Medicaid

Photo: The North Carolina General Assembly's Legislative Building
Jorge Valencia

The state House and Senate are entering their fifth week of negotiations over the state’s $21 billion budget. The Senate is scheduled on Monday night to take on at least one other major piece of legislation and two bills intended to beef up policing in North Carolina.

Medicaid Overhaul

The point of this legislative session is for the General Assembly to make adjustments to the state’s budget. But talks are moving so slowly, that Senate leaders last week said they might as well take up an overhaul of the Medicaid system.

North Carolina legislative building
Dave DeWitt / WUNC

Lawmakers in the North Carolina Senate have proposed a plan that sheds more light on how they’d like to manage the state's Medicaid program. But it differs significantly from plans put forward by the House and by Governor Pat McCrory. The Senate’s proposal would allow hospital and doctor-led health plans to see Medicaid patients as well as managed care plans run by insurance companies.

General Assembly
Dave DeWitt

Leaders in the state Senate have offered an eight percent pay raise for teachers as they inch closer to putting together a budget.

Senate leaders unveiled their offer to House budget negotiators late Tuesday afternoon. Senators had previously wanted to give educators raises of 11 percent, but House leaders said such a large increase would require cutting too many other areas.

North Carolina legislative building
Dave DeWitt / WUNC

Republican lawmakers have been moving slowly on state budget negotiations. They finally reached a compromise Wednesday on how much revenue they will rely on from the state lottery. But that came after hours of finger-pointing and debate over other education issues, including teacher pay.

Before negotiations even began on Wednesday morning, the mood felt sour. Senate leaders weren’t happy that the House had invited school leaders to argue against cutting teacher assistant jobs. Senator Harry Brown objected before the guests could even make their way to the podium.

North Carolina State Legislature
Dave Crosby / Flickr

 After weeks of almost no budget talks, state lawmakers finally agreed to break their deadlock.  At a public conference committee meeting on Wednesday, they openly negotiated their adjustments to the two-year budget plan and seemingly resolved differences over Medicaid funding.

NC Legislative building
NC General Assembly

  

It’s a new fiscal year as of Tuesday, but the legislature has yet to reach an agreement on budget adjustments. 

The House and Senate are still at odds over how to spend money on education and Medicaid. 

Lawmakers are also trying to sort out a coal ash regulation bill, public records rules for charter schools, and higher penalties for prison inmates who get a hold of cell phones.

NC Legislative building
NC General Assembly

North Carolina lawmakers say they want to break the impasse on a state budget this week. But those aren’t the only bills on their docket.

Leaders in the Senate and the House have been talking about Common Core and Coal Ash since they started meeting in May.

The Senate wants to consider keeping parts of Common Core, the national academic standards for public school students. The House wants to completely replace them.

State Senate chamber
Dave DeWitt / WUNC

House and Senate leaders are not showing signs of meeting their July 1 deadline to make adjustments to the state's two-year budget. They're still deadlocked over differences in their spending plans.

Senate leaders call the House's budget plans unbalanced and unsustainable. They say a five percent pay raise for teachers is not enough. Senators are offering 11 percent by cutting back on teacher assistants.

NC Senate committee
Jessica Jones

Governor McCrory and leaders in the state House are trying to speed up budget negotiations, but without much success so far. They’ve introduced a bill that’s a kind of mini-budget to give teachers 5 percent raises in case House and Senate leaders can’t agree on a comprehensive spending plan. But the biggest sticking point in the negotiations is over Medicaid. Thursday morning, State Budget Director Art Pope appeared before a Senate Finance Committee to answer senators’ questions.

State Senate chamber
Dave DeWitt / WUNC

Senate and House leaders are expected to begin meeting in conference committees this week to make adjustments to the two-year budget plan. 

They have until June 30th to resolve differences and send their spending plan to Governor Pat McCrory.

Medicaid funding and teacher pay raises are expected to be the key sticking points in negotiations. But many Republicans, like Representative Craig Horn (R-Union), say they’re optimistic about the process.

The state’s Medicaid Reform Advisory Committee is comprised by Sen. Louis Pate, Dr. Richard Gilbert, Dennis Barry, Peggy Terhune and Rep. Nelson Dollar
Jorge Valencia

A committee in the state House of Representatives is recommending a plan to reform Medicaid insurance for people who are poor or disabled.

The proposal says a majority of Medicaid patients would be treated by providers who receive a fixed amount of money per patient.

The governor’s office shows support for the bill. Health and Human Services Secretary Aldona Wos praised it in a committee hearing Thursday.

"We are very pleased with the House bill that it closely aligns with Gov. McCrory's medicaid reform plan," Wos said.

Protesters gathered outside the Senate chamber to demonstrate against policies they say are regressive.

Nineteen Moral Monday protesters were arrested yesterday after demonstrating in the legislative building against budget proposals and policies passed by Republican-led General Assembly.

Dozens of protesters stomped, danced, and chanted at the very tops of their lungs, days after a superior court judge struck down new rules that prohibit loud activities and noises that would cause disturbances. The Wake County judge on Friday argued that the rules were unconstitutional, overly broad and vague.

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

Senate leaders have released their proposed budget for the next fiscal year. They’re looking to spend about 21 billion dollars. Their plan would make substantial changes to the Medicaid program - and would scale back several state agencies, including the Department of Justice. Senate leaders also proposed hefty pay raises for public school teachers. 

For months now, Senate leaders have made it very clear that they want to give teachers pay raises. But they’ve been pretty coy about the details until this week.

