Smith expresses concern over Medicaid cuts

The original deadline for Medicaid cuts, reduction to services and an increase in reporting requirements seemed like a lifetime away to many when HR-1, aka “The Big Beautiful Bill” was passed in 2025, however the deadline is now fast approaching.

While most of the changes are not scheduled to be policy until Jan.1, 2027, Aug. 1 is the effective date of loss of coverage for the first group of enrollees who lose coverage due to work requirements.

On Oct. 1, the restrictions will be expanded and new immigration-related eligibility restrictions to Medicaid take effect eliminating federal funding for coverage provided to anyone who does not fall into a very narrow group defined by law, according to the Center on Budget and Policy Priorities. Making matters more difficult for many, the federal matching rate is significantly reduced for Medicaid.

These points were discussed last week during a meeting attended by Martin County Commissioner Ronnie Smith and representatives from the N.C. Department of Health and Human Services.

Smith shared information from the meeting troubling many officials in Raleigh. The renewal change from one year to six-months is causing havoc in many departments across the state, according to Smith.

“I sat in a meeting the other day and they offered numbers that were very disturbing. They talked about the increase going from one year, renewal to six months, and just in Raleigh, in Wake County, they have just hired and training 25 new people, just to handle this change.”

Smith raised the red flag citing other alarming numbers and wanted to make sure the county was ready for the onslaught of citizen’s needs and requests.

“On 1 January, they’ll be looking at every individual that is on Medicaid, and not only that, there are so many other requirements that’s gonna go along with that, I’m afraid that if we, on this board, are not aware of what’s gonna happen, come in January we may be, you know, surprised,” said Smith. “I would like for the director or representative to come and present this to know what their requirements would be and what the needs are, so we can address that before 1 January.”

Martin County Manager Drew Batts agreed with Smith that steps need to be taken to be proactive to the situation.

“So a little bit of feedback on that subject, for the last three months, we have been looking at that and we’ve been dealing with the state and some other things. And right now, NCDHHS (N.C. Department of Health and Human Services), said they do not have a real grasp on exactly how that’s going to affect the counties,” said Batts. “The county and the state were working together so we were kind of working hand in hand as they attempt to figure it out.”

Smith acknowledged Batts’ work on the problem and stressed the results after January could be overwhelming for county DSS staff.

“That’s the reason why I brought it up when I did, because the information I received, in the session I sat in the night before last, came directly from human services. I was pretty much as well aware as some of the other colleagues that were sitting in there, surprised that Department of Social Services did not have the answers, but the federal government’s gonna push forward.”

Smith encouraged preparedness.

“We have none and the state has no control over this process. It became law in July of 2025. North Carolina, along with some other states, have been pushing back, pushing back, asking for a waiver to give us a little more time. But, it’s already been etched in stone one, October this thing will begin,” said Smith.

Batts agreed that steps need to be taken to ready the department for the upcoming increase in service requests. A report on the department’s plan will be scheduled for a future commissioner’s meeting.