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Perspective | How will the new federal budget affect kids’ health in North Carolina?

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Health policy fans got a big Christmas present from Congress at the end of December. The Omnibus Appropriations Act included many important pieces of health care policy and funding that will make a big difference in health care for our kids and families this year. Here’s a quick look at what it means for North Carolina’s families.

Locking in post-partum coverage

One of the biggest changes in Medicaid coverage in years is the American Rescue Plan Act’s state plan option to provide 12 months of postpartum coverage. North Carolina opted in through legislation in 2021, with a sunset provision going into effect after five years. The new Appropriations Act made the 12-months option permanent — so as long as North Carolina opts in, our state will continue to receive the additional funding to keep new parents covered for 12 months after the birth of a child.

Continuous Medicaid eligibility for kids

North Carolina is one of 24 states that provides 12 months of continuous eligibility for children in Medicaid and NC Health Choice. The new Appropriations Act requires all states to provide this coverage to children under age 19, starting in 2024. While North Carolina is already doing this, a federal requirement provides additional safeguards for our kids’ coverage for years to come.

Investments in mental health and more

The Appropriations Act also creates more investments for mental health, establishes grant programs to address maternal mental health and substance use, improves the stability of coverage for youth involved in the justice system, requires states to publish public directories of mental health service providers who accept Medicaid (beginning in 2025), provides technical assistance to states on crisis response services, and more.

The Act also boosts investments in children’s health and nutrition programs, and reauthorizes critical maternal, infant and early childhood home visiting programs.

Children’s Health Insurance Program funding

The Appropriations Act secures federal funding for the Children’s Health Insurance Program (known here as NC Health Choice) through 2029 — federal funding for this program was previously set to expire in 2027. This provides more stability for families with children over six who rely on the CHIP program for their health coverage in our state.

Unwinding Medicaid coverage protections

The Act also ended the coverage provision that prevented states from disenrolling anyone covered by Medicaid during the COVID-19 public health emergency. As a result of delinking these coverage requirements from the public health emergency, states will be required to start the process of “redetermination” (determining whether Medicaid enrollees still qualify) starting on April 1, 2023. We at NC Child will be dedicating a blog to this issue soon.

Read more about what this high-impact legislation will mean for children’s health coverage in this detailed analysis from the Georgetown Center for Children and Families.

Kaylan Szafranski

Kaylan Szafranski is NC Child’s Health Program Director.