What NC could lose if Congress cuts Medicaid spending
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North Carolina Medicaid could lose as much as $27 billion in federal funding, the state program's head said Wednesday, if Congress passes a budget proposal that brings cuts to the government health care program for low-income Americans.
Why it matters: Under a Republican budget resolution that passed the U.S. House Tuesday night, the safety net program, which provides health care to 2.9 million North Carolinians, emerged as a prime target, Axios' Victoria Knight and Peter Sullivan report.
- Federal cuts to Medicaid could upend North Carolina's recent enactment of Medicaid expansion, which expanded health care coverage to more than 630,000 of the state's poorest residents. The slashes could also have an outsized impact on rural areas, deputy secretary for NC Medicaid Jay Ludlam told state lawmakers Wednesday morning.
State of play: The federal budget resolution, which still has a long way to go before it reaches the finish line, calls for a $2 trillion reduction in spending to partially fund $4.5 trillion in tax cuts.
- The proposal does not specifically call for cuts to Medicaid, and the resolution could become law without them, "but it won't be easy," the New York Times reports.
- The House Energy and Commerce Committee, which oversees Medicaid, must find $880 billion in cuts under the resolution.
How it works: One of the ways Congress could reduce Medicaid spending is by implementing a per capita cap on the money states receive for each person enrolled in the program.
- "We do anticipate up to a potential $27 billion in federal cuts in North Carolina" over a 10-year period, Ludlam told North Carolina state lawmakers Wednesday. "I don't know that it would be all of the federal match, but it could really change the way that the program is configured."
- The federal government could also reduce its contribution to states that have expanded Medicaid, which would result in a loss of $6 billion in federal funding in North Carolina, Ludlam said.
- The federal government currently covers 90% of the costs for Medicaid expansion enrollees, but if that rate drops below that amount, expansion would be discontinued in North Carolina, and those 630,000 would lose coverage.
- Congress could also opt to cut Medicaid spending through other avenues.
Threat level: Reductions in Medicaid funding will affect local, regional and state economies, Ludlam noted in slides presented to lawmakers — and "especially rural areas," he noted in bold.