NCDHHS officials address Joint Legislative Oversight Committee on Medicaid to request funding
RALEIGH, N.C. (WTVD) -- On Tuesday, leaders with the North Carolina Department of Health and Human Services (NCDHHS) addressed the Joint Legislative Oversight Committee on Medicaid to request $319 million in funding toward Medicaid Rebase, voicing concerns about the program's finances.
"We have a base budget in Medicaid, and the rebase is really the adjustments to the prior year base budget that account for enrollment utilization and medical inflation," explained Melanie Bush, Interim Deputy Secretary of NC Medicaid.
The $319 million figure was cited Monday by Gov. Josh Stein, who requested that amount as part of what he's referring to as his "critical needs" budget.
"In years past, we had more federal dollars coming in. We were able to manage the shortfall in funding that we've had appropriated to the North Carolina Medicaid program. But because it's such a thin margin this year that we have to include every single thing in the kitchen sink into our rebase to make sure that we are able to pay our bills," said Bush, when answering a question from Sen. Ralph Hise about recurring and nonrecurring funds.
"You saw $200 million of non-recurring cost built into the rebase figure. And I thought Sen. Hise asked a really good question because this isn't just a one-time recurring figure. This gets built upon year after year after year," said Sen.Benton Sawrey, a Republican Senator from Johnston County who serves as a Co-Chair of the Committee.
According to NCDHHS, one in four North Carolinians is enrolled in Medicaid, including two in five children. It's a group that includes 11-year-old Finley Thomas.
"She wants to do all the things that the normal 11-year-old wants to do," said her father, Dennis Thomas.
Shortly after her birth, she spent five months in neonatal intensive care, ultimately requiring a tracheostomy to help her breathe and allow her to come home.
"We basically have an intensive care unit in our house. We have 24/7 nursing coverage because somebody essentially has to watch her every minute of the day. That includes day and night, and none of that is covered by insurance. Medicaid picks up all of that. And as you can imagine, that's very expensive," said Thomas.
Both Dennis and his wife, Jennifer, work, and they have separate private health insurance. Still, Medicaid has been invaluable in providing services for Finley.
"We never thought we would have needed Medicaid. It's not something we ever dreamed that we would need that type of support. But then, when you look at the cost associated with some of these things, it's not just the medical care. It's physical therapy, it's occupational therapy, speech therapy, it's feeding therapy," said Thomas.
At this point, they have not had any negative effects on their care, but are concerned that could change if funding for the program does run out, which NCDHHS anticipates will happen by the end of the fiscal year (June 30) without further support.
"If we had to leave her current providers, it would be a nightmare because her medical history is so intense and it's massive for a provider to be able to read through her chart and adequately care for her," said Jennifer Thomas.
For Melinda Plue, the reality of addressing a change in providers is now occurring, affecting her brother-in-law, Jake.
"He has a provider who no longer is willing to accept Medicaid because it's become too complicated, and it's the only provider that can manage Jake's very specific ear and hearing loss situation," said Plue.
Plue serves as the legal guardian for Jake, who is 44 years old and has cognitive impairment, co-occurring mental health diagnoses, and physical limitations.
"He lives independently. He has support in the community. He has a job. He has providers that can see him. All of those things are funded by Medicaid and have been a lifeline for my family," said Plue.
Plue serves as the Director of Advocacy and Chapter Development with The Arc of North Carolina, a nonprofit that advocates on behalf of people with intellectual and developmental disabilities.
"I'm worried for Jake and all of the other Jakes of my community," said Plue.
Lawmakers are due back next month for the start of the short session.
"Look at the past 16 years. Have we ever had a gap or a lapse then? I think it's one thing (that) I can say it, but you can also look at our track (record). We have a track record of fiscal responsibility, managing state government well, and making sure that services are being delivered. And there's no reason to expect Republicans are going to do anything other than that with this current budget and Medicaid," said Sawrey.
