Budget shortfall could mean catastrophic Medicaid cuts after all

Posted December 5, 2011
Updated December 6, 2011

N.C. Department of Health and Human Services

— North Carolina Department of Health and Human Services officials said Monday that state lawmakers have changed their tune about finding funds to fill a projected $139 million Medicaid budget shortfall, forcing them to consider making catastrophic cuts to the program.

Unless lawmakers find more money for Medicaid, many adult services, like hospice care and mental health care, could be on the chopping block. The state could also reduce reimbursements to physicians who treat Medicaid patients by up to 20 percent, DHHS officials have said.

They say lawmakers publicly pledged to help fill the shortfall in October after it became clear that the agency couldn't make the $356 million in cuts required in the state budget.

"We are not going to cut services, and we are not going to cut rates to make up for one-time liabilities," said state Rep. Nelson Dollar, R-Wake, in October.

Speaker Thom Tillis also said at the time that lawmakers were looking at a $150 million surplus to plug the funding hole.

"That (money) could be appropriated for those areas where we're coming up short without necessarily having to go back and cut any reimbursement rates or programs," he said.

Medicaid cuts, Stevie Goodwin Medicaid budget hole could hurt state's 'most vulnerable'

Legislative leaders have since privately indicated to DHHS officials that the money isn't coming, according to correspondence between legislative leaders and Health and Human Services Secretary Lanier Cansler obtained by WRAL News.

That leaves officials with two options – "large-scale rate cuts or the elimination of some optional services," DHHS Deputy Secretary Michael Watson said.

"That kind of wrong-headed extreme view that has prevailed is going to hurt North Carolina citizens and North Carolina care providers," said Al Delia, senior advisor to Gov. Bev Perdue. "That only body that can fix that is the legislature."

A spokesman for House Speaker Thom Tillis said comments made in October about the state using budget surplus or rainy day funds to bridge the Medicaid gap were "best case scenario" options. The General Assembly never committed to find funds for Medicaid, he said.

More than 1.5 million North Carolina residents – mostly poor children, older adults and the disabled – receive Medicaid coverage. Stevie Goodwin, 55, is one of them. When he was 19, he was paralyzed from the chest down in a car accident. 

"I'm mentally sound. I'm just physically unable to do the things I need to go for myself," Goodwin said.

With the state's help, he is able to live independently in his own home, but some state leaders say in-home care is one of several state services on the chopping block.

"I would be institutionalized. There's no way I could live without the help I'm receiving," Goodwin said. "It kills me to think of that, physically and spiritually."

Delia said the state should not turn its back on patients like Goodwin.

"Let's be clear," he said. "These are the most vulnerable people in our state."


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  • cmeyrowitz Dec 8, 2011

    Florida's Medicaid Reform Pilot has been a decided success, improving the health of enrolled patients, achieving high patient satisfaction and keeping cost increases below average. Since then, Florida has passed its Statewide Reform, which promises to extend these benefits throughout the state. If Florida's Medicaid Reform Pilot experience were replicated nationwide, the outcomes in almost every facet of the program would be significantly improved and would offer participants meaningful reforms to a system that has been falling into decay, says Tarren Bragdon, of the Heritage Foundation. The pilot program, which was isolated to five counties in Florida, saved an estimated $118 million per year, with an aggregate estimated annual savings of $901 million when the reform is put in place statewide. Researchers suggest that if a similar program were to be put in place nationwide, it would save $28.6 billion annually. The pilot program's results can be fairly projected on the nation as a w

  • noel Dec 7, 2011

    get your facts straight folks. gphotohound2 says "My question is why is it that medicaid people get everything paid for while the ones on medicare are refused items like earring aids ,glasses and dental work .I pay for medicare and they pay for nothing." Medicaid is for people who are supposed to have very limited funds AND hearing aids, glasses and many of the dental services are only available to Medicaid patients who are UNDER 21. So I will assume that if you have Medicare you're most likely older than 21 and wouldn't get glasses under Medicaid to start with. What you MIGHT eventually qualify for when you run out of funds is long term care. If you would check on the amount of money Medicaid pays for this particular program you would see that that's a very large portion of the budget. There are area of abuse, but sniping about someone getting something that you don't doesn't help solve the problem. If you want to make suggestions for improvement you really need to know the fac

  • raleighlynn Dec 7, 2011

    As always, our government is balancing their budget on the poorest of the poor. Back in '05 I volunteered as a Hurricane Katrina RN. We had over 700 volunteers in our camp. Meanwhile, FEMA had the fairgrounds across the street outfitted with fancy Winnebagos. They never even showed until week 2. I rest my case.

  • seven74215 Dec 7, 2011

    To many people are getting free handouts from the government that don't need it or their families could give them a hand up and the need be filled as opposed to using Hospic or several other state funded entities. I'm not saying this is the case in every situation because sometimes you have no other choice but to turn for outside help.

    Head over to your local social services and spend just an hour and you will see the bulk of why or state is short funds. Today's generation is about useless and doesn't want to work to get anything, they want it given to them.

    In my day if you didn't work you didn't eat and if you owed a man money you better pay up or you knew what was coming. Then again my generation took pride in working, doing the best we could on the job at hand, and paying our on way. Not so true anymore.

    To change the economy you first have to change the mindset of the American people where working is concerned. That happens in the way you are brought up.

  • gphotohound2 Dec 6, 2011

    My question is why is it that medicaid people get everything paid for while the ones on medicare are refused items like earring aids ,glasses and dental work .I pay for medicare and they pay for nothing.

  • Gidder Dun Dec 6, 2011

    godnessgracious2-People are going to die if we don't tax the rich. I'm not going to sit here and let that happen.

    Now I see your logic in thinking. You are hopeless in your arguments. To equate people are going to die if we do not tax the rich. People have been dying even before Jesus walked this Earth. People will still die come tomorrow at this same time. Help all you want but even you can not stop death. Tell me the last time you saw a billonare not helping the poor? Better yet when was the last time you actually met one in person that stated they do not want to help the poor. Also to say they are not helping the poor is the biggest lie you ever told. Look at Bill & Melinda Gates, Oprah, Warren Bufffet, and many more like them. They each do more for the poor than you do here spewing your typical class warfare rhetoric.

  • mistervegas Dec 6, 2011

    Let's hear it for the republican near sighted budget.

  • godnessgracious2 Dec 6, 2011

    godnessgracious2 - The top 25% pay 87% of the federal income taxes. Maybe they should target the bottom 50% who only pay 2.25% of total federal income tax paid.

    Federal income taxes are only 1/5 of all taxes collected at all levels of American Government. Come back when you can tell me the entire story.

  • godnessgracious2 Dec 6, 2011

    yet you still hold your hand out for more when we have less to give.

    I am not asking for anything. I don't need any assitance. I am reading articles that are saying people need help, and I am seeing billionaires that could be helping them. Why do you insist that anybody that wants to tax billionaires to help the needy must be themselves in need? People are going to die if we don't tax the rich. I'm not going to sit here and let that happen.

  • godnessgracious2 Dec 6, 2011

    Also we are TAXED to death

    Taxes are the lowest in history. Get. A. Grip.