Medicaid stalemate threatens Burke health care

Time is running out in Raleigh, and the consequences will ripple all the way to Burke County.

With a looming Oct. 1 deadline, state lawmakers must act or face steep cuts to Medicaid provider rates. At risk are rural hospitals under strain, service reductions, layoffs, and a weaker safety net for low-income and elderly residents across western North Carolina.

UNC Health Blue Ridge CEO Gary Paxson has cited potential looming Medicare funding cuts, along with rising insurance costs, as a critical challenge to the impact of providing comprehensive health care to Burke County residents. The hospital, like rural hospitals statewide, depends heavily on Medicaid and Medicare reimbursements to offset costs.

Earlier this week, the North Carolina Senate and House each passed competing Medicaid funding bills — both promising a “rebase” of about $690 million to maintain existing services and providers. But neither chamber would accept the other’s version, dragging the state past the DHHS cutoff. If no agreement is reached before Oct. 1, provider rates could be slashed by 3% to 10%, with some services dropped altogether.

Republican leaders in both chambers blame each other — and the Democratic governor Josh Stein — for failing to shift the DHHS deadline. But whoever bears responsibility, the result is the same: the pressure will land on rural hospitals, providers, and the communities they serve.

House Speaker Destin Hall, R-Caldwell, and his colleagues fault Senate leaders for pushing through a Medicaid bill they knew would face opposition in the House, then leaving town without further negotiations. Hall also serves as attorney for the Burke County Commissioners.

In Burke County and neighboring rural communities, Medicaid and Medicare together form the financial backbone of much of the local health care infrastructure. According to Burke’s 2022 Community Health Assessment, local medical systems support nearly 1,500 full- and part-time jobs and provide a broad spectrum of care across primary care and specialty services.

While trading political barbs, Republican leaders shifted blame to Democratic Gov. Josh Stein, arguing he should have pressed DHHS to extend the deadline for Medicaid funding. Regardless of the finger-pointing, the reality is the same: provider rate cuts are imminent, and North Carolinians will bear the impact.