Now, broad cuts to North Carolina Medicaid will make finding and paying for care even more difficult. North Carolina and Idaho have already announced plans to cut Medicaid payments to health care providers, including hospitals, doctors, and caregivers. Now, cuts to North Carolina Medicaid will make finding caregivers more challenging. “It’s a difficult moment for North Carolina,” said Jay Ludlam, deputy secretary for North Carolina Medicaid. In North Carolina, Fabrello has been unable to work outside of caring for her son.