2018 Fiscal Year State Budget, NC Budget and Tax Center

Governor’s budget reflects high priority for the health of North Carolinians

 

Gov. Cooper presented a series of bold health initiatives in the budget proposal he released on Wednesday. In addition to Medicaid Expansion, it also would particularly improve access to care for North Carolinians with disabilities and mental health and substance abuse issues. The Governor proposed increasing the Health and Human Services budget overall by 6.5 percent, or $327 million, demonstrating that it is a top priority of the new Administration to protect the most vulnerable and help North Carolinians live healthy, productive lives.

Here are five key points from the Governor’s proposed budget related to health:

  1. Medicaid expansion is proposed and would cover over half a million additional individuals in need at minimal cost to the state’s general fund. According to the Governor’s proposed budget, expanding Medicaid eligibility would “cover 624,000 additional individuals and secure our share of federal resources that will inject over $4.4 billion in direct spending into our state. This expansion will create jobs, bolster our hospitals, save some rural hospitals from closing and stabilize private insurance markets.” By placing the state in a position to secure additional federal funding for Medicaid under existing laws to help North Carolina’s vulnerable populations, the Governor shows a continued commitment to join over 30 other states that have already done so. It should be noted that the Governor’s proposal does call for an additional $115 million over the next two years to cover changes to enrollment, utilization, costs, rates, and services associated with the Medicaid program.

  1. Mental Health funding sees the largest increase. The Governor’s proposal in this area represents a 26.9 percent — or $151.6 million — increase over the current 2017 fiscal year budget. The Governor’s emphasis on this topic aligns with the high priority that members of the General Assembly’s joint Health and Human Services Appropriations committee have recently given to Mental Health. DHHS strives to provide quality support to achieve self-determination for individuals with intellectual and/or developmental disabilities, as well as quality services to promote treatment and recovery for individuals with mental illness and substance use disorders.
  1. Funding of NC Health Choice, the Children’s Health Insurance Program, would undergo major restructuring. According to the Governor’s budget, “federal matching funds are increasing compared to the base budget and will decrease the need for state appropriations.” As a result, the need for state funding would be reduced by $43 million through the upcoming biennium. NC Health Choice for Children is the program that provides funding to extend health care coverage to approximately 87,000 children ages 6 through 18 each month whose family income exceeds Medicaid financial eligibility criteria but is at or below 200% of the federal poverty level.
  1. Older adults and people with disabilities will benefit from investments that support independent and community living options. The Governor’s proposal would provide an increase of 13.6 percent – or $6 million – to the Division of Aging and Adult Services. Of the $6 million, $4 million would provide in-home aides, transportation and meals to older, low-income residents in all 100 counties. The remaining $2 million would assist low-income households headed by adults with disabilities to access affordable rental housing. Additional funding for the Transition to Community Living Initiative will increase the number of individuals transitioning into housing, accessing supported employment and receiving Assertive Community Treatment.
  1. Almost 40 percent of the proposed increase for Public Health would go to Children’s Developmental Services Agencies (CDSA). The Governor’s proposal would increase the Division of Public Health’s budget by $6.8 million. Of this amount, $2.5 million would go to the 16 regional CDSAs to assist in funding clinical personnel and service coordinators that are needed to comply with federal mandates in order to serve children who have development disabilities between the ages of 0 to 3.

For more news and analysis during the budget debate, follow the Budget & Tax Center on Twitter @ncbudgetandtax.

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