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Public Policy Update: Medicaid Expansion Bill Signed, House Budget Released, Make Your Voice Heard to Senate

Expansion Bill Passes, Signed by Governor: House Bill 76 Access to Healthcare Options was passed by the NC General Assembly March 23 and signed into law March 27. The bill would extend Medicaid benefits to people in the health care coverage gap, whose income is under 133% of the federal poverty levels and do not otherwise qualify for Medicaid, including some people on the autism spectrum and their families whose income levels excluded them from other affordable health care coverage including health care tax benefits on the health care marketplace.

Next steps: In order for the bill to go into effect, the 2023-2024 state budget must pass first. More information on the state budget is below. Once the state budget is enacted, state agencies will begin the work needed to implement a new program including operationalizing the new law (including getting new coverage approved by the federal government), leading outreach efforts to people who may be eligible, and ensuring local departments of social services are supported in making eligibility determinations. This last part is especially important: with the end of the federal public health emergency declaration, beginning April 1, Medicaid will start redetermination processes that have been on hold for the last three years.

If you think you might be eligible for expanded Medicaid, you can begin enrollment online at https://epass.nc.gov/ to see if you currently qualify for Medicaid benefits.

If you have Medicaid and have not gone through eligibility re-determination the last three years, you should update your contact information during Continuous Coverage Unwinding so you do not inadvertently lose coverage. More information can be found though NC DHHS.

What does this mean for people on the autism spectrum? Autistic people and their families who did not have health care coverage may be able to get health care though Medicaid when the new program starts.


NC House Introduces Budget Bill: The NC General Assembly (NCGA) has begun the process of passing a two-year state budget. House Bill 259, 2023 Appropriations Act, was introduced into NC House Appropriations Committees and amended on Thursday March 30. Legislators introduced and discussed over 50 amendments to the bill, some of which passed and will be included in a new version of the bill. The revised bill is expected to be voted on by the House next week, prior to the legislature’s anticipated Spring break the week of April 10. Once the House passes its version, the NC Senate will make changes to the bill. Differences between the House and Senate version of the budget are worked out in a conference committee before the final bill is passed.

As it stands, the House budget includes 250 Innovations waiver slots, funding to support DSP wage increases in Innovations waiver and ICF services, and funding for the Medicaid ‚Äúrebase‚ÄĚ and ongoing Medicaid Transformation, which supports new services like tailored care management and 1915i services. The budget also increases teacher and other school staff salaries, as well as funding for new I/DD programs at state universities.

Notably missing are the larger investments in waiver slots to address more than 16,000 people waiting for waiver services as well as the removal of the funding cap on special education and school funding reforms that we discussed by education committees during the session interim. NC is one of only six states which still has caps on the amount of special education funding for school districts.

Budget documents can be found on the lefthand side of the NCGA website. Note that these documents are broken out into several sections: Committee Reports, sometimes called a ‚Äúmoney report,‚ÄĚ are a department-by-department list of funds that are added or removed from the state budget. The Bill Text shows funding amounts in the budget, but also includes all the ‚Äúspecial provisions‚ÄĚ which determine policies about how funds are used. You can track the progress of the budget bill here: https://www.ncleg.gov/BillLookUp/2023/hb259

What does this mean for people on the spectrum? The budget bill includes some of the things that advocates have asked for, like better DSP wages, but it does not have many things that advocates asked for, like more waiver slots and more special education funding. People should contact their NC state Senators and ask for what they need to be put in the budget.


How can you share your voice?

Talk to or write your NC state Senators and Senate Appropriations Chairs. The NC Senate will consider the budget next and things are moving fast.

Email or call your NCGA Senators! Prepare a short statement using our Advocacy Tips Sheet or Advocacy 101 Toolkit. BE BRIEF, BE RESPECTFUL.

  • Introduce yourself and how you are connected to autism.
  • Talk about how a lack of services at home or in school is affecting you.
  • Tell them that the DSP wage increase needs to stay in the budget ‚Äď DSPs are critical for services!
  • Ask them to make other investments in people on the autism spectrum, like waiver slots, education funding, or ask for services and supports that you need.

The NCGA website will help you identify who represents you. Be sure to check the circles at the top of the map for ‚ÄúNC Senate‚ÄĚ to see who represents you in the NC General Assembly‚Äôs Senate.

In addition to your own NCGA Senator, please also contact the NCGA Senate Budget Chairs listed below to advocate for better investments in people on the autism spectrum, including more services and better education funding.



Senate Appropriations Chairs

Senator Ralph Hise representing Madison, McDowell, Mitchell, Polk, Rutherford, and Yancey

Office Phone: (919) 733-3460 Email: Ralph.Hise@ncleg.gov

Senator Brent Jackson representing Sampson, Duplin, and Johnston

Office Phone: (919) 733-5705 Email: Brent.Jackson@ncleg.gov

Senator Michael V. Lee representing New Hannover

Office Phone: (919) 715-2525 Email: Michael.Lee@ncleg.gov


HHS Appropriations Chairs

Senator Jim Burgin representing Harnett, Johnston and Lee

Office Phone: (919) 733-5748 Email: Jim.Burgin@ncleg.gov

Senator Kevin Corbin representing Cherokee, Clay, Graham, Haywood, Jackson, Macon, Swain, and Transylvania

Office Phone: (919) 733-5875 Email: Kevin.Corbin@ncleg.gov

Senator Joyce Krawiec representing Forsyth and Davie

Office Phone: (919) 733-7850 Email: Joyce.Krawiec@ncleg.gov


Education Appropriations Chairs

Senator Lisa S. Barnes representing Franklin, Nash, and Vance

Office Phone: (919) 715-3030 Email: Lisa.Barnes@ncleg.gov

Senator Amy S. Galey representing Alamance and Randolph

Office Phone: (919) 301-1446 Email: Amy.Galey@ncleg.gov

Senator Dean Proctor representing Caldwell and Catawba

Office Phone: (919) 733-5876 Email: Dean.Proctor@ncleg.gov


Please contact Jennifer Mahan, ASNC Director of Public Policy, jmahan@autismsociety-nc.org for assistance connecting with your elected officials and other questions about advocacy.

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