North Carolina Lawmakers Approve Emergency Medicaid Funding With New Restrictions
State legislature passes $319 million emergency funding with new copays and work requirements despite advocates’ concerns about patient access.
RALEIGH, NORTH CAROLINA — North Carolina House and Senate lawmakers voted nearly unanimously Wednesday to approve emergency funding for the state’s Medicaid program, which was on the verge of running out of money after being underfunded last year.
House Bill 696 provides the $319 million bailout but includes a comprehensive list of policy changes and anti-fraud measures that supporters say are necessary to control rising costs. The legislation passed with bipartisan support despite concerns from healthcare advocates about potential negative impacts on patients.
Funding Crisis Background
The emergency arose after Republicans in the House and Senate failed to agree on adequate funding last year. Some Republicans had questioned whether the North Carolina Department of Health and Human Services’ $319 million request was accurate, but House and Senate Republican leaders said Tuesday they had reached agreement on the figure.
House Speaker Destin Hall said Tuesday the funding bill would include provisions to control costs, stating that the increasing cost of Medicaid is unsustainable. “We’ve got to get our arms around it,” Hall said.
New Oversight and Cost Control Measures
The legislation adds several oversight measures designed to mitigate waste and abuse. County-level officials will now be required to review eligibility more frequently, with monitoring changing from quarterly to monthly intervals.
The bill also raises copays for inpatient hospital care to $25 per visit, which represents the maximum allowable amount under federal Medicaid requirements. It implements a three-month “lookback period” for work requirements, requiring applicants to demonstrate 80 hours of work, educational, or community service activities per month over the three months prior to qualify for coverage.
Healthcare Advocates Express Concerns
Healthcare advocates have raised concerns about the potential impact of these changes on vulnerable populations. John Broome, the government relations director for the American Cancer Society Cancer Action Network North Carolina, said the bill will place an especially heavy burden on cancer patients who must receive frequent inpatient care.
“This bill creates unnecessary red tape for patients,” Broome said, according to the legislation’s critics who worry about unintended consequences from the new requirements.
Bill supporters from both parties argue the provisions are needed to maintain North Carolina’s expanded Medicaid program amid potential federal changes. However, advocates contend some changes are unnecessarily harsh and could create barriers to care for those who need it most.
The bailout ensures the Medicaid program can continue operating while state lawmakers work on broader budget issues that remain unresolved. The program serves hundreds of thousands of North Carolina residents and was expanded under the state’s recent Medicaid expansion.