North Carolina Legislative building
NC General Assembly

  Moral Monday protests resume as the General Assembly's short session continues. Protestors visit individual lawmakers today to lobby for Medicaid expansion, unemployment insurance and education reform. Last week, the North Carolina Senate approved a fracking bill and tentatively approved a regulatory overhaul. Both pieces of legislation may face challenges in the House. 

Image of NC General Assembly where lawmakers are considering two controversial bills.
Credit NC General Assembly

Officials with the state Department of Health and Human Services say they still expect a Medicaid shortfall of between $120- and $140-million this year. They spoke before state lawmakers today in a committee meeting at the General Assembly.

They first predicted a shortfall of this size about three weeks ago, and it's less than budget overruns of previous years. Republican Representative Nelson Dollar of Cary says that's good news.

Katie Short (far left in purple), mother Mary next to her.
Jessica Jones

Every month, state lawmakers on the General Assembly’s Health and Human Services Oversight Committee hold meetings to talk about health policy in North Carolina. Legislators sit at the front of the room to discuss their agenda, as staff members, reporters, and lobbyists listen. But in the back of the room, a mother and daughter, Mary and Katie Short, who attend every single meeting keep their eye on things too.

North Carolina legislative building
Dave DeWitt / WUNC

State officials say they expect a funding shortfall for the state’s Medicaid program this fiscal year.

Pam Kilpatrick is with the Office of State Budget and Management. She told state lawmakers what her office’s estimate was at a Health and Human Services oversight meeting this morning:

“The 120 to 140 million dollars would be the sum total of all the moving parts. That will be attributed as the department walks through the specifics,  and their methodologies, and they’re using more than one methodology to come up with this shortfall range.”

NC General Assembly

Members of the General Assembly’s Health and Human Services committee are scheduled to meet today in Raleigh. One of the biggest tasks the committee faces is reforming Medicaid- the program that provides health care for people in poverty.

Earlier this year, state officials seemed to be advocating for a move to managed care. But a new proposal recently put forth by state health officials would build on the state’s current system of treating Medicaid patients.

Doctors at Duke Hospital.
Duke Medecine

The NC Department of Health and Human Services unveiled its plan on Monday to reform the state's Medicaid system. While it had already signaled a shift from Managed Care Organizations (MCOs) to Accountable Care Organizations (ACOs) months ago, the new plan partially outlines how the state would like to achieve that shift.

Thousands marched to the North Carolina State Capitol building on Saturday.
James Willamor via Flickr

Organizers of Saturday’s moral march on Raleigh plan to use the event’s momentum to mobilize voters, they say. The event follows last year’s weekly Moral Monday rallies that criticized laws passed by North Carolina’s Republican-led government.  The new focus is on the fall elections.

Protesters crowd the capitol for a Moral Mondays protest.
Matthew Lenard

Thousands of people are expected to march in downtown Raleigh on Saturday, some coming in buses from other states, to call on North Carolina legislators to reverse laws they’ve signed over the last year including requiring voters to show IDs in polling stations, reducing unemployment benefits and blocking Medicaid expansion.

The state’s Medicaid Reform Advisory Committee is comprised by Sen. Louis Pate, Dr. Richard Gilbert, Dennis Barry, Peggy Terhune and Rep. Nelson Dollar
Jorge Valencia

  The North Carolina health department may create up to seven regional networks across the state to give Medicaid services, instead of allowing companies to compete to provide government insurance statewide, according to a new proposal.

NC General Assembly

State health officials say glitches are being worked out in the new Medicaid claims processing system called NCTracks.

Department of Health and Human Services Secretary Aldona Wos and other health officials testified before lawmakers in a day-long oversight session Tuesday.

Health care providers have complained that they’re not being reimbursed for services rendered to Medicaid patients. Some state lawmakers said they think health officials are getting things back on track.

Gov. Pat McCrory
NC Governor's Office

Governor Pat McCrory has again defended North Carolina's new voting law during a talk at a leading conservative think tank. 

McCrory spoke at an event Monday hosted by the Heritage Foundation in Washington.  He stood behind the state's new voting rules, which require a photo ID at the polls, pointing out that 32 other states have similar laws.  He also criticized attorney general Roy Cooper for speaking out against the law.

NC Office of the State Auditor

  

Recent controversy over the handling of the Medicaid system by the state’s Department of Health and Human Service has pointed a spotlight on a seemingly non-controversial office: the state auditor.

State Senator Phil Berger
Dave DeWitt

  

Controversy continues at the North Carolina Department of Health and Human Services with the Medicaid director resigning after only eight months on the job.

Two Ob/GYN doctors review test results.
Mercy Health

Members of a Raleigh-based community medical organization say a new study shows a transitional care program they launched has cut hospital re-admissions by 20 percent. 

Computer, medical.
Tabitha Kaylee Hawk via flickr, Creative Commons

The state Auditor has found that the North Carolina Department of Health and Human Services did not fully test a new computer system.

The DHHS system was installed to start processing Medicaid claims beginning in July.   Beth Wood's audit found that the nearly $500 million computer system was not put through all of its paces.  The report raises questions about the software and its ability to handle Medicaid claims paid by the state that exceed $12 billion. 

McCrory gives weekly GOP address
www.governor.state.nc.us

Gov. Pat McCrory gave a national audience a glimpse into reforms he wants to implement in North Carolina.  He delivered this past weekend's GOP response to President Obama's weekly address. 

McCrory criticized what he called Washington's "weak leadership" and urged national lawmakers to give more flexibility and accountability to states.  He says he needs that kind of freedom to implement a different approach to Medicaid reform.

A committee in the state House is considering a measure to extend Medicaid coverage for people who have Alzheimer's and dementia. 

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