Image of tools in doctor's office
Morgan / Flickr/Creative Commons

State health secretary Aldona Wos says North Carolina would likely need to change some of its Medicaid rules to expand the program under the Affordable Care Act. 

The health care law offered to pay for expanded Medicaid through 2016, but North Carolina was one of 24 states that rejected the expansion last year.  Gov. Pat McCrory said the state's Medicaid program was broken, and was not confident the federal government would cover the costs. 

But Wos says Medicaid is now more stable, and she plans to present the governor with options for expanding Medicaid. 

Aldona Vos, DHHS
North Carolina Department of Health and Human Services


North Carolina’s Medicaid program covers 1.7 million people at a cost of $14 billion per year.

The program for low-income and disabled residents has had a turbulent past. Last year, computer glitches created a long backlog of applications and payments for providers. And Medicaid has been a question mark in the budget, causing cost overruns for several years.

But health officials say the system is improving enough that the state could reconsider expanding Medicaid to half a million people who do not have health insurance.

DHHS Secretary Aldona Wos
Jessica Jones

North Carolina's Secretary of Health and Human Services spoke before a legislative committee Wednesday to explain organizational changes made in one of her divisions.

Secretary Aldona Wos explained the changes will help streamline the Division of Medical Assistance, which administers the state's Medicaid program. She also told legislators that a formerly enormous backlog in the IT system used to process Medicaid applications- called NC FAST- has been reduced by 81 percent. The Secretary says she expects the system to be caught up by the end of October.

Medicaid illustration: A Caduceus symbol and a dollar sign
Neff Conner / Flickr

North Carolina health officials say the state Medicaid program has a positive cash balance for the first time in years.

For years, the state health insurance for people who are poor or disabled has cost tax payers more than expected. We're talking hundreds of millions of dollars.

But that wasn't the case last year. Aldona Wos, the state secretary for Health and Human Services, says the Medicaid budget was in the black.

North Carolina will be missing out on $51 billion from Mediciad because they chose not to expand coverage.


Lawmakers in North Carolina decided to not to expand Medicaid under the Affordable Care Act. 

McCrory signs budget plan
Reema Khrais

Gov. Pat McCrory has signed into law the state’s $21.1 billion budget bill that was approved by the legislature last week.

The signing comes five weeks after the beginning of the fiscal year on July 1st, a deadline lawmakers did not meet because of stalled negotiations and debate largely over teacher pay and Medicaid funding. 

McCrory signed the 260-page budget deal on Thursday at the executive mansion, proudly noting that the spending plan includes raises for teachers and state employees, while not increasing taxes or making reductions in Medicaid eligibility.

Photo: The North Carolina seal in front of the state legislative building
Jorge Valencia

Gov. Pat McCrory has before him an annual spending plan for North Carolina, setting aside money to give public school teachers their first significant pay raise since 2008 - while cutting from public health, childhood development and other programs. McCrory has said he will sign the bill, and lawmakers said they have at least two other major pieces of legislation they will address this year. 

Gov. Pat McCrory

Governor Pat McCrory says he approves of the legislature's spending plan for state and will sign the bill.

The Senate already passed the $21 billion budget bill today and the House will likely approve it Saturday morning.

Governor Pat McCrory touted the budget proposal at a press conference on Friday.

“We've got a 2.2 percent increase in the general fund budget with no tax increase, with teacher pay raises, no elimination of teachers assistants and we've kept the integrity of our Medicaid, I'm proud of it,” he said.

NC Legislative Building
Dave DeWitt

After a 15-hour day at the legislature, Senators voted this morning to pass the $21.3 billion state spending plan. 

Senators didn't leave the legislative building until about 1 a.m. They were determined to make a final vote on the budget and wrap up any loose ends before heading home. 

But they'll be back soon enough. They're expected to return in a couple of weeks to take up any possible vetoes from the Governor. Then, they'll be back in November to pick up at least two bills they didn't finish. 

NC Legislative Building
Dave DeWitt

  After an extra month of negotiations, state lawmakers have agreed on a budget for the next fiscal year. 

The $21 billion proposal makes compromises between House and Senate leaders on teacher pay and Medicaid spending. But other issues outside of the budget remain. Lawmakers still have to consider a Medicaid reform bill, local sales taxes changes and environmental protection regulations.

Guest host Phoebe Judge talks with WUNC Capitol Bureau Chief Jessica Jones about the General Assembly’s short session.

photo of the North Carolina Senate
Government & Heritage Library, State Library of NC / Flickr

After spending a month dragging their feet on the state budget, lawmakers are now in a 48-hour race to wrap it up and go home. The $21.1 billion budget before them is a hefty 260-page document filled with hundreds of edits, figures and calculations.  But for many Republican lawmakers, including Sen. Harry Brown (R-Onslow), one item stands out.

“The priority of this session was education and, in particular, teacher pay,” Brown said.

NC Legislative Building
Dave DeWitt

 Nearly a month past their deadline, state leaders say they hope to release a final spending plan adjustment in the next couple of days.

Top negotiators haven't officially released any details yet, but they expect to give teachers average raises of about 7 percent. 

Photo: The North Carolina General Assembly's Legislative Building
Jorge Valencia

The state House and Senate are entering their fifth week of negotiations over the state’s $21 billion budget. The Senate is scheduled on Monday night to take on at least one other major piece of legislation and two bills intended to beef up policing in North Carolina.

