McCrory's path forward on Medicaid unclear

New Story by Binker on

Top officials [at NC DHHS] are about to embark on another "listening tour," according to a set of slides that Sandy Terrell, the Division of Medical Assistance's acting chief operating officer, presented at the North Carolina Institute of Medicines annual conference this month. It's unclear where and to whom the agency will be listening. Also unclear is what Terrell meant when she wrote that there would be "changes within the Division of Medical Assistance."

The Department of Health and Human Services refused a request to make Terrell or anyone else available to talk about pending changes in Medicaid, saying that an announcement was coming.

In response to a request for clarification, Ryan Tronovitch, a spokesman for McCrory, said that the governor was working "to fix a broken system that is hurting our ability to fund other areas of state government like education, public safety, and transportation. The governor will focus on a plan that takes a holistic approach to health care, one that improves the system for providers, and one that is predictable and sustainable for generations to come."

The Governor claimed to have a "secret" provision that allows his administration to create new waivers for Medicaid in NC. However, the legislation and its implementation appear somewhat different.

"I'm continuing to have dialogue with Washington representatives regarding the implementation of Medicaid and the management of Medicaid cost, including following through on some of the waivers that we've asked for," McCrory said.

Lawmakers created a five-member panel to oversee Medicaid reform and help draft recommendations. McCrory is to appoint three members of that panel; the Speaker of the House and President Pro Tempore of the Senate would each appoint one member. As of the close of business on Sept. 20, 2013, no members of that panel have been appointed, meaning a key cog in the legislature's vision of Medicaid reform does not even exist yet.

While I hope there is a real listening tour being planned, I doubt it will be as fruitful as those meetings of the spring. As Adam Searing rightly points out, "Even if he (McCrory) had something that was really innovative, he and secretary Wos have squandered so much of their good will and credibility, it's going to be difficult for them to move something."

I think there was a genuine effort at listening up until late May. I myself met privately during "office hours" with leaders of DMA and MHDDSAS (divisions of NC DHHS), and they appeared to be truly listening. One of their questions to me, however, was what blogs or social media could I suggest that were run by "conservatives." I was unable to suggest any then--or now. Part of their problem is the right wingers don't want Medicaid in any form or fashion, so there is little input available that they will listen to.


Next step

toward privatizing Medicaid and dismantling DHHS. McCrony's path on Medicaid is crystal clear. Decry costs, claim waste, stop delivering benefits, put DHHS out of business (after sucking every dime and giving those $ to cronies).

"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

I don't agree

Posmo: that was the original plan, I think. You have to recall that aside from their "customers" who are mainly indigent and politically powerless, there also are the health providers and the well connected health insurance company and hospital officials watching them closely. As Binker's story points out, there is a maze of special interests McCrory and Vos must weave through to achieve their goals. It won't be easy.

Martha Brock

Their goals?

The only goals I can see are cutting costs. When McCrory says "fix what's broken," that's all he means. But costs can't and won't be cut except on the backs of a growing segment of poor people.

The system is slowly teetering into a tail spin. Growing poverty = growing need.

The only answer I see is the only answer Republicans won't consider: raising taxes.

Medicaid cost overruns=phony issue

The problem of Medicaid spending exceeding budget for Medicaid (year after year) is a phony issue created by the legislative budget writers. They could come up with more accurate estimates, IF they wanted to. They intentionally low ball the budget to make Medicaid a target of public anger.

Guess what? Their plan is working. No one talks about why they never get an honest spending estimate in advance, when the legislators create the DHHS budget.

Martha Brock

DAG McCrony

has blamed Medicaid for EVERY funding issue, since he's taken office. He said Medicaid cost overruns are why we can't pay teachers more (and many other things, too -- he makes Medicaid the bogeyman that supposedly stands in the way of all the popular things that most people want in the budget).

It is indeed a phony issue. But my assertion remains that McCrony & Tillisberger will be riding this phony issue to deny benefits to people who need them, claim massive waste & fraud at DHHS and begin dismantling that department. They're already throwing some of the healthcare special interests under the bus.

"I will have a priority on building relationships with the minority caucus. I want to put substance behind those campaign speeches." -- Thom Tillis, Nov. 5, 2014

Letter from the N&O Monday: Unfit at DHHS

Unfit at DHHS

In 2010, as I and others reeled from the election results, I held out hope that a new legislature might bring a new transparency and an end to corruption as promised during the GOP campaigns for office in North Carolina. When the N.C. General Assembly convened, I met with leaders of the Legislative Oversight Committee on the Department of Health and Human Services still holding on to that hope.

I am no longer confident that positive change will happen in this huge and difficult-to-manage department of state government. Legislators have been told of the problems in DHHS. They ignore them. I hoped that the promised emphasis on customer service and efficiency was real and not just buzzwords.

Now I see that Dr. Aldona Wos simply is not competent to lead the department. I have no doubt she means well, but I watch the DHHS up close and personal. I find it not less chaotic, but more so. Her leadership style instills not confidence but fear. I had hoped it would not come to this, but Gov. Pat McCrory needs to stop defending her and take appropriate action.

(Note: I sent the N&O two versions of this letter. They chose to print this one. The recent revised version says "Gov. McCrory needs to stop defending Dr. Vos and send her packing."

Martha Brock

Unfit indeed

Thanks for sharing this.