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MomsRising: Closing the Medicaid gap

Posted February 1, 2012

I admit it. I know my pediatrician’s number by heart. I’m on a first name basis with the nurses and front desk staff. I’ve even been known to drop by goodies at the holidays. To put it simply, I adore my pediatrician and her staff. I know that if my kids are sick or hurting, they will both truly care and get them better. That’s tremendous comfort for a mother.

When sickness strikes, a doctor is a mom’s best friend. But imagine if you couldn’t get your child in to see a doctor or if the closest doctor who would see your child was far away?

Or what if your child faced severe enough medical challenges that they required special care to live at home, and you learned that the care they need may no longer be available?

Thanks to the state's current Medicaid budget shortfall that’s exactly what moms across the state may be facing in the near future unless our legislators act quickly.

As of March 2011, one in five North Carolinians were eligible for Medicaid. And 57.6 percent of those receiving Medicaid benefits in North Carolina were children.

Unfortunately, the state's Medicaid program is facing a budget shortfall of $150 million for this fiscal year and $243 million next year. Unless the General Assembly acts quickly to provide additional funding to fill this gap, we are facing a crisis which threatens access to health care for children on Medicaid.

The alternative is immediate deep cuts in medical services and provider rates, which will have serious negative impacts on children receiving Medicaid benefits as providers will likely choose to no longer accept them as patients. This has real consequences for families, especially in areas where there are few providers already.

How did we get to this point?

In summer 2011, lawmakers passed a $19.7 billion budget that called for cutting $356 million from the state’s Medicaid program. At the time, the Department of Health and Human Services warned repeatedly that this level of cuts was unrealistic. The current $150 million Medicaid shortfall is largely a result of the cuts included in the budget.

State officials have been warning legislators since earlier this fall that making up this gap would require deep cuts in medical services and provider rates. After an October legislative oversight hearing on the issue, House Speaker Thom Tillis told reporters better-than-expected state revenues could be used to help patch the shortfall and instructed Health and Human Services Secretary Lanier Cansler not to pursue more service and rate cuts.

Now legislative leaders have changed their minds and are saying that it’s up to Gov. Perdue to find the funds to make up the shortfall.

But, as a recent article by WRAL points out, it's not clear that the language of the budget allows Gov. Perdue to allocate additional money to Medicaid without action by state lawmakers. Furthermore, any money that Gov. Perdue might find would have to come from needed and existing health care programs.

This is not and should not be a political game. Medicaid is a lifesaver for families facing many different challenges, helping them care for their loved ones without having to give up their jobs and saving them from utter financial ruin due to unexpected medical costs.

Not only is Medicaid a lifeline for families, it’s also a smart public investment. Medicaid helps our state’s children receive the health care they need to prevent small health problems from becoming very serious and expensive problems later.

Whether its wintertime coughs, springtime check-ups, or back-to-school physicals, all of the state's children need access to doctors in their communities.

I hope you’ll consider joining me in asking our state’s legislators to close the Medicaid shortfall and ensure that all our state’s children have the health care they deserve.

Beth Messersmith is a Durham mother of two and NC Campaign Director for MomsRising.org. She writes monthly for Go Ask Mom.

12 Comments

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  • giraffe2112 Feb 2, 2012

    How did it get to this- My husbands emoloyer does not offer insurance and I have already looked into having my daughter put onto mine and it is considered a pre-existing condition and her supplies, her lifeline that is insulin, needles, test strips are very very expensive. Maybe the other people that don't "rely on government welfare" have the means to afford this disease mayb e they don't. I also at one point qualified for other governent aid but did not take it because I did not need it. This we need regardless of what anyone else says or thinks. Some people should take a walk in others shoes before judging

  • howdiditgettothis Feb 2, 2012

    Thinkoutloud - perhaps if the medicaid cuts (and time limits for receiving) many mentioned were put in place to begin with, there would be more money/benefits for those who truly need.

    Public welfare was created as a temporary helping hand, not a lifestyle or a generational entitlement, and certainly not a lifelong medical insurance policy.

    Giraffe2112 mentions her daughter has diabetes and has been on medicaid for FOUR plus years !!! Does she realize that many people who have diabetes do not rely on government welfare for years and years?

