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Public Policy Update: Tailored Plans, NC Budget, and Medicaid Expansion

Tailored Plans Delayed until October 1, 2023 

NC Department of Health and Human Services (NC DHHS) announced that the new Tailored Plans under Medicaid will be delayed again, this time until October 1, 2023. Citing concerns that people would have difficulties using primary care physicians and specialty health care services (“network adequacy”) and that other managed care claims and payments infrastructure was not yet operating as expected, the additional delay was announced on February 27th. Department officials outlined problems that led to the delay in their presentation to members of the NC General Assembly at the March 1 Health Committee meeting.  

In NC, these Tailored Plans would provide integrated physical health, behavioral care and developmental services to 143,000 people with significant health needs, including those with developmental disabilities. The NC General Assembly outlined requirements for North Carolina’s shift to Medicaid Managed Care in legislation passed in the 2015-2016 session [see H372 and S838].  

For more information on Tailored Plans, please visit ASNC’s page on Medicaid Transformation. 


NC Budget in Process 

North Carolina continues to have significant economic growth, and tax revenue is higher than expected. North Carolina General Assembly (NCGA) Appropriations committee chairs are discussing budget targets, and the NC House expects to have its budget completed before the legislative spring break the week of April 9th.   

Note that this year the NC House begins the budget process by developing their budget bill and passing it, before it then moves to the Senate who will develop their own version. Differences in the two budgets are then worked out in a legislative conference committee before being passed by both House and Senate and then sent to the Governor for signature or veto.  

ACTION: This is the time to contact your elected officials to advocate for you and your family members’ needs. ASNC has published its public policy priorities  which include greater access across disability services and education. More info on working with your elected officials can be found on our Make Your Voice Heard page. We encourage you to start by writing to your own NCGA members (be sure to use the maps for “NC House” and “NC Senate” to find them). Sharing your story is a powerful way to connect them to your experiences and advocate for more resources.  


Medicaid Expansion 

This week leaders of the NC House and Senate announced that they have reached a deal on moving Medicaid Expansion legislation forward. Earlier this year the NC House passed H76 Access to Healthcare  which would extend Medicaid coverage to single adults up to 133% of the Federal poverty level staring January 1 of 2024. H76 will use federal funding for 90% of the costs and the hospitals will cover the 10% additional funding that is needed. This funding model will not require any appropriations from our North Carolina general fund. H76 also includes provisions for some forgiveness of medical and nursing school debt intended to increase the practice of medicine in rural areas of NC.  

No new compromise bill has been released, however in their statements to the press, NC House and Senate leaders stated that the legislation will include some changes to the certificate of need for medical practices and would be “tied to the budget process.” Expanding Medicaid to people who fall into the health care coverage gap will bring in billions in additional funds that can be used to support better access to home and community based services for people with I/DD as well as provide coverage to low income adults with I/DD who did not meet the threshold for disability coverage.   

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