Quote:

---

On July 1, NC Medicaid moved the way it pays doctors and hospitals to care for Medicaid patients to a new system. Over the last three weeks, many health care practices have experienced major problems with not getting paid. I have heard of medical practices who haven’t been paid for a month of claims, who have had to take out $400,000 short term loans to keep operating and who, at this point, are literally about to go out of business. Clearly Governor Pat McCrory and his Department of Health and Human Services Secretary Aldona Wos are failing the first test of their plans to make big changes in our Medicaid system.

North Carolina’s Medicaid program – health and elder care coverage for low income people – has been tops on Governor McCrory’s list for changing what he has repeatedly called a “broken system” ever since he came into office. This is the same Medicaid system that US Sen. Richard Burr presented a national award to earlier this year for NC’s outstanding Medicaid “quality and efficiency” while posting the lowest cost growth in the nation.

Nevertheless McCrory used the “broken system” excuse to turn down billions of dollars in federal money available to expand Medicaid to adults in low-income working families under the Affordable Care Act. McCrory and other leaders also trumpeted again and again the fact that the General Assembly and outgoing Democratic Governor Perdue last year had not projected the Medicaid budget accurately enough and so had to make up the difference with additional money. Blaming the previous administration for perceived current problems became an article of faith. However, after a few months in office, that narrative began to lose steam for Governor McCrory. A closer look at NC Medicaid over the last few years shows low cost growth and budget increases that, given the recession and NC’s growing population, should have been entirely predictable. And once you’ve been in office a while its hard to blame the previous occupants for everything.
- See more at: http://pulse.ncpolicywatch.org/2013/07/23/big-problems-governor-mccror
ys-plan-to-run-nc-medicaid-like-a-business-means-some-health-care-providers-may-go-out-of-business/#sthash.wBS0C9XZ.dpuf

---

Quote:

---

So far this General Assembly session, lawmakers have rejected an expansion of Medicaid, cut unemployment benefits, and they're in the process of enacting tax reform that would lower personal and corporate income tax rates while raising and expanding sales tax. http://wunc.org/post/groups-tackles-intractable-north-carolina-poverty
-problem]

---

Quote:

---

A just released audit of the North Carolina Department of Health and Human Services found the agency wasted tens of thousands of taxpayer dollars.

The audit covers the parts of the department that get federal money, and suggested general mismanagement largely across the board.

"We have not been very accountable for the money that we spent," said DHHS Secretary Dr. Aldona Wos in January after a scathing audit ripped parts of the state's Medicaid program.

Now, there's another tough review. An audit of federal money that goes through DHHS showed often costly mismanagement. It's riddled with sections where "costs exceed $10,000."

It frequently mentions overdraws and underdraws -- sometimes well into the hundreds of thousands of dollars. In one case, there was an overdraw of more than $8.5 million.

It looks at foster care in North Carolina and said it went unmonitored in nine counties for at least three years.

The audit includes responses from the agency. In most cases, it says Wos agrees with the findings and promises change. Wood said what's really frustrating is that many of the problems have been pointed out before and keep happening. More at http://abclocal.go.com/wtvd/story?section=news/local&id=9058862]

---

Quote:

---

‘The North Carolina way’ takes a sharp right turn

RALEIGH Call it the big shift – a sharp right pivot by North Carolina state government in spending priorities, taxes, social policies and even in tone.

Not since the 1930s, when North Carolina was staggered by the Great Depression, has a legislature performed such radical surgery on the state’s body politic. This legislature moved to a flat tax and away from a graduated income tax first enacted in 1921, cut unemployment benefits to 1951 levels, turned down federal health insurance for the poor and made voting more difficult.

The changes were so stark they precipitated a social movement, with the kind of weekly mass demonstrations and civil disobedience usually reserved for causes such as civil rights or national independence. The unrest focused unwanted national attention on North Carolina, a state that has long prided itself on its level-headed moderation.

For generations, North Carolina tended to walk a middle path, spending more on roads, universities and culture, and later on community colleges and research parks, as a way to modernize. Often called “the North Carolina way,” the approach was backed by the state’s forward-looking business leadership as an alternative to the low-tax, low-regulation strategies of much of the rest of the South.

At the same time, the state had its conservative ways: anti-union, Bible-Belt traditionalism on social issues and, of course, support for segregation during its time.

“North Carolina has taken pride and sold itself as a progressive state, by which it means pro-business, pro-education, moderate,” said historian Karl Campbell of Appalachian State University, a biographer of Sen. Sam Ervin Jr. and Gov. Luther Hodges.

“That self-image has been rejected by this legislature,” Campbell said. “It seems that our leadership is turning now toward following (conservative) Southern trends, whereas in the past North Carolina tended to boast that it was leading in new directions. That is different in the state leadership’s self-perception.”

At one time, other creative Southern governors – from Bill Clinton of Arkansas to William Winter of Mississippi – beat a path to North Carolina to learn about the newest policy innovations. Now the conversation in Raleigh has flipped. It is focused on how North Carolina can catch up to its neighbors by having the lowest taxes and the fewest regulations. North Carolina has moved from being a regional leader to a follower.

Moderates vanished

The big shift was precipitated by Republicans taking control of both the legislature and the governor’s office for the first time since 1899. It is a more conservative Republican Party than it was even a generation or so ago.

Campbell said there are some striking differences between how North Carolina’s leaders responded to economic problems in the 1950s and today. In the 1950s, the problem was that North Carolina had the lowest industrial wages in the country. Today, North Carolina’s problem is that it has the fifth-highest unemployment rate in the nation because many of those 1950s-era plants have closed.

Hodges, governor from 1954 to 1961, was a conservative textile executive who wanted to stimulate the economy. He pushed a cut in corporate income taxes through a conservative Democratic legislature. But Hodges also got the minimum wage increased, started the industrial education centers that would morph into the community college system and began laying the groundwork for what would become Research Triangle Park.

In this legislature, there was not even a pretense of trying to provide political balance, Campbell said. Lawmakers just pushed through corporate and personal income tax cuts. Campbell called it “monotone” public policy. More at: http://www.charlotteobserver.com/2013/07/27/4195547/the-north-carolina
-way-takes-a.html#storylink=cpy

---