Uncategorized

Medicaid program designed for stability, not speed

During the recent legislative session, the NC Budget and Tax Center and others expressed doubts about the feasibility of enacting $359 million in Medicaid cuts in the first year of the biennium – concerns which were echoed in a letter sent by Gov. Perdue to legislative leaders prior to passage of the FY11-13 biennium budget. In a meeting of the Joint Legislative Oversight Committee for Health and Human Services yesterday, NC Department of Health and Human Services Secretary Lanier Cansler reported that there is a $100 million “hole” in the Medicaid budget attributable to various programmatic and administrative issues, of which the largest single piece is a $30 to $40 million shortfall due to delays in program change authorizations from the federal government.

In order to make changes to the Medicaid program in North Carolina – including changes to service delivery and access, such as the number of times patients can see their doctor in a given year – the NC Division of Medical Assistance (DMA) must request approval from the federal Centers for Medicare & Medicaid Services (CMS) which have broad oversight and control over each state program. What isn’t often stated in public debate and discussion about Medicaid is that gaining federal approval of changes within state programs is a slow process by design.

The Medicaid program was not designed to respond rapidly to changes in health care or the economy, or to prioritize cost-effectiveness over quality of care, even though Medicaid has proven to be better at controlling costs than private insurers in recent years. Instead, it was designed to be stable so that individuals who qualify for the program can access the care they need, and so that health care providers who serve them are compensated for their work even when their patients can’t afford to do so themselves.

The mandatory review process for changes to Medicaid is slow for a reason. North Carolina can’t possibly meet its own standards for providing quality care to low-income individuals and children by slashing Medicaid coverage left and right in order to meet arbitrary and unrealistic budget targets. Rapid changes to the program put program participants in the position to lose access to the health care and support they need in order to live productive, dignified lives. It may also have the undesirable effect of prompting health care providers to trim less profitable patients from their practices. This is the reality against which the Medical Care Advisory Committee has found itself uncomfortably positioned.

Check Also

K-12 public education retrospective: back to school edition

As the school year begins, we’ve paused to ...

Top Stories from NCPW

  • News
  • Commentary

When Gov. Roy Cooper visits Wilmington on Monday, it's unlikely that he will be greeted by the [...]

When Gov. Roy Cooper signed the Strengthen Opioid Misuse Prevention or STOP Act into law last month, [...]

Support for needy districts and key positions within North Carolina’s top public school agency may b [...]

Wilmington is bustling this summer. Downtown, horse-drawn carriages take tourists along the riverfro [...]

The post GenX & ’emerging contaminants’ appeared first on NC Policy Watch. [...]

73---number of days since the Senate passed its version of the state budget that spent $22.9 billion [...]

When you lower the bar enough for what’s possible, you create a new normal in which an inch forward [...]

It’s not an original thought to point out that the Trump Administration is a larger version of what [...]

Featured | Special Projects

NC Budget 2017
The maze of the NC Budget is complex. Follow the stories to follow the money.
Read more


NC Redistricting 2017
New map, new districts, new lawmakers. Here’s what you need to know about gerrymandering in NC.
Read more