North Carolina Budget Plan Includes Reduced Medicaid Reimbursement Rates, Increased Copayments

North Carolina legislators on Aug. 8 introduced a $3.35 billion spending plan that would make several changes to the state's Medicaid program and according to advocates would "make it harder for some [people] to get medical care," the Winston-Salem Journal reports. Budget authors were asked to cut $50 million from the proposed health and human services budget. The proposed budget would reduce Medicaid reimbursements to doctors to 95% of current levels, eliminate increases for inflation for Medicaid providers over the next two years and increase prescription drug copayments from $1 to $3 per prescription. Adam Searing of the N.C. Health Access Coalition said, "What this says to me is that the Legislature ... is more interested in limiting health care to children and elderly people and people with disabilities than they are in charging the same amount of tax to someone who buys a Mercedes Benz instead of a Chevy Truck. There's absolutely no question. It's very harsh." But state Rep. Ed Nye (D), co-chair of the appropriations subcommittee on health and human services, said, "This is about the best we could do on what we had to do with" (Damico, Winston-Salem Journal, 8/9).

Implications for CHIP
Also related to the budget problems is a delay in enrolling about 23,000 eligible children in Health Choice, the state's separate, non-Medicaid CHIP program, the Raleigh News & Observer reports (Gardner, Raleigh News & Observer, 8/9). On July 2, Gov. Mike Easley (D) announced the end of an enrollment freeze that would allow 5,000 additional children to enroll in the program. In January, the program had stopped accepting new applicants to "make sure [it] wouldn't run out of money." At the time of the freeze, 72,000 children were enrolled; however, over the next six months the total fell to 57,000 as children left the program. House and Senate budgets currently set the enrollment baseline at 62,000 children (Kaiser Daily Health Policy Report, 7/5). House and Senate Budget writers have tentatively agreed to increase enrollment to 82,000, but the Department of Health and Human Services has to wait for a final budget before it can begin to actively recruit children. Although they possess the power to do so, state lawmakers have "refused to allow" the new enrollment level to take immediate effect, the News & Observer reports. Searing said, "I think it's because of the atmosphere we have where no one's sure we can raise taxes. We can't help a few thousand more children? I think that's just too bad." Nye said the House and Senate are "on track" to add $8 million to Health Choice that would allow total enrollment to increase to 82,000 children (Raleigh News & Observer, 8/9). For further information on state health policy in North Carolina, visit State Health Facts Online.