Medicaid shortfall grows with no fix in sight

Posted January 3, 2012

N.C. Department of Health and Human Services

— The funding shortfall in North Carolina's Medicaid program has ballooned to $150 million, and the political fight over how to fill the growing budget hole shows no signs of a solution.

Health and Human Services Secretary Lanier Cansler says the Medicaid program, which serves more than 1 million people statewide, won't be able to achieve more than $350 million in cuts mandated by the state budget under its current operations.

Cansler says the budget offers him only one option to accomplish the required savings: deep cuts to optional services and to the reimbursement rates the state pays Medicaid providers.

DHHS Secretary Lanier Cansler Politicians haggle as Medicaid deficit grows

The federal government has approved fewer than half of the 54 rate cuts DHHS has proposed, he told lawmakers on Tuesday, which cuts into the projected savings they counted on in the budget.

"If we don't find a way to solve the problem come May, it's going to be extremely serious because, again, we can't write Medicaid checks if we don't have the money," he said.

Increased demand for services and overpayments DHHS made to providers aggravated the shortfall, which officials said could grow to $243 million by the 2012-13 fiscal year, which starts in July.

A standoff continues between Gov. Beverly Perdue's administration and Republican legislative leaders over who's responsible for erasing the shortfall.

"It's still on the governor. Once we pass a budget, it's her job to execute, and it's her job to make changes," said Rep. Justin Burr, R-Stanly.

Cansler countered that Perdue doesn't have emergency budget authority.

"She can't move that money around the way that she's done to help deal with issues like this in the past couple of years, and that's why the legislature has to be a part of the solution," he said.

Providers and advocates for groups served by Medicaid said they just want a solution to the impending crisis.

"This has turned into a big political debate. This is about who is at fault for this Medicaid shortfall. In the end, that's not the important thing. The important thing is the people who need the services," said Rob Thompson, executive director of Covenant with North Carolina's Children.


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  • Gettin Real Jan 5, 2012

    "illegals are really breaking our banks."

    In many ways, but not in the way that's being depicted here by folks that don't know the ins and outs of government run services. Also, remember I'm an right leaning independant. So, I've no lefty agenda here. Stating facts.

    "They pay no income taxes yet are still eligible for benefits."

    Some DO pay income taxes; a few do. NOT SURE, how that works but we see stubs with taxes taken out and WE KNOW these people have no status in the U.S. And NO, they are NOT eligible for ANY benefits such as Medicaid and Food Stamps. Their citizen wives, or husbands, or children MAY BE, but the ILLEGALS are NOT. Again, I WORK in the industry. So, you are speaking from what you've heard or read or THOUGHT you saw. I'm stating what I KNOW and IS.

  • Gettin Real Jan 5, 2012

    "As far as your comment about illegals defrauding in order to get health care coverage that is incorrect."

    NO, it's NOT.

    "If the provider can prove they are an illegal alien the state (taxpayers) pick up the tab."

    NO, they do not. ANd providers have NO WAY to legally verifiy status of ANY person.

    "It's not fraud, it's the state laws."

    NO, it's NOT.

    "As far as citizens committing fraud and putting more of a strain on the system I would agree somewhat"

    No, you agree ALL the way seeing as that IS the way it is.

  • fayncmike Jan 5, 2012

    "fayncmike.....did you read the title of this article??? Don't you see a problem with continuing to provide an entitlement that's bankrupting the state, and country? And your only solution, take more from the rich...right???

    I never said the system was without faults, did I? Instead of raving about shutting it down fix the problems. Is that too difficult concept to understand?

  • beaupeep Jan 4, 2012

    Well, i haven't SEEN the man's toes (nor has he, anytime recently), but I doubt they're anything special.

    I'm guessing it's 99% unnecessary.

  • whattheheck Jan 4, 2012

    Gettin real. Illegal aliens don't have to fraud the system when it comes to Medicare. All they have to do is get paid cash, have a kid and they are set forever. As far as your comment about illegals defrauding in order to get health care coverage that is incorrect. They don't have to defraud anyone. If the provider can prove they are an illegal alien the state (taxpayers) pick up the tab. It's not fraud, it's the state laws. As far as citizens committing fraud and putting more of a strain on the system I would agree somewhat but illegals are really breaking our banks. They pay no income taxes yet are still eligible for benefits. The numbers are astounding, so much that people wouldn't believe it without seeing it.

    I do want to say, I appreciate your insight and thoughtfulness in this discussion.

  • davidk_at_unc Jan 4, 2012

    "You should see the names of the recipients. I can't pronounce over half of them. Tell ya anything?" -- cjennings1160

    Yes, you need to improve your reading skills!

  • maybelle Jan 4, 2012

    What is needed is more Fraud Investigation on clients. Who lives in the home, who is self employeed, is the childs father in the home?
    If income taxes are not paid and filed why are clients entitled to receive Medicaid?
    My list could go on and on.
    Food stamps.If you are illegal and you have an esposo in the home why is he not counted? Just because his last name is not the same as the wifes it can't be traced.
    I still could go on and on.
    Why is child support not inforced better and dead beats allowed to get so far behind in payments.

  • Mark Hayes Jan 4, 2012

    beaupeep,Had me going on that one but still there has to be more to it than just a pedicure even for medicare to pay.

  • LuvLivingInCary Jan 4, 2012

    they passed the budget now figure a way to live within the bounds of it.

  • beaupeep Jan 4, 2012

    serious as a heartattack.

    entitlement is like a cancer, ain't it?