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@NCCapitol

Berger: Medicaid primary sticking point in budget

Posted June 30, 2014

— With a new fiscal year beginning Tuesday, lawmakers remain far apart in negotiations on a state budget.

Senate President Pro Tem Phil Berger said Monday that Medicaid is the main issue holding up an agreement. Any budget deal must include better control on Medicaid spending, including a reduction in how many people are eligible for the health care assistance, he said.

"We want reductions in the welfare spending that is ongoing at the present time," Berger said.

The spending plan the Senate adopted in late May would cut thousands of elderly and disabled from the Medicaid rolls and would push for a managed care-type system to control future costs.

The House and Gov. Pat McCrory favor a plan that puts physicians and other health care providers in charge of cost control and doesn't change eligibility requirements.

Senators don't believe the forecasts McCrory's staff have assembled on Medicaid costs in the coming year, however, believing that the state needs to set aside $200 million to $300 million more than state Budget Director Art Pope says is needed.

"Those numbers are not accurate," Berger said of the Medicaid projections.

McCrory and House leaders announced a deal last week on a slimmed-down budget that would provide raises for teachers and state workers and let the rest of state government operate on the two-year budget lawmakers passed last year.

No senators were involved in those discussions. The Senate budget would provide larger raises for teachers but would pay for them by cutting more than 7,000 teaching assistants statewide and would make the raises contingent on teachers giving up their tenure rights.

Berger was coy when asked why neither he nor other Senate leaders were invited to take part in those negotiations, but he said he wouldn't have backed the plan McCrory and the House crafted.

"I could not support what they did after I've had a chance to look at it," he said. "The position of the Senate is a very reasonable position. We're hopeful that we'll be able to work out the differences that we have."

Without a deal, McCrory has instructed all state agencies to operate at reduced spending levels.

Berger said he isn't optimistic about a quick resolution.

"Even under the best of circumstances, we're looking at being here through most of July," he said.

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  • rushbot Jul 1, 2014

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    how do you know what you are saying is true, sir or ma'am???filled with indicates nothing else is in the space or system observed...filled means nothing else is in there...i would like to read whatever data you can provide backing up your assertion...

  • nctarheel59 Jul 1, 2014

    I agree with everything said except the IT system part. New system being debugged with retraining at all levels of DHHS. Why not give financial incentives to county DSS agencies to confirm fraud cases since county DSS is the source of NC DHHS data? Then, give the county with the most confirmed cases of fraud per capita an additional financial bonus. Sen. Berger, Rep. Tillis, Gov. McCrory are playing politics with this issue for different reasons for offices in future elections. Rep. Tillis knows this issue will increase minority, older, and poor voter participation in the November election tipping the election to Sen. Hagan keeping the US Senate with a Democratic majority. Why do to Medicaid what has failed with Mental Health which is far less expensive than Medicaid compounding the effect on both programs exponentially? For- profit management of these programs gives managed care entities a financial incentive to deny/delay services. Just ask any psychiatrist, psychologist, etc. !!

  • Eq Videri Jun 30, 2014

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    Sounds great. Since you have all the answers, what office are you running for?

  • miseem Jun 30, 2014

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    I doubt you will find $300 million annually in the state share of Medicaid due to waste, fraud and an inept IT system. Too many people think that any government program automatically has tons of waste because too many people bandy that idea around. The one item where this may be true, military procurement, is the one area politicians and the public don't want to do anything about. You can't eliminate all waste in any activity, public or private, particularly if you don't spend enough on loss prevention. And any time you have a program that serves millions of people, many in nursing homes, having serious permanent disabilities, or in the last few months of their life, you are going to have a very expensive program. However, with the resources given for administration, I doubt if a private concern would do nearly as well.

  • mep Jun 30, 2014

    Medicaid is a very expensive program... and is filled with waste, fraud and an inept IT system. We need to find ways of cutting costs, while still providing care to the folks that really need and deserve it.