Sep 122013



By Michael Abramowitz

Wednesday, September 11, 2013

The absence of a state policy on Medicaid reform is posing some clear challenges to Pitt County public health officials as the Oct. 1 start of public enrollment in health insurance expansion nears.

At Tuesday’s meeting of the county Board of Health, Public Health Director Dr. John Morrow told the board members that there still is not a lot of clarity about the state’s intentions for Medicaid reform. The N.C. General Assembly and Gov. Pat McCrory earlier this year rejected federal Medicaid expansion and chose not to participate in the insurance exchange process (more information about the insurance Marketplace and the Affordable Care Act is available at, the U.S. government’s official marketplace site).

The legislature’s decision leaves more than a half-million state residents without health insurance coverage, leaving public health officials faced with significant health care challenges and costs.

“It’s my understanding that (North Carolina) sent back millions of dollars to the federal government that would have helped public health agencies, the Department of Social Services and other like agencies work through this process,” Morrow said. “Because we decided not to participate in expansion, that money had to go back to Washington.”

McCrory has said Medicaid in North Carolina is broken and needs to be reformed, but he has not presented any alternatives. The General Assembly in the 2013-14 budget did not present any reforms, but directed state Medicaid officials to prepare a report and present it with specific recommendations to the legislative body when it reconvenes in March.

The challenge now for state health agencies is to figure out how to provide for people’s health care needs with very little resources, the county health director said. Morrow mentioned several grants, including one that could help put a couple more staff members working locally in the Community Care North Carolina network’s Access East provider.

“But that is regional, for a lot of counties, not just for Pitt County,” Morrow said.

The local federally qualified health center, the Bernstein Center, also is the recipient of a grant that will help them enroll some more patients, he said. Morrow has been meeting with officials at Vidant Medical Center and the Brody School of Medicine at East Carolina University, both of which are short on additional resources, he said. DSS also is stretching its resources to provide needed services to the local underserved population, he said.

Pitt County Social Services will not be serving as navigators or application counselors for people wishing to enroll in the new insurance marketplace, Morrow said. He was unsure if Vidant will provide online certification training for application counselors. Public health will not have staffing dedicated to enrollment, he said, adding that official assistance is not required.

“People can go online and do this (marketplace enrollment) without assistance,” Morrow said. “We’re looking at things like possibly having a kiosk in our waiting area where people can get enrolled online.”

Contact Michael Abramowitz at or

via The Daily Reflector.


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