NC House’s “Mini Budget” Omits Crucial Healthy Opportunities Funding
Understanding the Context
On June 25, 2025, the North Carolina House of Representatives made headlines by passing a “mini budget,” a move closely following the Senate’s stopgap spending proposal. This plan aims to ensure state operations continue smoothly until lawmakers can overcome a contentious budget impasse. However, the House’s version has sparked significant conversation due to its glaring omission of funds for the Healthy Opportunities Pilot, a Medicaid initiative crucial for addressing the nonmedical health needs of low-income North Carolinians.
The Stalled Budget Negotiations
As the clock ticks down to the new fiscal year on July 1, it appears increasingly likely that state legislators may depart Raleigh without a comprehensive budget agreement. This delay has left the House and Senate at odds over their respective mini budget proposals.
House Speaker Destin Hall (R-Granite Falls) expressed skepticism, stating the House would not conform to the Senate’s approach. “It sort of creeps into trying to get as close to a comprehensive budget as possible without having one,” he remarked.
Senate Leader Phil Berger (R-Eden) countered that a budget, in any form, is unlikely to pass immediately.
Key Features of the House’s Mini Budget
The House’s more focused spending plan, as outlined in House Bill 192 and Senate Bill 177, addresses only the essentials for the upcoming month. This includes modest adjustments to Medicaid funding and plans to eliminate 20% of vacant state government positions. Importantly, the budget proposes a 6.4% salary increase for public school teachers, along with a 2.5% raise for state employees.
However, the glaring absence of funding for the Healthy Opportunities Pilot remains a contentious issue. Although the program has shown promise—reportedly saving up to $1,020 per year for participating Medicaid beneficiaries—Rep. Donny Lambeth (R-Winston Salem) argued that the savings do not outweigh costs.
Despite attempts to include pilot funding in the House appropriations committee by Rep. Lindsey Prather (D-Candler), the amendment failed to gain traction.
Funding Tweaks for Medicaid and Others
The House’s mini budget designates $500 million for Medicaid rebasing, supporting healthcare for over 3 million low-income North Carolinians. While this amount mirrors the House’s full budget proposal, it’s $200 million short of what state health officials project is necessary for the upcoming year.
This discussion comes at a precarious time, as Congress is currently deliberating future federal funding levels for Medicaid, leaving projections for subsequent years in a state of uncertainty.
Additionally, the budget proposes a roughly $18 million cut to the state-authorized regional mental health services management organizations (LME-MCOs), which provide essential services for underinsured individuals with mental health challenges. It’s vital that these organizations continue to receive adequate funding to support communities in need.
Other notable measures include offsetting a $7 million state fund reduction for child care subsidies with federal block grant funding, allowing low-income families to access necessary child care services.
Cuts That Raise Red Flags
Among the most concerning elements of the mini budget is the elimination of funding for the Medically Assisted Treatment in Jails grant program. This program is integral in offering treatment for individuals with opioid use disorders while incarcerated. The potential consequences are dire; research suggests that individuals released from incarceration without access to treatment are 40 times more likely to die from an opioid overdose within two weeks of discharge.
Moreover, another reduction of $8 million in state dollars to the Department of Health and Human Services (DHHS) will be balanced out by a settlement received from Johnson & Johnson. This settlement pertains to the company’s deceptive marketing practices concerning talcum powder.
Conclusion: What Lies Ahead?
As the North Carolina House and Senate grapple with their mini budget visions, the absence of essential funding for the Healthy Opportunities Pilot and significant cuts to health programs raise alarms. The likelihood that neither budget will gain legal stature means spending levels will remain stagnant, further complicating the state’s ability to meet the needs of its most vulnerable residents.
In these turbulent financial times, it is crucial for constituents to stay informed and advocate for policies that prioritize health, safety, and well-being. To learn more about North Carolina’s budget and its impact on public health, visit North Carolina Health News.
