Archives

News

North Carolina’s Health and Human Service Secretary Aldona Wos will be at the state legislature today, rolling out her plan to restructure the $18 billion state agency as well the state Medicaid program that provides healthcare for more than 1.5 million North Carolinians.

DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

Wos, in a 14-page letter addressed to the heads of the Joint Legislative Program Evaluation Oversight Committee, reiterated to lawmakers that she came into her $1-a-year job to find the state’s largest agency in disarray.

“As you know, I inherited a department with a well-documented history of serious and chronic problems,” she wrote. “We have been on a path toward a sustainable department over the last 20 months and we have built the foundation for a stronger Medicaid program.”

She hopes the restructuring of Medicaid program will to fend off proposals in the legislature by Senate Republicans to move Medicaid, the massive $13 billion program that provides health care to low-income children, seniors and disabled residents – to its own standalone agency.

Wos, a wealthy Greensboro physician and prominent Republican fundraiser appointed by Gov. Pat McCrory in January 2013, has had a rocky tenure as the head of the DHHS, with controversies swirling over her granting big salaries and contracts to associates and McCrory campaign workers. Her first year on the job also saw botched rollouts of two technology projects that led to lengthy delays in medical providers getting paid for Medicaid services and in thousands of low-income families accessing food stamps

Read More

Commentary

Health-Reform-SBFinding irony and contradictions in the arguments espoused by Obamacare haters is not a difficult thing to do. Heck, one of the nation’s most powerful opponents of the new law is trying to force its repeal even as he embraces its remarkably positive impact in his home state!

That said, a new issue brief from the Center for Economic and Policy Research points to an especially interesting and problematic finding for opponents who continue to lambaste the law as an “assault on freedom”: the law is actually enhancing freedom. It’s doing this for millions of average Americans in a vitally important way by expanding their choices when it comes to how, when and where they work. Here’s the introduction:

“Most of the discussion of the Affordable Care Act (ACA) has focused on the extent to which it has extended health insurance coverage to the formerly uninsured. This is certainly an important aspect of the law. However by allowing people to buy insurance through the exchanges and extending Medicaid coverage to millions of people,
the ACA also largely ends workers’ dependence on their employer for insurance. This gives tens of millions of people the option to change their job, to work part-time, or take time off to be with young children or family members in need of care, or to retire early. Read More

News

The Charlotte Observer had an article yesterday about the nonprofit public hospital system Carolinas Health Care cutting $110 million from its budget next year, largely in management positions that are currently vacant.

The large hospital system cited the need for cuts as stemming from decisions by both North Carolina and South Carolina politicians to turn down federal Medicaid expansion dollars, as well as other decisions made at the state and federal level related to Medicaid and Medicare. The $4 billion hospital system — which operates 40 hospitals in the Carolinas and Georgia — says it’s been left treating large numbers of poor patients unable to access health insurance or pay their health bills.

North Carolina is one of 21 states to opt out of the Medicaid expansion, which would provide health care for an estimated 400,000 low-income North Carolinians who are currently uninsured. (Click here for updated list of where different states stand on expansion).

From the Observer article:

[Carolinas HealthCare CEO Michael} Tarwater blamed much of the financial stress on cutbacks in state and federal programs. For example, he said North Carolina legislators have for a second year declined to accept federal funds to expand Medicaid. That contributed to the system’s unreimbursed charges, which rose to $668 million in the first half of this year, an increase of 9.4 percent over last year.

“We’re not treating this as a crisis … but it is a challenge,” Tarwater said. “I can assure you we have a solid plan, and we have the team in place to carry it out. I’m certain that we’ll emerge stronger and more competitive.”

 

You can read the entire article here.

News

The head of North Carolina’s troubled health and human services department told lawmakers Tuesday that moving the Medicaid program out from under her purview to a stand-alone agency would “be against common sense.”

“Absolutely not,” said N.C. Health and Human Services Secretary Aldona Wos in a response to a question about whether moving the $13 billion Medicaid outside of her domain would make things easier on the agency.

“To separate parts of [DHHS functions] out to the department will actually go backwards,” she said.

DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

Wos made her comments Tuesday at a legislative oversight committee hearing. It also comes as lawmakers consider whether to embark next year on an ambitious plan by Senate Republicans to move the state’s Medicaid program to a standalone agency reporting jointly to the governor and state lawmakers.

A special program evaluation committee recently formed to consider different scenarios for Medicaid, an entitlement program that provides health care for the poor seniors, children and disabled residents, is funded through a mix of federal and state dollars.

Lawmakers have for years voiced frustration with faulty budget forecasts and unexpected cost overruns within the Medicaid program. Several Republican politicians — including legislative leaders and Gov. Pat McCrory — have held up the forecasting roblems as reason why North Carolina should not expand its Medicaid program, a move that would tap federal money to provide healthcare for an estimated 400,000 North Carolinians unable to afford their own insurance.

Wos, a Greensboro physician and wealthy Republican fundraiser appointed by McCrory to lead the state’s largest agency in January 2013, had plenty of other tough topics to cover with Tuesday’s legislative oversight committee. The tense reception has become a routine scenario for Wos as she’s grappled with negative coverage over high-dollar personal contracts and raises for close associates, as well as major disruptions in the state’s Medicaid billing and food stamp dispersal systems.

On Tuesday, Wos and her staff faced questions about a $6.8 million no-bid contract given to a consulting firm Alvarez & Marshal to advise and manage the Medicaid program.

Wos told lawmakers that she needed to hire the firm because she didn’t have any staff able to manage the program properly as she and other agency staff were developing a comprehensive Medicaid reform plan.

“We had an emergency,” Wos said. “We had to figure out how to get our daily work done.”

State law requires most contracts to go through a bidding process, in order to keep costs down and to allow for competition in lucrative contracts. Wos credited the consulting firm’s work with allowing the Medicaid program to meet its budget this year, and return $63 million to the state’s general fund.

Read More

Commentary
Cover me

Image: NC AIDS Action Network – www.ncaan.org

A new report from the Pew Charitable Trusts makes clearer than ever just how mean-spirited and morally bankrupt the decision of state lawmakers and Governor McCrory to turn down federally-funded Medicaid coverage for hundreds of thousands of  low-income North Carolinians is turning out to be. The report, “Southern States Are Now Epicenter of HIV/AIDS in the U.S.” tells the story of a woman from New York named Deadra Malloy who had successfully managed her HIV infection for decades while living in New York where public subsidies made medication affordable. When she moved to North Carolina and then South Carolina, however, all that changed. Soon she was skimping on necessary drugs and quickly wound up in the hospital with pneumonia.

As the story notes, the woman’s case is sadly typical:  Read More