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If you’re trying to get up to speed on this week’s colorful and cantankerous state budget negotiations, here are three quick takeaways:

Budget conferees are expected to meet again today, though an exact time has not been announced. The NC House goes into session at 11:00 a.m., the Senate at 2:00 p.m.

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Medicaid 3As state lawmakers and Gov. McCrory argue about ways to cut public outlays for Medicaid — the public health insurance system for people of low income — the lead editorials in North Carolina’s two largest newspapers offer some straightforward and compelling truths this morning that ought to guide their discussions:

1) Service cuts harm real people in need and 2)  Things ain’t gonna’ improve as long as Dr. Aldona Wos runs the show.

As Raleigh’s News & Observer reminds us, when legislators cut services to save money (even though, as the editorial notes, per person costs are down and quality of service is up) they make life hell for people like Mason Leonard and his mom Colleen:

“Mason Leonard, 14, of Cary is severely disabled. He was brain-damaged at birth and cannot care for himself. He can’t be left alone, can’t feed himself or look after any of his needs.

But thanks to a few Medicaid services, he receives therapy, gets out a little, gets trained in things like making his bed, which, when he accomplishes it, is considered a big step….

A Medicaid policy change last year, for example, eliminated weekend hours for teaching Mason how to function with basic skills. His mother understandably fears what new hardships further “reform” will produce.

Here is what the public needs to understand about the budget cutting and reform conducted under the banner of ‘efficiency.’ For each cut, for each decision to eliminate some benefit, a disabled person such as Mason Leonard or a poor person with no alternative for care except what Medicaid provides and their caregivers and family members suffer discomfort or pain.”

And then there’s this bit of plain truth from the Charlotte Observer: state Health and Human Services Secretary Aldona Wos simply has to go. As the Observer notes: Read More

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nci-vol-2174-300The White House Council of Economic Advisers released a report today detailing the health and economic consequences of refusing to accept federal Medicaid money to expand insurance coverage in North Carolina.

If the state accepted federal funds we could provide insurance coverage to 377,000 more people. This influx of federal money would also create jobs and boost our economy. And reducing our uninsured rate would have salutary impacts on the lives of those able to obtain affordable health care.

For example: 27,000 women would gain access to to recommended health screenings; 90,000 people would gain access to a medical home; 50,000 more people would report that they are in good health. The individual financial impacts are no less dramatic. Closing the coverage gap here would mean 17,000 fewer families facing catastrophic medical bills and 53,600 fewer people borrowing money to finance their health needs.

Some claim that North Carolina can’t afford to extend health coverage to more people. When you look at the numbers it’s clear that we can’t afford not to expand coverage. In 2014 the state is giving up $2.7 billion in federal funds. In 2015 that increases to $3.2 billion. In 2016 it’s $3.6 billion. In 2014 we could create 8,700 jobs. In 2015 we could create 19,400 jobs. If a private company or a new military base opened in North Carolina that created 19,000 jobs, politicians would be elbowing each other to get to the ribbon cutting.

The Council of Economic Advisers calls the decision to refuse new Medicaid funds a “missed opportunity.” That’s an understatement; it’s more like a terrible shame.

 

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In case you missed it, be sure to check out today’s edition of the Fitzsimon File in which Chris explains what’s really at issue in the stalemated state budget negotiations. Most notable on the list: the remarkably regressive positions of Senate President Pro Tem Phil Berger.

“Senate President Pro Tem Phil Berger told WRAL-TV that any budget deal must not only include the Senate’s estimates of Medicaid costs but must also reduce the number of people who are covered by the program.

Berger said the Senate wanted ‘reductions in the welfare spending that is ongoing at the present time.’  Medicaid, the health care safety net for the most vulnerable people in North Carolina, is now welfare in Berger’s far-right view of the world.

The budget the Senate passed earlier this session would kick at least 5,200 aged, blind and disabled people off of Medicaid. More than 1,600 of them have Alzheimer’s or dementia and are in special care units, which to Berger must be a new fancy way of saying welfare.”

As Chris also notes, there is an easy way out of the mess: Read More

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The N.C. Department of Health and Human Services released a cheerful video this afternoon touting the supposed successes of the state’s new Medicaid billing system that delayed payments for thousands of medical providers for months over the last year.

The nearly 4-minute video produced by state employees includes interviews set to upbeat instrumental music with several providers and DHHS officials talking about how well the complicated Medicaid billing system is working one year after its bungled July 1, 2013 launch.

Much of the system is working now, and providers are getting paid faster than before, DHHS officials say in the video.

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 N.C Tracks replaced the state’s previous 25-year-old Medicaid system and came online despite warnings in a May 2013 performance audit from the state auditor’s office that DHHS hadn’t fully tested the system, left too much up to vendors’ discretion and had no way of knowing ahead of time if the system was ready.

The billing problems have left legislative fiscal research staff without firm budget numbers on the $13 billion program, a major point of contention in the current budget negotiations for Republican state Senate leaders.

Missing from DHHS’ birthday video were some of the choicer statements doctors, lawmakers and others have had about new system and its rollout last year under N.C. DHHS Secretary Aldona Wos.

Here’s a few of the less-than-glowing comments:

  • “NCTracks has made billing go from complex to borderline impossible,” said Sandra Williams, chief financial officer of Cape Fear Valley Health System, at an October legislative hearing.
  • “NCTracks was a disaster, and the State was beyond the point of no return,” lawyers wrote in a lawsuit filed by medical providers in January against the state agency.
  • “We are pretty much in the dark with trying to figure out where we are in the current year,” said Susan Jacobs, a fiscal analyst for the legislature in January about getting budget data from N.C. Tracks.
  • “It’s June 19 and we still don’t have the numbers,” Sen. Tom Apodoca, a Hendersonville Republican, said in a hearing earlier this month about Medicaid budget information, according to the News & Observer. “If push comes to shove, we can always issue subpoenas.”
  • “We are having to manually key claims and do things that before would pay automatically,” Laura Williard of High Point’s Advanced Home Care told WNCN in early June. “At one point, I had 11 temps working for our company to do something that was paid automatically before.”