    What is preventing her from getting a private insurance policy or medical insurance through her (or husbands') employer??? like the rest of us do..........

    IMHO - medicaid cuts are sorely needed, as well as TIME LIMITS and CAPS on benefits received !!

  • BlueForever Feb 2, 2012

    Just a couple of facts about Medicaid:
    Medicaid covers delivery expenses of a pregnant illegal immigrant who meets the income guidelines. what's the chance? Then the child typically qualifies as it is a US citizen and the household meets the income guidelines.
    Medicaid covers Mental Health services - including substance abuse services - for both children on Medicaid, and also their mothers who typically qualify for Medicaid also. This includes their prescriptions for ADHD, bipolar, depression...need I go on? Anyone in the Mental Health business in North carolina knows there has been a tremendous amount of waste in the mental health system in the past few years since Mental Health "reform" with the community service provider model.
    People who qualify for social security disability insurance - a program completely out of control - get Medicaid.
    So not all Medicaid dollars are to provide physical health needs of children - stop drinking the koolaid.

  • amap30 Feb 2, 2012

    howdiditgettothis, jkparrish, BaseBallMommy, storchheim - ditto and well said!! In my line of work I see the overwhelming abuse of this system. It's time to end it, not perpetuate it. I, too, will absolutely NOT petition the legislators as requested in this "article".

  • giraffe2112 Feb 2, 2012

    "Instead of trying to ensure more people receive Medicaid shouldn't we be finding ways for families or individuals to provide for their own families? Medicaid is there for people when times are tough, not for them to raise the family and continue having children since it is free while the rest of us taxpayers pay for us and them. I think it is about time we cut into Medicaid!!"

    Medicaid was and is a lifesaver for families. My daughter was on medicaid from the time she was born until about 4 years old, then we switched to NC health choice which was also a life saver because at 4 years old she was diagnosed with type 1 diabetes and her monthly supplies and every 3 month doctor visits exceed mine and my husband's income. Now because of a small raise that I got at work, we have been made to pay $200 for this insurance and its been very hard on us financially and we are constantly faced with the fact that she may be cut off and then what would we do?

  • thinkoutloud Feb 2, 2012

    "Howdiditgettothis?" - No one can disagree that there are those who game the system, but Medicaid cuts obviously won't affect just them. It will affect thousands more who indeed do NEED the assistance and are legitimately eligible. This budget shortfall isn't about putting "limits" on Medicaid; it's about taking medical care away from children who need it.
    It's unfathomable to me how stingy so many Americans have become. It's as if the attitude is, "So long as I can take my kids to the doctor at the drop of a hat, who cares about the rest?"
    Oh, and last I heard, these ARE touch times we're in, BaseBallMommy.

  • storchheim Feb 1, 2012

    "shouldn't we be finding ways for families or individuals to provide for their own families?"

    You'd think so, but that's not the mission of Tara Larson, who works two levels under Lanier Cansler (late of DHHS). Her stated mission, verbatim, is: "I want to get more people on Medicaid!" You know, job security...who cares how much we lowly taxpayers have to sacrifice, as long as she's got a job and benefits?

  • storchheim Feb 1, 2012

    Hmmm...let's look at "family of four". Too often it's never-married "mom" and 3 kids. Do you doubt some purposely have enough kids to qualify for Medicaid?

    Do we ask that they limit the size of their brood? No.

    Sorry, I'm not going to petition the legislators to take even more money away from me and hand it to people who won't be helped.

  • BaseBallMommy Feb 1, 2012

    Instead of trying to ensure more people receive Medicaid shouldn't we be finding ways for families or individuals to provide for their own families? Medicaid is there for people when times are tough, not for them to raise the family and continue having children since it is free while the rest of us taxpayers pay for us and them. I think it is about time we cut into Medicaid!!!

  • jkparrish Feb 1, 2012

    I know a few people on medicaid who take their kids to the doctor at the drop of a hat. A little cough, a mid grade fever, or a small cut and they are rushing to the emergency room.

    really? I bet if that was coming out of their own pocket they'd think a bit before rushing off to the hospital at every cry their child peeps and save it for more emergent situations.

    limits on medicaid is right!

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