medicaid_bill1RALEIGH—State lawmakers say there is still a long road ahead before leaders agree on Medicaid reform.

With only a few days left for lawmakers to file bills for this two year legislative session, there have been many proposals on what to do about Medicaid. When lawmakers began the 2015 legislative session, there was general agreement that finding answer for Medicaid reform was amongst the top priorities.

“Every year you continue to see the Medicaid program grow and grow and it is like Pac Man. It is eating away at the dollars that are available to spend on the entire budget. So we have fewer dollars to spend on education, transportation, economic development, justice and public safety. And it is all getting fed to feed the Medicaid beast,” said Rep. Justin Burr, a Stanly County Republican.

The idea of reform is still prevalent, but so are the number of ways lawmakers are looking to solve the issue.

Medicaid helps provide health care for over a million low-income folks, as well as people with disabilities. For years, there have been cost overruns in the hundreds of millions of dollars in the program.

Those overruns have been essentially controlled in recent years, but lawmakers say they still need a way to stop the escalating costs of the program.

One idea is to use ACO’s, or provider-led networks, to manage the costs.

“The provider community, the hospitals, the physicians, the specialists, various therapists are really on board with helping to take responsibility for how we manage the care of our patients. And that’s the type of legislation we want to see in the house moving forward,” said Rep. Nelson Dollar, a Wake County Republican.

But other bills suggest using MCO’s, or commercially-run managed care companies. That idea is more in line with what many Senate leaders have expressed. Other proposals say the state should combine the ideas.

“Where you have the ACO, which would be the providers, and the MCO, the managed care companies, both competing in North Carolina to manage our medicaid population and hope us one make the patients healthier and two control the cost,” said Rep. Burr.

The disagreement over Medicaid is one of the causes of last years long session. On both the House and Senate sides, multiple bills have been put forward-but lawmakers say they are still optimistic a compromise can be found.

None of the Medicaid bills have been scheduled for hearings yet. Legislative leaders say work on finding a compromise for Medicaid will continue as they work to write North Carolina’s next two-year spending plan.

– Loretta Boniti