New proposal could impact Medicaid patients

The State of North Carolina is overhauling its Medicaid program and state health officials are now estimating it will come in up to $300 million under budget.

The state is moving its fee-for-service to a pre-paid health plan.

The Department of Health and Human Services officials unveiled their plan for the program Tuesday at a Joint Legislative Oversight Committee meeting.

Many details still must be finalized, including solvency standards for the prepaid health plans to ensure they can cover patient expenses.

One mom is fearful this change will create tremendous difficulties.

"I don't want to lose my doctor," Mary Short said.

Short's daughter, Katie, has a rare neurological disorder and sees several doctors in several different cities in the state. That could be changing within the next few years.

"It's hard enough to find a neurologist that will accept Medicaid," Short said. "The idea that they're going to create these regions that are going to separate her from her neurologist is beyond scary to me."

The state would be chopped up into six regions under the proposal. The state would contract with local doctors or hospitals in an effort to contain costs, and Medicaid recipients would have to stay in their region.

Health officials said the plan is similar to Alabama's program.

"What we're putting forth is an innovative plan that builds on the strengths of what we have going on in North Carolina and gives us the flexibility that we need to take care to the next level," said DHHS Secretary Rick Brajer.

Nearly 2 million North Carolinians rely on Medicaid. One in five people are enrolled.

Some lawmakers are concerned the proposal will hurt folks living in rural communities.

"The elephant in the room is the failure of the state to even be willing to look at expanding Medicaid to close the insurance gap because all of these areas, the rural and lower wealth areas, leave a high number of people who are in the gap and are not covered," said Sen. Angela Bryant.

The proposal does require legislative approval.

Short is worried her daughter might regress if these regions are approved and Katie is forced to go to someone new.

"She been stable. For this disorder, she's been stable. So I'm one of the lucky ones," Short said.

DHHS has to submit the state's waiver application to the federal government by June 1.

The agency with meet with lawmakers again April 12 for another Joint Legislative Oversight Committee meeting.

DHHS does plan to hold a series of public hearings on the proposed changes. There will be 12 meeting. DHHS is still working out the schedule. Health officials say the first will likely be held in Raleigh at the end of the month.