding Medicaid to half a million people who do not have health insurance.

DHHS Secretary Aldona Wos
Jessica Jones

North Carolina's Secretary of Health and Human Services spoke before a legislative committee Wednesday to explain organizational changes made in one of her divisions.

Secretary Aldona Wos explained the changes will help streamline the Division of Medical Assistance, which administers the state's Medicaid program. She also told legislators that a formerly enormous backlog in the IT system used to process Medicaid applications- called NC FAST- has been reduced by 81 percent. The Secretary says she expects the system to be caught up by the end of October.

Medicaid illustration: A Caduceus symbol and a dollar sign
Neff Conner / Flickr

North Carolina health officials say the state Medicaid program has a positive cash balance for the first time in years.

For years, the state health insurance for people who are poor or disabled has cost tax payers more than expected. We're talking hundreds of millions of dollars.

But that wasn't the case last year. Aldona Wos, the state secretary for Health and Human Services, says the Medicaid budget was in the black.

North Carolina will be missing out on $51 billion from Mediciad because they chose not to expand coverage.
http://eofdreams.com/money.html

    

Lawmakers in North Carolina decided to not to expand Medicaid under the Affordable Care Act. 

McCrory signs budget plan
Reema Khrais

Gov. Pat McCrory has signed into law the state’s $21.1 billion budget bill that was approved by the legislature last week.

The signing comes five weeks after the beginning of the fiscal year on July 1st, a deadline lawmakers did not meet because of stalled negotiations and debate largely over teacher pay and Medicaid funding. 

McCrory signed the 260-page budget deal on Thursday at the executive mansion, proudly noting that the spending plan includes raises for teachers and state employees, while not increasing taxes or making reductions in Medicaid eligibility.

Photo: The North Carolina seal in front of the state legislative building
Jorge Valencia

Gov. Pat McCrory has before him an annual spending plan for North Carolina, setting aside money to give public school teachers their first significant pay raise since 2008 - while cutting from public health, childhood development and other programs. McCrory has said he will sign the bill, and lawmakers said they have at least two other major pieces of legislation they will address this year. 

Gov. Pat McCrory
www.governor.state.nc.us

Governor Pat McCrory says he approves of the legislature's spending plan for state and will sign the bill.

The Senate already passed the $21 billion budget bill today and the House will likely approve it Saturday morning.

Governor Pat McCrory touted the budget proposal at a press conference on Friday.

“We've got a 2.2 percent increase in the general fund budget with no tax increase, with teacher pay raises, no elimination of teachers assistants and we've kept the integrity of our Medicaid, I'm proud of it,” he said.

NC Legislative Building
Dave DeWitt / WUNC

After a 15-hour day at the legislature, Senators voted this morning to pass the $21.3 billion state spending plan. 

Senators didn't leave the legislative building until about 1 a.m. They were determined to make a final vote on the budget and wrap up any loose ends before heading home. 

But they'll be back soon enough. They're expected to return in a couple of weeks to take up any possible vetoes from the Governor. Then, they'll be back in November to pick up at least two bills they didn't finish. 

NC Legislative Building
Dave DeWitt / WUNC

  After an extra month of negotiations, state lawmakers have agreed on a budget for the next fiscal year. 

The $21 billion proposal makes compromises between House and Senate leaders on teacher pay and Medicaid spending. But other issues outside of the budget remain. Lawmakers still have to consider a Medicaid reform bill, local sales taxes changes and environmental protection regulations.

Guest host Phoebe Judge talks with WUNC Capitol Bureau Chief Jessica Jones about the General Assembly’s short session.

photo of the North Carolina Senate
Government & Heritage Library, State Library of NC / Flickr

After spending a month dragging their feet on the state budget, lawmakers are now in a 48-hour race to wrap it up and go home. The $21.1 billion budget before them is a hefty 260-page document filled with hundreds of edits, figures and calculations.  But for many Republican lawmakers, including Sen. Harry Brown (R-Onslow), one item stands out.

“The priority of this session was education and, in particular, teacher pay,” Brown said.

NC Legislative Building
Dave DeWitt / WUNC

 Nearly a month past their deadline, state leaders say they hope to release a final spending plan adjustment in the next couple of days.

Top negotiators haven't officially released any details yet, but they expect to give teachers average raises of about 7 percent. 

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