North Carolina Democrats didn't get the broad Medicaid expansion they hoped for in the state budget.
Still, the government program that provides health insurance to needy families did see expansions in some areas, including a significant expansion in a program that finances support for families with children with intellectual and developmental disabilities.
Called the Innovations Waiver, it's a program within Medicaid offers benefits for in-home or community based care, like speech or behavioral therapies, to families with children with disabilities. It's a program that offers generous benefits to families, but one that doesn't have enough funding to support all the families in need. The budget calls for an expansion of 1,000 new additions in to the program, which N.C. Department of Health and Human Services deputy secretary for Medicaid Dave Richard called significant.
"1,000 slots is a big deal," he said.
What's more, there could be more increases to come. The budget calls for the Division of Health Benefits to add another 1,000 slots by 2025.
"I think it shows legislative intent," Richard said. "A desire to really address this issue over multiple years, which is really important."
Equally important to expanding the slots, according to Richard, is a wage increase for in-home care workers. Already, the state faces a shortage of as many as 20,000 nurses in the coming decade. Finding qualified workers could prove a challenge.
"Having increased wages will go a long way and be able to find more workers," Richard said.
Even with this significant expansion, it won't clear the backlog of families who need help. There are fewer than 13,000 slots in the Innovations Waiver program, a number that has been relatively unchanged for years. Meanwhile, the need has steadily increased, from fewer than 21,000 families in 2014 to more than 28,000 this year.
Those who qualify for help must sit on a waitlist, sometimes for years, before funding comes available. Even with the additional slots, more than 10,000 families will remain on that waitlist.
Richard hopes the program will continue to be expanded in the future. Disabilities hit families of all political stripes, so finding common ground is possible.
"This is an issue in which Republicans and Democrats believe that these services should be in place for families," he said. "So you can get that kind of coalescing around these issues."