House HHS Budget chair Rep. Nelson Dollar, R-Wake, says money to fill a projected $139 million gap in the state's Medicaid program will have to come out of the budget - and it's up to Gov. Bev Perdue to find it.
Dollar took issue with our characterization of his position in this earlier story. He says he does NOT expect Secretary Cansler to find the extra money in HHS. He says Perdue should look elsewhere to bridge the gap.
"The governor is the manager of the budget. The governor needs to find those funds out of one-time monies that are available in other areas of the budget," Dollar said.
Even if the governor were to find the money, however, it's not clear that the language of the HHS budget - written under Dollar's supervision - would allow rescue funds to be found or spent without action by state lawmakers.
Here's the section that dictates how the Medicaid budget can be managed, and what the Secretary can cut to achieve it.
SECTION 10.31.(d) The Department of Health and Human Services (DHHS) shall operate and manage the Medicaid program within the annual State appropriation. DHHS shall establish policies, practices, rates, and expenditure procedures that are in compliance with CMS regulations and approved State Plans, State laws, and regulations.
(1) Mandatory Services. – In order to manage the Medicaid program within the annual State appropriation, the Secretary shall have the authority to submit State Plan amendments and establish temporary rules affecting the amount of service and payment rate for the following mandatory services...
(2) Optional Services. – In order to manage the Medicaid program within the annual State appropriation, the Secretary shall have the authority to submit State Plan amendments and establish temporary rules affecting the amount of service, payment rate, or elimination of the following optional services....
The "annual State appropriation" is the purview of the General Assembly. The governor can manage the budget, but she can't appropriate funds.
Perdue spokeswoman Chris Mackey issued the following response to Dollar's statement today.
"The Republican-controlled legislature is acting just like Congress -- saying one thing and doing another. Children and seniors deserve more than lip service. The Republicans budget slashed Medicaid by $2 billion and now they are trying to evade responsibility for their own budget."
Mackey also says Perdue sent two letters warning budget-writers the Medicaid cuts were unrealistic.