Children's hospital funding remains a sticking point for North Carolina Republicans
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Rendering: Courtesy of NC Children's Hospital
The Republican-led North Carolina General Assembly remains divided over approving a full state budget. Now, an effort to address some health care funding needs in the state also appears to be stuck in a standstill.
Why it matters: This summer, when it became clear that a full budget was not happening, state lawmakers agreed to put $600 million toward Medicaid rebase funding as part of a mini-budget.
- That figure, however, is short of the $819 million Medicaid funding needed to keep the current level of services, NC Health and Human Services Secretary Dev Sangvai said last month.
- If more rebase funding isn't directed toward Medicaid, Sangvai said, cuts to services and to health providers will be necessary come Oct. 1. Republicans have called the potential cuts premature and politically motivated. (DHHS is part of Gov. Josh Stein's cabinet.)
State of play: Rebase funding, put simply, is how much money is needed to keep providing Medicaid to the same people at the same level as last year. It's a regular part of the state's budgeting cycle.
- An effort to put more money toward Medicaid rebase funding appears to be hung up on additional spending the N.C. Senate wants for the future NC Children's hospital in Apex and funding for N.C. Cares, a program that supports rural hospitals.
- "House appropriators and health leaders have proposed a plan to fully fund Medicaid and prevent the NCDHHS' politically-motivated cuts," Demi Dowdy, a spokesperson for House speaker Destin Hall, said in a statement to Axios. "We are hopeful that unrelated budget items will not hold up an agreement on this plan."
- However, Senate Republicans say they only want to include money that had already been approved in 2023.
Zoom in: In 2023, a state budget that was negotiated by Senate leader Phil Berger and former House speaker Tim Moore approved around $103 million for the children's hospital and another $105 million for N.C. Cares for this fiscal year using money from the American Rescue Plan Act.
- That spending, however, needs to be re-approved in the 2025 budget, and House Republicans, under new House speaker Destin Hall, want to re-evaluate the spending because of worries over declining state tax revenues.
- The children's hospital is expected to cost around $3 billion to build. It's already received more than $200 million from the state, but it is also seeking private funding from corporate and philanthropic donations.
Sen. Michael Lee, the Senate's majority leader, said it's imperative that the General Assembly provide funding that had already been allocated for the two programs.
- "A lot of people are relying on the General Assembly to live up to what they said they were going to do," Lee said.
Between the lines: As part of negotiations over Medicaid rebase funding, the Senate has already reduced what it is asking for the children's hospital.
- Its previous budget proposal sought to add more than $500 million in additional funding for the hospital.
- In a statement, UNC Health said that state lawmakers' commitment to the children's hospital "ensures that children across North Carolina with the most complex health issues will have access to highly specialized pediatric services right here in North Carolina."
What's next: State lawmakers are returning to Raleigh next week, where they're expected to discuss a new crime bill in the wake of a stabbing on Charlotte's light rail system.
- But it remains unclear if lawmakers will be able to come to an agreement on health care spending as well.
What they're saying: North Carolina is "on the clock" to fully fund Medicaid, Gov. Stein, a Democrat, said in a statement Thursday.
- "I am committed to working with the General Assembly to find a solution that keeps the program running so that North Carolinians do not lose their health care."