The suspension of North Carolina’s Medicaid transformation plan is a setback, but was never the solution to the state’s health care troubles, according to the head of the North Carolina Department of Health and Human Services.
Secretary Mandy Cohen spoke to an audience at a symposium Thursday at the North Carolina Biotechnology Center in Durham, North Carolina. She and Gov. Roy Cooper were opening speakers at the Vital Directions for Health and Healthcare: The North Carolina Experience, where health care policymakers and experts are talking about the status of healthcare in the state over the next two days.
“The black eye is we have not expanded Medicaid. It is embarrassing. It is well overdue but it is also so necessary to help all these things we want to be successful,” Cohen said.
The state’s Department of Health and Human Services announced Wednesday that the transformation of Medicaid to managed care from the existing fee-for-service system will not begin as scheduled on Feb. 1, 2020. The halted plan is a result of a four-month standoff between Republican lawmakers and Democrat Cooper.
The governor vetoed the $24 million budget in late June that included hundreds of millions of dollars for the transformation process. With the managed care system, the state will base monthly payments per patient on health plan group rates. The rates and the selection of providers cannot be finalized without a 2019 budget, according to the NCHHS. A mini-bill authored by Republicans to allocate the funds for the transformation was also vetoed by Cooper in August.
Cooper proposed a $2 billion Medicaid expansion in his budget proposal before the General Assembly finalized its spending bill in June. The vetoed legislation did not include the Medicaid expansion plan that would be 90 percent funded by the federal government.
Both Cooper and Cohen said Thursday that the expansion would help address the state’s pressing health care issues including the opioid crisis, mental health care in schools, disparities in infant mortality and coverage for more residents.
“… The thing we could do that will move North Carolina for the most in terms of fighting the opioid crisis and helping hospitals is not managed-care, it is Medicaid expansion. I want to make sure we get our priorities right,” Cohen said.
Republicans argue that the Medicaid transformation would make the existing program “more efficient” and save taxpayers money.
“The reckless decisions to veto Medicaid transformation funding and halt the process appear to be efforts by the governor to divert attention from his administration’s failure to properly prepare for Medicaid transformation by delaying its implementation,” said Rep. Donny Lambeth, R-Forsyth.
Republican Sen. Joyce Krawiec, also from Forsyth, said the decision to stop the transformation also puts thousands of jobs in jeopardy.
“His veto will force insurers to lay off thousands of people they’ve already hired as part of the years-long plan to transform Medicaid,” she said.
Republican lawmakers oppose expanding Medicaid because of the cost.