Medicaid Matters

Our series, MEDICAID MATTERS: Protect and Expand NC Health Care, aims to highlight the success of Medicaid and the Children’s Health Insurance Program (CHIP) as well as examine the proposals being set forth by Congress that threaten the very existence of these programs.

This series of policy briefs will illustrate how Medicaid and CHIP affect the health and well-being of children, older adults, people with disabilities, caregivers, as well as the North Carolina state budget. The series will be updated weekly through early April.

MEDICAID MATTERS to North Carolina’s Most Vulnerable. Medicaid is a joint state and federal health coverage program that has helped improve the health of children, low-income adults and families, pregnant women, people with disabilities, and older adults for over 50 years. The Children’s Health Insurance Program (CHIP) was established in 1997 to extend financial support to states in order to provide care to more children. Despite bipartisan support for CHIP and the great coverage gains in states that enacted Medicaid expansion, Medicaid and CHIP are both under attack in Congress.

MEDICAID MATTERS for North Carolina’s Children’s Healthy Development. Reckless plans to restructure Medicaid will put the health and well-being of 1.4 million children across the state at risk. One service at risk of cuts is Early and Periodic, Screening, Diagnostic and Treatment (EPSDT), a cornerstone of Medicaid’s capacity to ensure children living in poverty are healthy and are able to reach their full potential. EPSDT will be under threat if states share a greater risk for covering the cost of health services covered by this program.

MEDICAID MATTERS for North Carolina’s revenue, state budget, and economic wellbeing. Medicaid supports children, families, and older adults, helps people with disabilities reach their full potential, and serves as a safety net to all of North Carolina. It also impacts our state’s economy – the state would face a shortfall of at least $4.4 billion over the next 10 years if lawmakers restructure Medicaid. It’s deeply concerning that members of Congress have produced a bill that would fundamentally restructure who Medicaid serves and how much North Carolina receives in federal money by establishing a per capita-based cap on federal payments.

MEDICAID MATTERS for supporting long-term care of seniors, caregivers, and adults with disabilities. Medicaid provides crucial resources for meeting the long-term care needs of North Carolina’s seniors and adults with disabilities, resources that will only become more important since the population over 65 is projected to more than double by 2050. As this population expands, a growing number of seniors and adults with disabilities will need low-cost solutions for the challenge of long-term care. Unfortunately, the rate at which Medicaid reimburses home health care providers in North Carolina is just $13.88—the fourth lowest in the nation and well below the national average reimbursement rate of $18.82 an hour.

MEDICAID MATTERS to North Carolina’s Schools. North Carolina’s children benefit tremendously from Medicaid and the Children’s Health Insurance Program (CHIP), which provide direct and indirect financial support to schools, as well as the improved health outcomes associated with broader access to health coverage lead to improved educational outcomes for students. In the past year, proposals at the federal level would have fundamentally restructured Medicaid, decreasing the federal government’s commitment to states by changing the Medicaid funding structure to either a block grant or per capita cap and limiting CHIP’s reach and effectiveness. This would limit the availability of health care to the state’s residents who have Medicaid coverage, including school-aged children.