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Medicaid work requirements a sticking point in budget talks

A new requirement for some Medicaid recipients is at issue as top House, Senate negotiators work to polish off the state budget.

Posted Updated
N.C. health, mental health, Medicaid generic
By
Travis Fain
, WRAL statehouse reporter
RALEIGH, N.C. — New work requirements for current Medicaid recipients are part of the final budget negotiations going on between top leaders from the House and the Senate.

The matter is one of several policy items that House Speaker Tim Moore and Senate President Pro Tem Phil Berger are hashing out as they wrangle over the $24 billion budget. The change appears to be a Senate priority without support from key budget writers in the House.

"We're talking about it," Berger, R-Rockingham, confirmed Wednesday evening as he emerged from budget talks for a dinner break.

Negotiations were expected to continue later Wednesday evening. Much of the budget has been worked out between House and Senate budget writers for the GOP majority, to the point that leadership plans votes on the final plan next week and will bring the budget to the floor without allowing amendments on the floor or in public committee meetings.

But there are a number of items the two sides hadn't agreed to as of Wednesday evening, leaving work for Moore, R-Cleveland, and Berger to do.

The potential Medicaid requirements would affect about 60,000 people, according to state Rep. Donny Lambeth, R-Forsyth, a House budget chairman as well as a chairman on the House Health and Health Care Reform committees.

Exemptions would cover other recipients of the taxpayer-funded health insurance program, Lambeth said.

The change would require approval from the federal government, but the Trump administration has indicated it's open to similar changes.

The proposal at issue deals with current Medicaid recipients, not a potential Medicaid expansion population. The state has already sought federal approval to include work requirements if it ever expands Medicaid, but the legislature's Republican majority has shown little willingness to take that step.

Because adding work requirements to the current program would be a policy change, as opposed to a strictly fiscal piece of budget language, Lambeth said he and other House budget chairs don't support it.

“It needs much more discussion than the budget would allow," he said.

All seven House budget chairs backed this position before Moore went to negotiate with Berger, Lambeth said.

"It was a good healthy discussion," he said. "(The speaker) did not make a decision."

Moore was in Washington, D.C., earlier this week meeting with fellow state House speakers from around the country, as well as President Donald Trump and Vice President Mike Pence.

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