Women Advance: 'NC Medicaid Reform Explained in 2 Minutes'


I’m no expert on health insurance. Each time I go to the doctor I struggle to understand the myriad rules governing co-pays, out-of-network visits, and deductibles. It just makes my head swim.

Naturally, the idea of changing the way that 1.8 million North Carolinians receive their health care is completely overwhelming to me. But that’s just what the General Assembly wants to do by reforming Medicaid. Despite having a nationally recognized system for managing Medicaid patients, legislators are now considering building an entirely new system from the ground-up.

North Carolina legislators are anxious to find ways to save money and improve budgeting for the $13 billion plan. And they’re not alone...

Response to this post from Orange County Dem Rep.Verla Insko:

There is a third option Republicans are touting as a compromise. They will introduce the concept this session probably in a Senate bill; although a House Republican may also introduce it – most likely Rep. Justin Burr. It transfers the entire Division of Medical Assistance (DMA or Medicaid) to an independent board of directors housed within the NC Department of Health and Human Services. The Board would be appointed 1/3 each by the Governor, the Senate and the House. The first draft of the bill got some push back from the Joint Oversight Committee on Program Evaluation because the board members represented health care administrators and financial experts to the exclusion of patient advocates.

The board would have the authority to set rates and eliminate optional services to stay within the set budget. They would also set their own annual salaries to be capped at no higher than the NC Secretary of State. NC House Democrats, along with most House Republicans, oppose this option and support building on the successful CCNC program we have and moving to an Accountable Care Organization approach that also involves a capitated Medicaid budget. This would meet the goal of having a predictable Medicaid budget without turning the system over to an organization that excludes both patients and providers.