Medicaid Transformation On The Move, Finally

Joyce Krawiec serves in the North Carolina Senate. She represents Davie County and Forsyth County, NC. Christian, wife, mother, small business owner, and conservative.

During my time in the North Carolina Senate, the health and wellness of North Carolinians has remained a top priority. Back in 2015, my colleagues and I made a promise to reform the Medicaid system through Medicaid Transformation. This promise meant improving health outcomes for North Carolina’s most underserved and vulnerable populations, ensuring greater accountability and budget predictability for the state, and improving provider engagement and support. 

 

The COVID-19 pandemic has created significant stress for North Carolina. We’re facing a budgetary shortfall of more than $4 billion dollars. The delay of Medicaid Transformation not only puts thousands of jobs at risk when our employment rate is historically high, but also results in the loss of a whopping $17.6 million dollars in savings for the state each month – savings that could be directed to meaningful uses in our great state. 

 

The decision to transition to Medicaid managed care was made on a bipartisan basis, and our state has been preparing for it for over five years. Federal approval was granted in October 2018, and five health plans were carefully selected in February 2019 to serve North Carolinians – including a local, provider-led plan. 

 

As of July 2019, 40 states, plus the District of Columbia have implemented Medicaid managed care. These states have enjoyed more predictable Medicaid budgets and the improved overall health of the Medicaid population enrolled in these plans, and most have expanded managed care, either geographically or into new populations. 

 

In November of 2019, the N.C. Department of Health and Human Services announced that North Carolina’s transition to Medicaid managed care was suspended. This suspension came with significant consequences, including the loss of the investment made by the State, providers, health care plans and numerous other stakeholders. Importantly, it also means the delay in the improved health outcomes and whole-person, integrated care of Medicaid beneficiaries, and implementation of value-based payment arrangements for the first time in Medicaid. It also means not addressing unmet social needs through community services. 

 

In a time when the state is facing this financial uncertainty, continuing to lose millions of dollars by delaying the implementation of Medicaid Transformation is an unforced error. Instead, I’m asking my colleagues in the General Assembly and Governor Cooper to take advantage of the investments we have already made and finish the job by passing and signing S 808 into law. 

 

Launching Medicaid Transformation would not only instill greater predictability for North Carolina’s budget, but most importantly, improve care and ensure better health outcomes for Medicaid beneficiaries across our state. This needs to be done now – North Carolina can begin to realize the benefits from these cost savings instead of wasting money on a half-completed transition. The sooner the transition is launched, the healthier North Carolina will be.

 

S 808 has passed the Senate with bipartisan support. There were only 5 votes opposed in the Senate. I expect a similar outcome in the House. Then it’s up to the Governor. After failing to follow the current law to transform Medicaid, let’s hope the Governor will sign this bipartisan bill and allow Medicaid beneficiaries to receive better health care services. 

 

Senator Joyce Krawiec serves as chair of Senate Health and Senate Health Appropriations and the primary sponsor of Medicaid Transformation.