A months-long dispute about Medicaid funding is nearing a conclusion, as both chambers of the N.C. General Assembly overwhelmingly voted Tuesday to send legislation paying for the program for the rest of this fiscal year to Gov. Josh Stein.
House Bill 696 moves $319 million out of the state's Medicaid reserve to fund the program for the rest of this year. That's a figure Stein and N.C. Department of Health and Human Services Secretary Dev Sangvai have been requesting for months.
The legislation also makes a slew of changes to the state's Medicaid program that are required by last year's H.R. 1, the federal legislation known as the One Big Beautiful Bill Act. Those include implementing work requirements for anyone on Medicaid between 19 and 64 years old and updating eligibility to clarify that people who aren't citizens is limited to the level required for federal participation in the program.
DHHS officials have expressed concern to lawmakers that the language could threaten the coverage of 27,000 people who are in the country legally but haven't yet been here for the five years typically required to receive federal benefits. They are eligible for Medicaid through a waiver the General Assembly agreed to in 2009.
That includes 26,500 children and about 500 pregnant women, Sen. Jim Burgin, D-Lee, said Tuesday.
Sen. Michael Garrett, D-Guilford, voted against the bill on both its second and third readings, pointing to that provision. Garrett blasted Republican bill writers, accusing them of tying health coverage for pregnant women and their children to must-pass Medicaid funding.
"You do not have to accept that cruelty is the price of getting a bill passed in your state and in your name. You do not have to accept that your legislature uses pregnant women as bargaining chips," Garrett said on the Senate floor.
But Senate Republicans don't think those 27,000 people will lose coverage under this bill.
Speaking after Tuesday's vote, Sen. Benton Sawrey, R-Johnston, called that eligibility "untouched" and said Senate Republicans did not intend to strip Medicaid from those women and children.
"DHHS has raised a concern. We're going to examine it. We're going to talk to our partners at (The U.S. Center for Medicare & Medicaid Services) and if for some reason they say otherwise, we'll come back and address it," Sawrey told reporters.
The eligibility provision, Sawrey added, doesn't become effective until Oct. 1, giving lawmakers time to determine if there is any discrepancy with what they intended.
Implementing work requirements
The legislation also requires that anyone seeking Medicaid coverage prove that they had been complying with its work requirements for at least three months before applying.
H.R. 1 only mandates that states look back a month before the application, but North Carolina chose to use the maximum three-month period.
Speaker of the House Destin Hall, R-Caldwell, told reporters after Tuesday's session that Medicaid costs need to come down and the work requirements are a measure that could encourage recipients to find healthcare elsewhere.
"Our goal on my side of the aisle is to have a program in place that meets the needs of those folks who truly need it, and the real measure of success is how many folks who get on it who are able to work do you get off it and get back in the workforce," Hall said.
