2018 Fiscal Year State Budget, NC Budget and Tax Center

Major differences in NC: Comparing Governor’s and Senate budgets on Health and Human Services

It is clear that the Governor and the Senate have different views when it comes to making health a priority for North Carolinians. Back in March we wrote about the top 5 things you needed to know about the Governor’s recommended budget related to health and human services. This list is presented again below, but this time with the NC Senate budget approach to each of the Governor’s key health related items.

Point #1

Governor Proposal: 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.

Senate Proposal: Does not propose Medicaid expansion for the state. In other words, does not expand Medicaid eligibility to cover 624,000 vulnerable North Carolinians.

Point #2

Governor Proposal: 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.

Senate Proposal: Provides $684 million next year to the Division of Mental Health-Developmental Disabilities-Substance Abuse Services. This is $30.2 million less than what the Governor had recommended ($714 million).

Point #3

Governor Proposal: 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.

Senate Proposal: Matches the Governor’s recommendation.

Point #4

Governor Proposal: 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.

Senate Proposal: Provides only $1 million to the Division of Aging and Adult Services next year. This is $5 million less than what the Governor recommended. The Senate’s additional funding would be for the “Home and Community Care Block Grant.”

Point #5

Governor Proposal: 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.

Senate Proposal: 14 percent of the proposed Senate increase for Public Health would go to Children’s Developmental Services Agencies. Only provides an increase of $4.5 million next year to the Division of Public Health. In other words, falls $2.3 Million short compared to what the Governor proposed for this division. Over the full biennium, the Senate only provides $7.5 million while the Governor had called for $17.7 million.

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