(The Center Square) – Officials with the North Carolina Department of Health and Human Services on Tuesday will update lawmakers on Medicaid enrollment as they work to expand coverage.
Department Secretary Kody Kinsley along with Adam Levinson and Jay Ludlam will address the Joint Legislative Oversight Committee on Medicaid to provide a variety of updates. Levinson is the department’s chief financial officer, and Ludlam is secretary for North Carolina Medicaid.
Following comments from Kinsley, Levinson is expected to discuss enrollment and financials, followed by Ludlam’s presentations on Medicaid transformation and a North Carolina Health Works update. Mark Collins, fiscal analyst with the General Assembly’s Fiscal Research Division, will also discuss state savings from adding North Carolina Health Works Medicaid coverage.
Committee co-chairmen Donny Lambeth, R-Forsyth, and Larry Potts, R-Davidson, from the House of Representatives declined to discuss the upcoming hearing. Officials at the Health Department responded to The Center Square’s request for comment with a link to a committee website. Messages left with co-chairman Sen. Jim Burgin, R-Harnett, of the Senate and Collins were not returned prior to publication.
“Prefer not to comment on the agenda before I hear the presentation made by DHHS,” Potts wrote in an email.
Kinsey noted in late January that since the state launched Medicaid expansion on Dec. 1, it has covered more than 150,000 prescriptions for new enrollees and more than $2.5 million in claims for dental services. Kinsey, Gov. Roy Cooper, and Republicans in the General Assembly have touted the benefits for those now taking advantage of the government health insurance.
“We can already see the important impact expansion has on improving the health and lives of North Carolinians,” Kinsey said in a January statement. “They are our neighbors, child care specialists, construction workers, veterans, loved ones struggling with behavioral health challenges or substance use, and so many others.”
The department’s Medicaid Expansion Dashboard shows 314,101 North Carolinians enrolled in Medicaid between Dec. 1 and Jan. 12, including 272,937 enrolled on Day 1. While 75% (235,313) of those enrolled live in urban areas and 25% (78,788) in rural areas, the percentage of rural enrollees exceeds the proportion of North Carolinians between the ages of 19 and 64 who live in rural areas.
Counties with the highest proportions of adults enrolled include Robeson (11.9%), Edgecombe (10.9%) and Richmond (9.6%). About 56% of those who have enrolled are women, 32% are between the ages of 19 and 29, 25% are 30-39, 19.5% are 40-49, 16.6% are 50-59, and 6.8% are between 60 and 64.
The expansion comes as North Carolina is working through Medicaid eligibility reviews following a continuous coverage requirement during the pandemic that has since expired. Since the unwinding began in June, the state has removed 196,198 from the rolls through December. The pace of those removed has been cut in half since Medicaid expansion, which the Medicaid Continuous Coverage Unwinding Dashboard notes “is a contributing factor to the overall decrease in terminations.”
The state had completed about 1.1 million renewals through the end of 2023, out of about 2.6 million to review.
While Ludlam said in a recent statement the department is “excited” to continue efforts to increase enrollments in Medicaid – pointing to 1,000 community members recently trained by the department to help sign people up – others continue to sound the alarm about how expansion impacts those who need coverage the most.
“While much of the discussion surrounding Medicaid expansion has focused on boosting enrollment, too little emphasis has been placed on access to actual care,” Mitch Kokai, senior political analyst at the John Locke Foundation, told The Center Square. “It’s one thing to say 300,000 or 400,000 more people effectively have a new insurance card.
“That’s not the same thing as saying those people are actually going to be able to see a health care provider. Nor have we seen good answers to the questions about new enrollees crowding out services for the traditional Medicaid population, who tend to have fewer resources and greater needs.”
