Cuts to Medicaid reimbursements for adult care homes must remain blocked for now, a judge ruled Thursday, in a blow to Gov. Josh Stein\u2019s administration that could have broader implications in a political fight over Medicaid funding.<\/p>\n
The cuts had already been temporarily blocked; Thursday\u2019s decision extends that ruling until next week when a more permanent decision is expected on whether the state Department of Health and Human Services has the power to make the cuts at all. The administrative law judge hearing the case expressed skepticism of DHHS\u2019 legal arguments during a court hearing<\/a> earlier this week.<\/p>\n If a full ruling were to stand against DHHS, it would likely lead to similar legal challenges by other health care providers, seeking similar rulings as the adult care homes who sued in this case. Spokespeople for the department didn’t immediately respond to a request for comment Thursday.<\/p>\n Another similar lawsuit was filed this week by the North Carolina Medical Society, which represents doctors statewide, as well as a host of smaller trade groups representing others in the health care industry: Speech pathologists, addiction counselors, home health specialists and more.<\/p>\n The existing lawsuits, and the potential for more, raise questions about whether millions of North Carolinians will have health care after May \u2014 part of an ongoing political fight between the state\u2019s Democratic governor and Republican-led General Assembly.<\/p>\n Medicaid is underfunded by millions of dollars because the state legislature has failed to pass a new budget<\/a>. Lawmakers also haven\u2019t passed a standalone Medicaid bill<\/a> that would work in lieu of a comprehensive budget. Lacking a new budget, the program is operating at last year\u2019s levels. But health care costs have shot up since then, leaving a looming shortfall of hundreds of millions of dollars.<\/p>\n Medicaid \u2014 which provides health care coverage for 3 million North Carolinians \u2014 could run out of money in a few months, state health officials say, unless the legislature acts before then.<\/p>\n Some in the health care industry have shrugged off the state’s financial warnings, putting faith in the legislature to eventually get around to funding the program. In the meantime, the state has been reducing reimbursements to health care providers to guard against the shortfall. The cuts range from 3% to 10% for providers, depending on the type of health care they practice.\u00a0<\/p>\n In the meantime, they\u2019re seeking court rulings like the one Thursday, which will stop their losses in the short term. One of the biggest winners in Thursday\u2019s ruling in favor of the adult care homes is Hickory-based chain ALG Senior.<\/p>\n \u201cThe individuals who reside in our homes are more than residents, they are our family,\u201d Bryan Starnes, the company\u2019s chief financial officer, told WRAL in a statement. \u201cThey are seniors and adults with disabilities who rely on us for essential daily support, from a warm meal to a safe, dignified place to live. While these recent legal actions were not steps we wished to take, they are steps we must take to protect the well-being and stability of those in our care.\u201d<\/p>\n \t\t\t\t\t\tLooming 2026 deadline<\/p>\n During a hearing this week, a lawyer for the North Carolina Department of Health and Human Services told the judge that Medicaid could run out of money by May if DHHS is forced to stop its strategy of reducing payments to providers like ALG Senior.\u00a0<\/p>\n Running out of money for Medicaid could lead to the end of health care coverage for nearly one-third of the state\u2019s entire population.<\/p>\n \u201cI’m dismayed that the General Assembly refuses to do what they know they need to do,\u201d Stein told WRAL on Wednesday. \u201cThey agree that Medicaid doesn’t have enough money. \u2026 They were here in session, and they failed to do what they knew they needed to do, which is to fund Medicaid.\u201d<\/p>\n Stein said the situation could cause hospitals or doctors offices to shut down, leading to disastrous consequences for health outcomes and local economies \u2014 particularly in rural areas where higher percentages of residents are on Medicaid.<\/p>\n \u201cIf they’re not getting enough money to keep their doors open, and they have to shutter, all patients will suffer,\u201d Stein said. \u201cNot just Medicaid patients.\u201d<\/p>\n Demi Dowdy, a spokesperson for House Speaker Destin Hall, accused Stein of pushing the Medicaid cuts for political reasons, not out of fiscal necessity. “Governor Stein\u2019s politically motivated Medicaid cuts are not only unnecessary\u2014 they\u2019re hurting North Carolinians in need of care,” she said.<\/p>\n