COVID-19NC: Phase Two Freeze, Budget Breakdown & Medicaid Moment

Aug 16, 2020

Every Friday,  BPR's Helen Chickering talks with NC Health News founding editor Rose Hoban.  This week (after a week off) they discuss the seemingly stabilizing coronavirus trends as NC college students return to campus and public schools begin to open, the testing numbers error that shines a light on outdated data collection methods and  the coronavirus budget breakdown that included a “what if we had expanded Medicaid” moment.

HC: Rose. It's great to talk with you again. When I got back, I noticed trends seem to be pretty stable. And I also noticed the state isn't hosting as many Corona virus, media briefings, as we saw at the beginning of the pandemic.

RH: I feel like they're holding off because trends are going in the right direction. As health secretary Mandy Cohen likes to say that, you know, there are glimmers of hope. She also said that she had someone stop her on the street and say, are you the ’Three Ws lady?’.  So, people are really starting to absorb it.  I will say that I think the governor and the secretary are getting a lot of flak for holding off this phase two for five more weeks, which I was surprised they went for that long. I thought it would be like three, but their rationale is that we've got all these kids going back to school. 

 HC: Making news this week, the overcount  (by 200,000 plus) of completed coronavirus tests in the state. Dr. Cohen was quick to point out that the error did not affect the percent positive rate in North Carolina.   Most of the blame going to the lab (Lab Corps) but this does seem to shine the spotlight on the outdated data collection methods still in place in public. Yeah.

RH: Well, one of the things that I know from having worked in public health, I think people think that like public health and government is CSI, right? You watch TV and they've got all these fancy computers and they tap the screen and the database shows up and they know everything about you. And the reality is that a lot of this information is being aggregated on sheets of paper that are being faxed to their data team in Raleigh, and then having they're having to go over them and make sure that they're all correct. And I think that was part of what happened with Lab Corps that they would get like from the labs.  They would get these daily electronic data dumps. I picture them  - almost like sort of drowning in paper.  

HC:  This week, you sat in on a lengthy meeting as Dr. Cohen reviewed the state coronavirus budget with lawmakers.

RH: The secretary spent a couple hours  detailing to lawmaker what we've been getting  in exchange for all this money that's been spent on COVID. So basically, it's been 1.3 billion will be spent in North Carolina in 2020 for the costs of COVID.  That's 345 million that came from the federal CARES act through the legislature that went to DHHS and like of that three 45, there's around 125 million for testing and contact tracing. That's something that we are all thinking about these days, right? Then there was additional federal funding that came in the form of state grants that came straight to the state and that's another half billion. And then finally the feds bumped up our matching rate for Medicaid because Medicaid is paid for by the state and the feds .

HC: What caught my eye in that article is that during this exchange, a Republican lawmaker asked Dr. Cohen how much North Carolina would have saved, had lawmakers expanded Medicaid.

RH: As a matter of fact, when I was relistening to the tape, you could hear one lawmaker whisper to the other, “he shouldn't have asked that, he gave her the opening.”  You know, this lawmaker, who's not  particularly a fan of Medicaid expansion, said something to her. And she pointed out the fact that for example, we had to spend state dollars. We had spent 50 million of state dollars providing mental health services, which have been desperately in need of being provided during COVID. And,  if these folks  had expanded Medicaid, they could have gone to a mental health provider and had it covered and we would have had 50 million to do other things. So she was making that point about Medicaid expansion.

About Rose Hoban: 

Rose Hoban is the founder and editor of NC Health News, as well as being the state government reporter. Hoban has been a registered nurse since 1992, but transitioned to journalism after earning degrees in public health policy and journalism. She's reported on science, health, policy and research in NC since 2005. Contact: editor at northcarolinahealthnews.org