Medicaid Expansion Won’t Wait for State Budget Ratification

A budget agreement is expected by mid-August.

NCDHHS Secretary Kody H. Kinsley
NCDHHS Secretary Kody H. Kinsley
By Cash Michaels –

Medicaid expansion in North Carolina will begin on October 1, assuming the state legislature adopts a budget by September 1, according to NC Dept. of Health and Human Resources officials.

“We are thankful for leadership and partnership in passing Medicaid Expansion which will save lives, increase access to care and bring billions of dollars to North Carolina,” said NCDHHS Secretary Kody H. Kinsley. “Moving forward now sets the department on a path to be able to get health care coverage to thousands of people as soon as possible.”

Doing so is part of a compromise agreement between NCDHHS and the Centers for Medicare and Medicaid Services that would allow North Carolina to move forward with the required public notices for beneficiaries, counties, and providers while waiting for the NC General Assembly to act on the state budget.

And if for some reason the legislature fails to ratify a state budget by the September 1st deadline, then December 1st, or sometime next year will be the target, NCDHHS officials say.

Their reasoning is that it will take 90 to 120 days to jumpstart the administrative apparatus once Medicaid expansion becomes law, so it makes sense to set benchmarks now so it can be up and running, at most, 30 days after a state budget is adopted. An estimated 300,000 residents will be covered on the first day.

Republican legislative leaders agreed to a state expansion of the federal program to help lower-income North Carolinians last March—thirteen years after Obamacare (the ACA) was passed—but only as part of the still-pending budget. Gov. Roy Cooper has been lobbying for the program throughout his two terms, saying that passage would help an additional 600,000 state residents.

[Covering more than half a million residents would also create tens of thousands of new jobs in the state, but despite the fact that the federal government will pay 90% of the cost each year, bringing noticeable economic benefits to the state, Republicans have until now rejected expansion.]

The hope was that the state budget would be passed in time for the beginning of fiscal year 2024, which began on July 1, but as August passes and school begins, there is still no state budget.

Now a budget agreement is expected by mid-August, a NCDHHS spokesman says.

Gov. Cooper had lobbied Republican legislative leaders to separate Medicaid expansion from state budget passage, but that request, too, was rejected.