Medicaid expansion further delayed amid NC budget negotiations

RALEIGH, N.C. (WNCN) – While Republicans have tentatively scheduled votes on the state budget in the middle of next month, health officials say the delay in getting that resolved has pushed the start date for Medicaid expansion until at least the end of the year.

The North Carolina Department of Health and Human Services had targeted an Oct. 1 launch date for expanded Medicaid coverage to begin if the state budget was enacted by this Friday or if the legislature gave the agency the authority to move forward with expansion while lawmakers continue their budget talks.

Neither of those things will occur this week, as Republicans continue to negotiate among themselves what to include in the budget.

"People are going to get sicker. Some people are going to die unnecessarily. And, people are going to face medical debt that they didn't have to face," said Rebecca Cerese, health policy advocate at the left-leaning NC Justice Center.

House Speaker Tim Moore (R-Cleveland) says with the budget talks in the final stages, he thinks it's "more than likely" that votes on it will occur the week of Sept. 11.

He said negotiators have narrowed the number of issues to address and are determining the specifics of funding various projects, including spending one-time money the state has available.

"And so, that's the kind of thing you do once you're getting to the end of the process of it. And, really, the issues that are in contention are very, very small," he said.

Republicans have a supermajority in the legislature and have been meeting for months to try to reach a final resolution. They are also in a position to override a potential veto by Gov. Roy Cooper (D) if the GOP sticks together.

NCDHHS Sec. Kody Kinsley said the delay in enacting a budget means Medicaid expansion will not take effect until December "at the earliest" and potentially not until early 2024.

"This is a tragic loss of health insurance for nearly 300,000 people that would have coverage on day one, delaying something that we know they and their families need so badly," he said.

In total, about 600,000 people are estimated to qualify for coverage under Medicaid expansion, with the majority of them being low-income working adults.

As the budget talks continue, some people who currently have coverage through Medicaid are losing it now that the COVID-19 public health emergency is over. State officials say about 9,000 people per month are being dropped who would not have lost their coverage if expansion had taken effect.

Anthony Brooks is among them. He told CBS 17 last week he makes $7 too much to keep his coverage and is poised to lose that coverage later this week. He's appealing that decision.

He says it's a life-or-death matter, as he needs surgery on his heart.

"I'm not gonna make it. I feel like I'm walking dead. My number's gonna be coming soon. I'm really stressed," he said.

Sec. Kinsley said his agency is taking a variety of steps to cut down on the time it will take for coverage to begin once the legislature gives final authorization.

He also pointed to the broader issues that state government agencies are having with hiring people, saying he's hopeful that pay raises included in the budget may help to address that.

"We have a 26% vacancy rate at the department that provides critical healthcare for people all across the state. So, I'm eager for a budget too," he said.