Medicaid Overhaul

The point of this legislative session is for the General Assembly to make adjustments to the state’s budget. But talks are moving so slowly, that Senate leaders last week said they might as well take up an overhaul of the Medicaid system.

N.C. General Assembly, State Legislature
Dave DeWitt / WUNC

Lawmakers in the North Carolina Senate have proposed a plan that sheds more light on how they’d like to manage the state's Medicaid program. But it differs significantly from plans put forward by the House and by Governor Pat McCrory. The Senate’s proposal would allow hospital and doctor-led health plans to see Medicaid patients as well as managed care plans run by insurance companies.

General Assembly
Dave DeWitt

Leaders in the state Senate have offered an eight percent pay raise for teachers as they inch closer to putting together a budget.

Senate leaders unveiled their offer to House budget negotiators late Tuesday afternoon. Senators had previously wanted to give educators raises of 11 percent, but House leaders said such a large increase would require cutting too many other areas.

N.C. General Assembly, State Legislature
Dave DeWitt / WUNC

Republican lawmakers have been moving slowly on state budget negotiations. They finally reached a compromise Wednesday on how much revenue they will rely on from the state lottery. But that came after hours of finger-pointing and debate over other education issues, including teacher pay.

Before negotiations even began on Wednesday morning, the mood felt sour. Senate leaders weren’t happy that the House had invited school leaders to argue against cutting teacher assistant jobs. Senator Harry Brown objected before the guests could even make their way to the podium.

North Carolina State Legislature
Dave Crosby / Flickr

 After weeks of almost no budget talks, state lawmakers finally agreed to break their deadlock.  At a public conference committee meeting on Wednesday, they openly negotiated their adjustments to the two-year budget plan and seemingly resolved differences over Medicaid funding.

NC Legislative building
NC General Assembly


It’s a new fiscal year as of Tuesday, but the legislature has yet to reach an agreement on budget adjustments. 

The House and Senate are still at odds over how to spend money on education and Medicaid. 

Lawmakers are also trying to sort out a coal ash regulation bill, public records rules for charter schools, and higher penalties for prison inmates who get a hold of cell phones.

NC Legislative building
NC General Assembly

North Carolina lawmakers say they want to break the impasse on a state budget this week. But those aren’t the only bills on their docket.

Leaders in the Senate and the House have been talking about Common Core and Coal Ash since they started meeting in May.

The Senate wants to consider keeping parts of Common Core, the national academic standards for public school students. The House wants to completely replace them.

State Senate chamber
Dave DeWitt / WUNC

House and Senate leaders are not showing signs of meeting their July 1 deadline to make adjustments to the state's two-year budget. They're still deadlocked over differences in their spending plans.

Senate leaders call the House's budget plans unbalanced and unsustainable. They say a five percent pay raise for teachers is not enough. Senators are offering 11 percent by cutting back on teacher assistants.

NC Senate committee
Jessica Jones

Governor McCrory and leaders in the state House are trying to speed up budget negotiations, but without much success so far. They’ve introduced a bill that’s a kind of mini-budget to give teachers 5 percent raises in case House and Senate leaders can’t agree on a comprehensive spending plan. But the biggest sticking point in the negotiations is over Medicaid. Thursday morning, State Budget Director Art Pope appeared before a Senate Finance Committee to answer senators’ questions.

State Senate chamber
Dave DeWitt / WUNC

Senate and House leaders are expected to begin meeting in conference committees this week to make adjustments to the two-year budget plan. 

They have until June 30th to resolve differences and send their spending plan to Governor Pat McCrory.

Medicaid funding and teacher pay raises are expected to be the key sticking points in negotiations. But many Republicans, like Representative Craig Horn (R-Union), say they’re optimistic about the process.

The state’s Medicaid Reform Advisory Committee is comprised by Sen. Louis Pate, Dr. Richard Gilbert, Dennis Barry, Peggy Terhune and Rep. Nelson Dollar
Jorge Valencia

A committee in the state House of Representatives is recommending a plan to reform Medicaid insurance for people who are poor or disabled.

The proposal says a majority of Medicaid patients would be treated by providers who receive a fixed amount of money per patient.

The governor’s office shows support for the bill. Health and Human Services Secretary Aldona Wos praised it in a committee hearing Thursday.

"We are very pleased with the House bill that it closely aligns with Gov. McCrory's medicaid reform plan," Wos said.

Protesters gathered outside the Senate chamber to demonstrate against policies they say are regressive.

Nineteen Moral Monday protesters were arrested yesterday after demonstrating in the legislative building against budget proposals and policies passed by Republican-led General Assembly.

Dozens of protesters stomped, danced, and chanted at the very tops of their lungs, days after a superior court judge struck down new rules that prohibit loud activities and noises that would cause disturbances. The Wake County judge on Friday argued that the rules were unconstitutional, overly broad and vague.

photo of the North Carolina Senate
Government & Heritage Library, State Library of NC / Flickr

Senate leaders have released their proposed budget for the next fiscal year. They’re looking to spend about 21 billion dollars. Their plan would make substantial changes to the Medicaid program - and would scale back several state agencies, including the Department of Justice. Senate leaders also proposed hefty pay raises for public school teachers. 

For months now, Senate leaders have made it very clear that they want to give teachers pay raises. But they’ve been pretty coy about the details until this week.