The General Assembly will not meet to address Medicaid funding next week, despite Gov. Josh Stein's formal call for a special session.
In a letter sent Thursday, Senate leader Phil Berger and Speaker of the House Destin Hall told Stein that a special session to address Medicaid is unconstitutional and unjustified.
Stein called the special session last week, saying the General Assembly must address a projected $319 million shortfall in the state's Medicaid program. That shortfall is the result of inflation, pricey pharmaceuticals and the increased use of some behavioral health services.
But the legislature is already in session, Berger and Hall told Stein.
"Your Proclamation is therefore ineffective and functions as an unconstitutional attempt to usurp the General Assembly's authority to set its calendar," they wrote.
The General Assembly's adjournment resolution scheduled it to come back for a regular session beginning at 10 a.m. Under the terms of that resolution, the only bills that can be considered during that session are conference reports for which conferees were appointed before September 25 and bills sent back to their original chamber before September 25 for concurrence.
Monday. Hall's office said in its news release that House members have been told to not expect voting sessions next week. When the House adjourned in October, Hall told them not to expect votes for the rest of the year.
In a statement Thursday evening, Stein said, “Speaker Hall and President Pro Tempore Berger would rather come up with excuses than fund Medicaid for the people of North Carolina. This is the latest example of their dysfunction that has become the norm of this North Carolina’s General Assembly.”
On Oct. 1, the N.C. Department of Health and Human Services slashed the rates providers receive for treating Medicaid recipients.
That happened because the House and Senate were unable to reach an agreement to provide additional funds to the Medicaid program. Without a deal, Stein and DHHS Secretary Dev Sangvai have said, it is irresponsible to leave the state's Medicaid program on a path to run out of funds next spring.
About 3.1 million North Carolinians receive their health insurance through Medicaid.
Stein has said he is willing to accept $190 million in additional funds now, which would help delay cuts until at least January, or to dip into the state's $500 million Medicaid Contingency Reserve to make up the shortfall. With no extra funding coming, he said, the state's Medicaid program needed to be prudent with the money it does have.
"It would be absolutely reckless were we to spend money knowing that we're going to run out of money at some point next year," Stein said while calling the special session last week, noting that there's no guarantee Republicans in the House and Senate will ever reach agreement.
Legislative leaders maintain that any crisis for Medicaid is at least five months away, with the program slated to remain solvent until April 2026.
For that reason, they told Stein, the call for a special session does not meet the threshold for an "extraordinary occasion" required by the state constitution.
"This power was never meant to be used as a platform for political messaging or to circumvent the legislative process to achieve a preferred political outcome. To that end, if circumstances surrounding the Medicaid rebase are in fact extraordinary, it is only in the context of your administration's failure to address them," Berger and Hall wrote.
In July, the General Assembly appropriated $600 million to the Medicaid program to address rising costs, with DHHS using $100 million to address a shortfall in the Medicaid Managed Care Oversight Fund.
Both the House and Senate passed bills in September to provide an additional $190 million to Medicaid, but neither became law due to a legislative dispute over funding for a Wake County children's hospital and rural health clinics.
“They are forcing health care providers to make painful decisions to stop accepting Medicaid patients, cut salaries, reduce critical services, or close altogether. NCDHHS can’t put health care costs on a credit card. The longer the General Assembly refuses to fund our Medicaid program, the more they erode our health care system,” Stein said in his statement Thursday.
Sangvai warned last week that providers have started to tell DHHS that they will soon no longer see patients covered by Medicaid due to the reduced rates.
