NC Medicaid cuts spur emotional testimony as GOP leaders decline to return

Republican lawmakers, who control North Carolina’s purse strings, declined to return Monday to take action on Medicaid cuts.

But medical providers showed up at the General Assembly to plead for relief, with several shedding tears as they described the effects of the cuts on employees, children and families.

They spoke at an unofficial hearing hosted by Sen. Natalie Murdock, a Durham Democrat, who was one of the few lawmakers visible in the Legislative Building that morning.

About 30 Senate and House Democrats spoke to the news media later Monday at the Legislative Building about the cuts and the delayed state budget, as well as federal Border Patrol actions and arrests in Charlotte.

“These cuts are affecting real lives today, children in early intervention, older adults, individuals with disabilities and families who rely on services to keep their loved ones healthy, stable and able to participate in their communities,” Murdock said.

She said some clinics in her district and across the state have gone more than 20 years without a rate increase while rent, wages and insurance costs climbed, leaving some providers unable to accept Medicaid at all and others preparing to lay off staff or shrink service areas.

When families can’t find a provider who will take their coverage, she said, “that is not just an inconvenience, that is a denial of medically necessary care.”

“These folks are going to have to come to the table. We just have to be so loud they cannot ignore the cries of the children,” she said.

GOP disagreement

She was referring to Republican lawmakers who rejected Democratic Gov. Josh Stein’s call for a special session to address the Medicaid shortfall and have so far been unable to agree on a deal to fund Medicaid.

At the core of their rejection — which came via a letter to Stein — is a disagreement on whether the governor can call them back when they are already in session, and if the occasion is in fact extraordinary, The News & Observer previously reported.

“If circumstances surrounding the Medicaid rebase are in fact extraordinary, it is only in the context of your administration’s failure to address them,” House Speaker Destin Hall and Senate Leader Phil Berger wrote in the letter, The N&O reported. The Republican leaders say Stein’s cuts were politically motivated and question why the reductions couldn’t have been delayed, pointing to funding not running out until next year. The state is facing a lawsuit against Medicaid cuts made to some autism care services. Stein has said that the state can’t put health care costs on a credit card and that the state’s spending must remain balanced.

Stein’s administration enacted Medicaid provider rate cuts of 3% to 10% on Oct. 1 after telling lawmakers it would do so without additional funding to cover a projected shortfall. Cuts are across the board, impacting hospitals, nursing homes, community based services and more. Lawmakers approved $600 million for Medicaid in July, but state health officials say the amount falls short of what’s needed through June 2026 and that reserves could run out as early as April 2026 without further action.

Republican lawmakers, who control both legislative chambers, agree some more funding is needed but the Senate wants a bill that includes money for a children’s hospital, while the House supports one that does not. That dispute is also wrapped up in the stalled budget negotiations. North Carolina is now the only state in the nation that has not passed a budget this year. GOP leaders have signaled they may not return until next year.

Providers speak on Medicaid cuts impact

“I’m going to get emotional,” Stephanie Molina, a speech therapist with KM Pediatric Therapy Inc. said Monday at the gathering of providers, “because I’m here to represent my team of speech therapists and occupational therapists, the children that we serve every day diligently, the families who do not have a voice.”

She said they serve children in Durham, Johnston and Wake counties, providing therapy in homes, day cares, preschools and other settings. They work with children with autism, Down syndrome, cerebral palsy, Angelman syndrome, neurological conditions and rare genetic disorders “that don’t even have a name.”

“These are not elective therapies,” she said. “These are critical therapies that teach life skills that will not develop naturally because the children have underlying medical conditions that they did not ask for.”

Molina said providers at KM Pediatric are “at a breaking point,” noting that they have not received a reimbursement rate increase in 20 years and now face an additional 3% cut. “We cannot continue to bear the burden,” she said, adding that about 70% of the children they see are on Medicaid. Without relief, she said, they will be forced to reduce treatment frequency and duration and limit the number of Medicaid patients they can take.

“I am not naive. I know that politically there are things going on behind the scenes that are bigger than me sitting here today,” she said. “But my God — what could be more important than this, helping the children who are the most vulnerable?”

Molina said she was at the legislature during the last brief session in late October — one of only a few short return days lawmakers scheduled after ending their long session without a budget deal.

She said she was joined by about 30 colleagues. Lawmakers met with them, shook their hands, took photos and said they understood, she said. But instead of taking up the issue, they “chose to discuss and vote on the redistricting maps,” she said.

Parents shared similar fears. Tina Sherman, with MomsRising — a grassroots organization advocating on issues affecting women, mothers, and families — read a series of accounts from families across the state who rely on Medicaid:

–One Raleigh single mother said the program allows her and her child to “keep our head above water” as she juggles multiple jobs.

–A man in Asheville said Medicaid has kept him in a skilled nursing facility for two years after a massive stroke that he was expected to survive only by days.

–Another parent in Gibsonville said Medicaid enables her adult son with cerebral palsy, intellectual disability, autism and bipolar disorder to live in the community.

–A Cary mother said Medicaid is the only way her son — left with permanent heart damage from a virus contracted at school — can afford lifelong medication.

Sherman said families are already seeing doctors refuse Medicaid patients.

Tildsley Clifford McManus with Therapy Smarts Inc. in Durham and Chapel Hill, said she grew up watching her father fight insurance companies on behalf of patients at his independent pharmacy in Lee County. “Those memories shaped me and taught me that behind every policy decision and every reimbursement code … there is a real human, often a child, waiting for help,” McManus said.

McManus said she is “a proud Republican” but is “deeply concerned because where the state stands does not reflect the values that I support.”

Democratic action and Republicans' response

Murdock said Democrats would hand-deliver testimony from Monday, and more that her office has received, to lawmakers, federal officials and others. She also said they’d be holding several other hearings and events to keep the focus on the cuts.

As Democrats who came to the legislature spoke to the media, House Minority Leader Robert Reives said his party was “ready to work,” pointing to several Democrats who had traveled as much as four hours to get to the Legislative Building.

He criticized Republican leaders for not returning, saying the inaction reflects personal priorities rather than the needs of North Carolinians.

“If their offices were closed, if their sources of income were gone, if their ability to care for their families was taken away, I promise you we’d all be sitting in here right now. It’s easy to take a principled stand on somebody else’s money.”

Referring to Berger and Hall, Senate Minority Leader Sydney Batch said “last time I checked, two people were not able and should not be able to stop all of the legislation that happens in this building. But that’s exactly what’s happening.”

Demi Dowdy, a spokesperson for Hall, said Democrats were trying “to play politics with people’s health care, using fear to mislead the millions of North Carolinians who rely on Medicaid.”

“It’s time for Gov. Stein to stop playing politics and end all rate cuts, given that the General Assembly will add more funding in due course,” Dowdy said in a statement.

Lauren Horsch with Berger’s office said Senate Republicans attempted to pass Medicaid funding earlier this year and have since the beginning of the session “made addressing the cost of health care a priority, including tackling faciilty fees, surprise billing,” and more.

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