State Medicaid cuts won't be easy, DHHS chief says

Posted August 4, 2011

— One month into the new fiscal year, the North Carolina Department of Health and Human Services is still unsure what deep cuts will be like for Medicaid programs and services for adults.

This year's legislative mandate is to cut approximately $356 million in state Medicaid funding, and for the first time, lawmakers have added a provision to the budget that essentially directs state agencies to make any changes to their spending plans that are necessary to operate within their budget.

Health and Human Services Secretary Lanier Cansler said Thursday that the federal government requires a 60-day public notice of proposed changes to Medicaid service or programs. Then, the federal government has 90 days to approve the changes or question them. If it has questions, there is another 90-day period.

That could potentially mean that any changes to the DHHS Medicaid budget wouldn't be in place before April.

"The concern is that we're not going to be able to get the changes the legislature approved made quickly enough to achieve the savings that the legislature has put in the budget," Cansler said. "Therefore, we're going to have to make additional reductions to achieve the budget as required by the legislature."

Lanier Cansler NC's Medicaid cuts still uncertain

If it's April, for example, before the cuts are federally approved, the reductions would then come from the last quarter of the fiscal year, which means a much larger reduction in patient services than if the cuts were spread over the entire fiscal year.

"It's just really going to be next to impossible to achieve this budget, and I'm not sure where the legislature will go with that," Cansler said. "The fact that this budget plays into next year (means next year) is going to be a difficult budget year as well."

That's why Cansler says he wants the process to be open. He is going outside the department to seek public input and has expanded the North Carolina Medical Care Advisory Committee to assist in the effort.

By federal law, the Medical Care Advisory Committee advises DHHS and the state's Medicaid agency, the Division of Medical Assistance, on policies regarding the quality of care and access to care for Medicaid recipients.

The committee is holding its first public forum from 9 a.m. to noon on Friday at the McKimmon Center on the North Carolina State University campus.

"I decided to use the Medical Care Advisory Committee as a public forum to have the debate and the discussion (about what to cut)," Cansler said. "There's not going to be anything easy about it, and no matter what service you modify or reduce or eliminate, you impact somebody."


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  • rroadrunner99 Aug 5, 2011

    They want to cut assistance to American citizens, but have you heard anything about cutting aid to overseas Countries, to people who have never paid a single penny in taxes in the USA? Ihad rather see America's tax Dollars spent here in America, on OUR citizens than see it shipped out of the country to other Nations myself.Let the bussiness's here make that money.

  • Hater like Darth Vader Aug 5, 2011

    "Darth Vader: Medicaid pays for the $300.00 a month in anti-seizure medication for a 47 year old epileptic whose brain damage was cause by physical abuse as a child from his father - would you like to cut off his Medicaid and SSI, on the theory that he can work somewhere (if anyone would hire him?)"

    Yes, I would like to cut off his Medicaid and SSI. I don't see how him not having seizures is going to benefit anyone in society, and I also don't see how this is the government's problem and not his family or church family.

  • Hater like Darth Vader Aug 5, 2011

    "Darth Vader, Medicaid isn't just for those who you think are just lazy. Medicaid is for the disabled too, many who are incapable of working or can't work at jobs that would fully support them. My brother is developmentally disabled (since birth)and he has worked at a Red Lobster for the past 15 years, making on average $500 per month - Medicaid provides health care for people like him." -Tropicalgirl

    I still don't see the benefit to our society to keep your brother's head above water, your parents chose to raise him to adulthood, let it be their responsibility. My children are all healthy thank God, but I wouldn't expect the government to make the world fair for my mentally handicapped child.

  • storchheim Aug 5, 2011

    "no welfare, no food stamps, no medicaid. if you can't take care of yourself, you better ham family or friends that will.

    In other words, we'd better start treating each other better, if not out of love, then out of fear. That wouldn't be a bad thing at all. Maybe one reason we're so self-absorbed, rude, and hateful is that we assume govt will HAVE to step in.

    The law of unintended consequences!

  • schooldoctor Aug 5, 2011

    This is such a simple problem to solve, just drug test everyone that gets a check. Clean means green $$$. Very elementary solution.

    While you are at it look up wasteful govt. spending and see where the feds. pay 2.6 million to help Chinese prostitutes learn to drink less alcohol while on the job. And we borrow 42 cents on the dollar from them to make this payment. ONLY IN AMERICA!!

  • gunny462 Aug 5, 2011

    "the attorneys that advertise their assistance to help people get rid of their money & belongings (usually to other family members) so that grandma can qualify for Medicaid"

    Never seen one of those ads. Interesting though

  • gunny462 Aug 5, 2011

    Sadly, wait until obamacare goes into full swing and see what happens to medicaid. And emergency rooms? They will be just as crowded as before.

    "I'm investing what little I have left in firearms and firearms training.storchheim"

    Quite a few good places to go for either in the surrounding.

  • Dollars-and-Sense Aug 5, 2011

    What has always bothered me is all the attorneys that advertise their assistance to help people get rid of their money & belongings (usually to other family members) so that grandma can qualify for Medicaid. Why should a taxpayer have to pay for grandma's stay in a nursing home when 3 years earlier she owned 150 acres of land, a boat, a vacation home, and stock in Coca Cola and IBM? The attorneys helped transfer these assets to the kids or grandkids.

  • storchheim Aug 5, 2011

    Karma0784: "Well all that money you'll save on taxes from cutting those programs, I hope you will invest it in a good alarm system for your home and car. They will get their money somehow!"

    I'm investing what little I have left in firearms and firearms training.

  • grimreaper Aug 5, 2011

    I'll tell you what to cut for the state's medicaid...cut the dental. People should at least have the responsibility to do daily care and biannual prevention. The state does not get medicaid money for dental from the federal government...this is an entitlement the state provides...it is generally unnecessary as it really is preventable...unlike most medical accidents and illnesses.