North Carolina lawmakers got the first granular look at the state’s Medicaid program in 20 years, showing the program’s improving financial condition but continuing major debts to medical providers.

The audit found the Medicaid fund balance was $350 million in the red for the fiscal year ended June 30, 2014—almost $59 million better than a year earlier.



State Auditor Beth Wood presented the financial report to a General Assembly oversight committee that requested it in October, along with audits of other state agencies, including the Department of Public Instruction. The Department of Health and Human Services, which spends $18 billion annually, accounts for the state’s biggest expenses.

“When you start your budgeting process and you’re looking at what this document gives you, it gives you not only what we spent, but what we owe next year,” Wood said.

State budget writers will be able to “know what the true expenses for a year are, not just the cash that we put out the door.”

State lawmakers have been grappling for years with the Division of Medical Assistance, which runs Medicaid and costs for than $13 billion per year. Republican leaders in the House of Representatives have supported a plan to restructure the program within the health department while their Senate counterparts say they want to create a new agency dedicated to administering it.