RALEIGH — Leaders at the General Assembly have rejected North Carolina Gov. Josh Stein’s request to hold a special extra session on Nov. 17 to deal with Medicaid rebase funding.
Medicaid rebase funding adjusts monthly payments made to managed care organizations to account for enrollment changes, costs and federal match rates.
House Speaker Destin Hall (R-Granite Falls) and Senate Leader Phil Berger (R-Eden) rejected Stein’s call for a special extra session on Thursday in a joint letter to Stein informing him of their position.
The letter says Stein’s request fails “to follow the requirements of the Constitution. Article III, Section 5(7) authorizes a governor to convene the General Assembly in ‘extra session’ only ‘on extraordinary occasions.’”
“The General Assembly is already in session,” the lawmakers wrote. “Your Proclamation is therefore ineffective and functions as an unconstitutional attempt to usurp the General Assembly’s authority to set its calendar.”
“With this call for an extra session, Gov. Stein is trying to shift blame from his self-created crisis” Hall said in a press release. “He can and should simply stop all Medicaid cuts since the legislature will be back this spring with more than enough time to add additional funds if needed.”
Stein’s extra session order, issued last Friday, noted that the General Assembly isn’t scheduled to take any more votes this session.
“The North Carolina House will not tolerate political games being played at the expense of people’s health and access to care,” said Hall. “That’s why the House has acted responsibly by passing three clean bills to fund the rebase and protect North Carolinians.”
A separate press release by Berger also called Stein’s request “a self-inflicted crisis.”
“Gov. Stein’s call is not extraordinary,” Berger’s press release reads. “This is a self-inflicted ‘crisis’ that was entirely avoidable. All Gov. Stein and the Department of Health and Human Services Secretary had to do was pause their Medicaid reimbursement rate cuts.”
Berger’s statement also said, “Instead of political gamesmanship, Gov. Stein should be working with his agency to get its financial house in order.”
The Senate leader’s press release explains that the General Assembly’s nonpartisan fiscal analysts found that the Department of Health and Human Services (NCDHHS) routinely reverts and carries forward funds at fiscal year-end, and last year, NCDHHS reverted $110 million to the general fund and carried forward $243 million, including $166 million from Medicaid, which remains eligible for the next year’s use.
The General Assembly allocated $600 million for Medicaid rebasing in House Bill 125, but Berger’s statement says that NCDHHS diverted $100 million to administrative costs rather than services and that NCDHHS’s secretary admitted the existing funding suffices for uninterrupted Medicaid operations through April 2026.
Berger says NCDHHS now seeks an additional $190 million — about 2% of the $23 billion total estimated Medicaid spending, including federal funds.
The governor’s March budget called for $700 million to fund the rebase, but a later estimate from the NCDHHS and the Office of Budget and Management came in at $819 million. Stein informed lawmakers of the revised increase on Aug. 11.
On Sept. 25, NCDHHS announced it would cut provider rates by at least 3% beginning Oct. 1, with some services facing up to 10% reductions.
Both chambers of the General Assembly passed bills to address additional Medicaid rebase funding in mid to late September, but neither chamber has passed the other’s legislation to send to Stein.
