Rules kicking thousands of North Carolinians off Medicaid, forcing them into a tough decision

Samantha Kummerer Image
BySamantha Kummerer WTVD logo
Tuesday, September 5, 2023
New rules kicking thousands of North Carolinians off Medicaid
Meet the Strongs: Two of 60,000 North Carolinians who have been terminated from Medicaid already this year.

RALEIGH, N.C. (WTVD) -- The letter the Strong family received earlier this summer sent them scrambling.

"That's the scary part of it. It scared me when we got the letter, and it's scaring me now," Annette Strong said.

That letter was from the Franklin County Department of Social Services, alerting the Strongs that they would no longer be eligible for Medicaid at the end of August. Annette Strong and her husband Jeffery both have medical conditions that require daily attention and keep them from working.

For the last few years, the couple has paid for this care with Medicaid. However, a change to their income means they're now making just enough to not be eligible for Medicaid without meeting a $15,000 deductible every six months.

"I mean you want $31,500 a year?" Annette Strong said. "That's money we don't make."

She said they struggle to get by as it is and will be forced to pay the deductibles or go into debt. The loss of Medicaid coverage also means the couple will lose their in-home care and Annette Strong fears she will be forced to put her 48-year-old husband in a nursing home.

The Strongs are one case of an estimated 60,000 North Carolinians who have been terminated from Medicaid already this year.

"This is probably the most unprecedented time and Medicaid in North Carolina that we have ever seen," said Rebekah Garcia, an attorney with Legal Aid of North Carolina who handles Medicaid cases.

For the last three years, people who became ineligible for Medicaid were not able to be terminated because of the Federal Public Health Emergency that began in January 2020. That provision ended this past spring and took many by surprise.

"We have seen a significant increase of individuals saying that they've gotten termination notices, or that they have found out that they no longer have coverage after going to the doctor and being told that their Medicaid is no longer current," Garcia said.

She said income and family size changes are some of the main reasons people became ineligible.

NCDHHS data shows that 87% of the North Carolinians who have been terminated stemmed from procedural reasons, not because they were no longer eligible.

Earlier this year, North Carolina lawmakers voted to expand Medicaid. Garcia said this will help some of the people who have lost eligibility recently.

"It certainly will help a number of individuals who have been terminated because they are no longer eligible," Garcia said.

The expansion within the state was scheduled to begin in October but has been pushed to an undetermined later date as state lawmakers continue to fail to pass a final budget.

"It's a shame that the General Assembly cannot get together, get a budget and expand Medicaid along with so many other things that are in there that would help me in my and my husband's circumstance," Annette Strong said. She said she's not sure if the expansion in the state will directly help her family's situation but is hopeful.

Garcia recommended that people reach out to their local DSS office if they think they might fall into this category.

However, Garcia explained for those like the Strongs who no longer meet the eligibility requirements there is not much that can be done.

This leaves families forced into medical debt.

"So certainly an issue that medical providers are going to be seeing and certainly a big impact on individuals in North Carolina," Garcia said.

Garcia recommends people currently on Medicaid stay up-to-date on any mail and notices they may receive. If families do receive notification of eligibility changes or termination, Garcia suggests that they reach out to the North Carolina Medicaid Ombudsman, Affordable Care Act navigators, or Legal Aid.

The Strongs were able to get their coverage extended for one month. Annette Strong still doesn't know what they will do at the end of September but has started raising money for a wheel-chair assessable van in case they have to resort to providing their own transportation to dialysis appointments.