NEW HANOVER COUNTY — North Carolina will become the 40th state to implement federal Medicaid expansion on December 1, 2023.
read more: Medicaid expansion bill heads to governor’s desk
Gov. Roy Cooper and North Carolina Department of Health and Human Services Secretary Cody H. Kinsley announced the start date Monday after budget delays pushed the schedule back from Oct. 1.
Cooper said in a press release that while this is overdue, it is also a “monumental achievement in expanding health care coverage to those who need it.”
“This means improved care, including for patients with mental health and substance use disorders, gives hope to rural hospitals struggling to stay open, and brings billions of dollars into the economy.” “I will,” he added.
The announcement came after Cooper said he would allow the nearly three-month-delayed state Republican budget bill to go into effect without his signature. The governor said the budget was bad overall, but he didn’t want to delay the expansion any further.
A bill to expand Medicaid coverage to more than 600,000 North Carolinians passed in March, but was tied to passage of the state budget. All three county legislators except Rep. Carson Smith (R-Pender County) voted to support the bill.
The expansion is aimed at closing the “Medicaid gap,” which includes hundreds of thousands of low-income North Carolinians who cannot afford health insurance because their incomes are too high to qualify for the program under the current system. Currently, it primarily targets children from low-income families, some of their parents, people with disabilities, and elderly people with limited financial resources.
The expansion expands eligibility to adults ages 19 to 64 with incomes up to 138% of the federal poverty level. For example, the expansion provides health insurance coverage to single people whose annual income is less than her $20,000. Similarly, her family of three, whose combined income is less than her $34,000, would also be eligible.
According to the bill, the federal government would pay 90% of Medicaid costs, and states would pay the remaining 10%. However, it stipulates that individual coverage under the expansion will be discontinued if the federal government’s share falls below 90%.
Estimate North Carolina’s premiums range from $224 million in the first year to about $700 million in the fourth year. These costs are covered by hospital taxes. In return, hospitals would be able to take advantage of the federal Healthcare Access Stabilization Program, which increases the amount hospitals pay for services to Medicaid patients. Hospital payments for Medicaid patients are significantly lower than for commercially insured patients.
An estimated 17,000 people in New Hanover County will be eligible for Medicaid, said Tonya Jackson, director of social services for the New Hanover County Department of Health and Human Services. Port City Daily interviewed her on May 3 in anticipation of passing the budget before the end of the fiscal year on June 30.
“We will be able to provide coverage to the working class who fall into the 138% poverty income gap,” Jackson said. “So they currently make too much money to receive Medicaid, but they don’t actually make enough money to pay for health insurance at private rates, or they work in jobs that don’t offer health insurance.” It’s either…that’s where we’re going to go “to have a healthier workforce.” ”
Jackson added that the expansion will also be a boon for veterans and people living in rural areas, giving them the opportunity to receive regular care.
Critics of the bill argue that the expansion would spike demand and wait times for services, increase state taxes and inflation, and increase Medicaid spending.
“People who would normally be rushing to the emergency room right now are going to need a primary care provider,” Jackson said. “One of my concerns is how many health care providers in the county are going to accept these new patients with insurance coverage.”
While the nursing staff shortage has received most of the attention in national and local press, Jackson said the focus is on whether the county has enough specialists and Medicaid providers. In addition to the need for medical staff, Jackson said in May that the county would need an additional 10 to 14 people to process the influx of applications and support newcomers to the program. State law includes funding to help with that need.
As for the surge in demand, Jackson allayed those concerns.
“People will apply, but just because they apply doesn’t mean they’re eligible. So it’s essentially a trickle,” Jackson said. “
He said hospitals could be overwhelmed with patients for the first 90 days, but if there are enough providers in the county, patients in need could be spread out among more facilities. Stated.
Medical experts have voiced concerns about health care costs, but Johns Hopkins University researcher Ge Bai and former Delaware Medical Board Executive Director Anne Kempski told the News & Observer The Health Care Access Stabilization Program, which went into effect in July, allows hospitals to increase costs and could trigger private insurers to raise premiums, but there is no cap on how much they can do.
Hospitals are not the sole decision makers in pricing. You will also need to negotiate with your insurance company. Barak Richman, a health policy expert at the Duke Margolis Center for Health Policy, told The N&O that insurers may have little leverage when large hospital systems like Atrium threaten to walk out of negotiations. Told.
Jackson told PCD that the benefits of Medicaid expansion outweigh the challenges the state would face.
“My hope is that our hospitals and health care providers will not be subject to non-payments to the individuals they care for because they are not covered by insurance, and will be able to put more funds back into the local economy. “It’s going to happen,” Jackson said. . “Because if you get 17,000 more people on Medicaid, you’re going to have 17,000 more people going to their local mom-and-baby pharmacy. You’re going to have more people going to big box stores like Walgreens, Walmart, and CVS. Now that the service is accessible, more individuals will come to the store to take advantage of the service.”
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