Concerns Grow Over Medicaid Access in North Carolina
RAILY, N.C. (AP) — Medicaid recipients in North Carolina are facing potential cuts to their access to essential services. This latest move comes as part of expense reduction strategies that have added to the ongoing standoff over Medicaid funding in the state.
The administration of Josh Stein, which manages Medicaid for approximately 3.1 million people in North Carolina, announced on Thursday that starting next week, reimbursement rates for doctors, hospitals, and various healthcare providers will be lowered.
Stein expressed skepticism about the chances of the Republican-controlled Congress resolving this issue in a timely manner. He noted that if a solution isn’t reached soon, there might be a significant exodus of doctors from the Medicaid program, leaving many enrollees in a precarious situation. “This could lead to longer wait times, delayed diagnoses, and ultimately worse health outcomes, particularly for those in rural areas who are already underserved,” Dr. Jenna Beckham shared during a press conference in Raleigh.
Stein’s administration has been vocal about these concerns for weeks. The North Carolina General Assembly had previously approved additional Medicaid funds, but a $319 million shortfall remains due to population changes and increasing healthcare expenses. The revised fee reductions are set to go into effect on October 1. However, legislative disagreements over funding for two healthcare projects have stalled progress this week.
With Congress scheduled to return on October 20, Stein emphasized the urgency for the state’s Medicaid agency to act in order to prevent deeper cuts in the future. He criticized lawmakers, saying the reductions range from 3% for home health and ambulance services to 10% for hospitals, nursing homes, and hospice care.
“They prioritize political conflict over the health of our citizens,” Stein remarked during a discussion with Alliance Medical Ministries. “Their issues are unrelated to Medicaid, and the depth of their failures is hard to communicate.”
In response, Republican lawmakers characterized Stein’s unilateral decisions as unprecedented so early in the fiscal year. They suggested that such rate cuts might lead some providers to reconsider their involvement with Medicaid altogether. “The governor seems to be using threats against North Carolinians who require healthcare in light of these significant cuts,” one Republican stated.
Deputy Health Secretaries Stein and Jay Rudlum, the head of Medicaid in North Carolina, clarified that, unlike in previous years, they do not anticipate filling the current shortfall.
Recently, House and Senate Republicans passed a competing bill proposing an increase in Medicaid funding to $190 million annually, which might be accepted by federal agents until early 2026. This legislation included a provision that allocated previously received federal funds towards medical schools and rural health initiatives at two universities.
Senate Republicans asserted that both their chamber and the House agreed to allocate funding for hospital and rural health projects in 2023. However, House Republicans are now reconsidering these initiatives, suggesting that they should be part of broader budget discussions. House Speaker Destin Hall raised concerns, questioning why substantial funds should go to a new hospital in Wake County that appears to be performing adequately from an economic standpoint. Senator Phil Berger noted that House Republicans have criticized Medicaid services for not adhering to past agreements on healthcare projects.
Stein, along with his Democratic allies, has argued that spending policies enacted in July threaten the health of countless residents and rural hospitals. Meanwhile, Republican lawmakers have minimized these concerns, although the reduction in funding from Washington has prompted them to adopt a more cautious fiscal approach.
