NC leaders negotiating on state budget, delays on Medicaid expansion

RALEIGH, N.C. (WNCN) – Wake County commissioners voted Monday to hire dozens of people to process applications from people who will eventually qualify for Medicaid coverage once state leaders reach an agreement on the budget.

The new fiscal year began July 1 as Republicans continue to negotiate issues like how much to cut state income taxes and what to do with billions of dollars in reserve funds.

When Republicans agreed to expand Medicaid earlier this year to more than half a million low-income people, they made expansion conditional on the budget being enacted.

"It's like, what's the hold up?" said Adrienne Hayes-Singleton, who has been a long-time advocate of Medicaid expansion.

She's among about 600,000 people who would qualify for Medicaid coverage. The population that would be included is mostly comprised of working adults who make too much money to qualify for traditional Medicaid but also cannot afford subsidized insurance.

Hayes-Singleton lost her sister Sharon several years ago after she was diagnosed with stage four cancer. Sharon was also in the coverage gap. Hayes-Singleton believes her sister could have survived if she'd been able to afford routine doctors' appointments and screenings.

"To get all the way to the finish line and be like you can't step over the line just yet, it's kind of a slap in the face to be honest," she said. "These are people. They're not numbers."

Republican legislative leaders say they're still trying to resolve key differences they have on how much to cut the state's personal income tax rate and how to allocate billions of dollars in one-time money into various reserve funds.

"It's not as close as I would like for us to be, but there's been progress. We'll get there. It just may take some time," House Speaker Tim Moore (R-Cleveland) recently told CBS 17.

Gov. Roy Cooper (D) has called on Republicans to allow Medicaid expansion to go into effect now while they continue to try to craft a budget agreement. He said the delay costs the state about half a billion dollars per month.

Additionally, he said about 9,000 people who qualified for coverage during the pandemic will lose that coverage this month now that the public health emergency has ended. Those people would have kept coverage if Medicaid expansion were in effect.

In Wake County, about 212,000 people currently qualify for Medicaid, with some of those people having been added during the pandemic.

County officials estimate between 40,000 to 60,000 people qualify for expanded Medicaid coverage. County commissioners voted Monday to create 74 new full-time positions to process applications and to handle renewals going forward. They expect to receive tens of thousands of applications from people who do not qualify as well.

"Medicaid expansion is tremendous for this population. But, it does mean that we've got some work to do to make sure we're ready for it. So, we're doing everything we can to stay ahead of the curve," said Commissioner Matt Calabria.

Dr. Joel Gallagher, a physician who specializes in treatment of allergies and asthma, said he's concerned by the delay in allowing Medicaid expansion to take effect. He said some patients are delaying appointments out of concern they can't afford them. Additionally, he said his office is trying to make free samples of inhalers from manufacturers available to patients but noted there's a limited supply.

"I'm very concerned about it, to be honest with you. A lot of our patients are in a holding pattern," he said. "And, they don't know whether they can come in and get an issue evaluated because they don't want to be strapped with medical debt."