Franklin – Dr. Matt Corbin is a Franklin-based dentist who struggles to provide dental care for low-income patients on Medicaid, while some other health-care providers have simply given up.
Corbin – son of N.C. Sen. Kevin Corbin (R-Franklin) – said the 34% Medicaid reimbursement his practice receives doesn’t cover the basic costs of seeing a Medicaid patient. With more and more medical providers dropping Medicaid patients, it puts strain on individuals as well as emergency care providers.
People who forego preventative treatment – whether dental or medical – often wind up having more severe health problems later on, then wind up seeking treatment in hospital emergency departments, he said.
Deferred dental care leads to poor oral health and a host of other problems including heart disease and other systemic health issues. Corbin said he is happy to continue seeing Medicaid patients if only the reimbursement rate was high enough to cover his costs.
The Cherokee Scout’s interview of Corbin was held in May. Today, the situation appears worse.
The N.C. Department of Health & Human Services plans to cut Medicaid rates for all providers by 3% effective Oct. 1, with some areas of care like inpatient and residential services and research-based therapy for autism receiving up to 10% rate reductions – for a total of roughly $320 million in cuts.
Updated projections were reported to the General Assembly for the state fiscal year 2025-26 Medicaid rebase – the funding needed to maintain services and provider payments.
“The rebase need is now $819 million, an increase from the $700 million in the governor’s budget, which was developed based on older data from January,” Dr. Devdutta Sangvai, secretary of Health & Human Services, said in a letter to legislators. “We also noted that without full funding for the rebase, we would have to make cuts to the Medicaid program.
“On July 30, the N.C. General Assembly passed H125, which includes $600 million for both the Medicaid rebase and the Medicaid Oversight Fund. Given the program’s administrative requirements, this appropriation results in only $500 million for the rebase, leaving a $319 million shortfall.”
The full impact to North Carolina health-care providers will be substantially larger than the lost state dollars, as that reduction also means a corresponding loss in federal matching funds, Sangvai said.
The Medicaid rebase has fallen short in recent years, but the state was able to compensate for that underfunding by using federal COVID-19 and other funding. However, those funds and options are no longer available.
“The current underfunding of the Medicaid rebase by the General Assembly requires painful cuts to Medicaid. By the end of this month, NCDHHS will begin to cut $319 million from Medicaid by implementing rate reductions of 3% across all providers, as well as rate reductions of 8% or 10% for select providers, and elimination of certain services altogether – all with an effective date of Oct. 1, 2025,” Sangvai said.
“These reductions carry serious and far-reaching consequences. Most immediately, reduced rates and the elimination of services could drive providers out of the Medicaid program, threatening access to care for those who need it most.”
To meet an effective date of Oct. 1, the department must begin several administrative steps earlier, including notifying providers and beneficiaries, updating contracts and systems, and informing our federal partners at the Centers for Medicare & Medicaid Services.
“We have attempted to make these cuts reversible in the event that additional funding is approved,” he said. “Absent additional appropriations by the General Assembly; however, NCDHHS will proceed with the reductions described herein.”