By Jheri Hardaway
Staff Writer
NC General Assembly - Durham Senator Natalie Murdock held a hearing regarding Medicaid on November 17th. The political standoff over fully funding North Carolina’s Medicaid system is pushing healthcare providers to a devastating breaking point, threatening to dismantle critical services for the state’s most vulnerable citizens. This stark reality was presented during a recent emergency hearing hosted by Senator Natalie Murdock, where clinic owners and advocates offered emotional, first-hand accounts of the crisis. Representatives Abe Jones and Phil Rubin were also on hand to listen to Medicaid providers.
The hearing highlighted the desperate straits of pediatric therapists and specialized care providers who have not seen a Medicaid rate increase in over 20 years and are now reeling from recent cuts. Senator Murdock, representing South Durham and Chatham County, a district where a hospital is at risk of closure due to the funding shortfall, opened the discussion with a clear call to action. "I heard from clinics," Senator Murdock stated, "they have not seen a Medicaid rate increase in more than 20 years, while the cost of rent, supplies, wages, and insurance has climbed steadily... Let me be clear, when a family cannot find a provider who will accept Medicaid, that is not just an inconvenience, that is a denial of medically necessary care. The core of the issue is the failure of the General Assembly to fully fund the Medicaid rebates, a process that should align reimbursement rates with the actual cost of care in 2025, not 2003.
Avani Shah, a speech pathologist and owner of Therapy Smarts, testified that the current reimbursement rate is now 9% lower than what it was 21 years ago. "We are not asking for luxuries," Shah pleaded. "We’re only asking for sustainability so that these children can continue to receive the care they deserve."
The financial peril has only been exacerbated by a recent 3% cut to therapy reimbursements, a reduction that has profound, non-numerical consequences. As Kristen DeSana, a pediatric speech-language pathologist, explained: "This cut comes after more than 20 years without a single rate increase... We can't absorb another cut. Small community-based providers like my practice are the backbone of Medicaid services, and we're at risk of disappearing." The hearing was defined by powerful testimonials from families and providers alike, emphasizing that the cuts are a "direct threat to children's access to life-changing care."
Representatives from Mom’s Rising shared poignant stories from across the state. They spoke of children relying on Medicaid for critical heart medications, adults with complex disabilities maintaining dignity in community living, and stroke survivors fighting to go home after two years in a skilled nursing facility. The most emotional plea came from Stephanie Molina, owner of KM Pediatric Therapy, who spoke through tears on behalf of her team and the children who cannot speak for themselves. "We are begging you to stop this," Molina said, her voice heavy with the gravity of the situation. She highlighted the painful irony of her highly educated staff—including those with Master’s and PhDs—working "diligently, day in and day out" but reaching a "breaking point." Molina also revealed that many therapists are paid per visit, not salaried, meaning every missed appointment, every cancellation during flu season, and every political delay translates directly into lost income. She shared the shocking reality of full-time therapists having to bartend or look into becoming real estate agents just to pay their bills. "We don’t have the ability to continue to make it work while everyone fights this out behind the scenes," Molina added that she felt additional frustration that, upon her last visit to the General Assembly, legislators smiled and took pictures acting as though her issue was important, but instead chose to focus on redistricting maps instead of the Medicaid funding bill. "My God, what could be more important than this, helping the children who are the most vulnerable?"
The conversation repeatedly pivoted to the fiscal irresponsibility of the state's inaction. Providers, including Tildsley Clifford McManus from Therapy Smarts Inc., stressed that delaying early intervention is a guaranteed way to increase future costs. "If they cannot access therapy now, they will enter the public school system, requiring even more intensive resources funded by tax dollars," she argued. "Why cut off the service now, only to be significantly paying for it later? It is fiscally irresponsible."
Representative Phil Rubin, a Democrat, confirmed the maddening political gridlock, stating, “The House and the Senate agree that they should fund this and how much. And yet the games have kept it from being funded.”
Senator Murdock closed the hearing by dissecting the sheer scale of the political failure. Out of a $32 billion state budget, the current gap needed to adequately fund the Medicaid rebates and protect these services is estimated to be around $250 to $300 million, an amount equivalent to just 0.006% of the total budget. "We can’t cough up $300 million? It’s ridiculous," Senator Murdock said. "We shouldn’t be able to sleep comfortably knowing these are parents and children that are needing this care."
The message was unified and unequivocal: "March is too late." Providers are urging citizens to maintain pressure, lest this critical issue "fall out of the news" while vulnerable families wait in the balance.
