Counties react to removal of Medicaid relief from budget

The decision by Senate and House budget negotiators to remove $15 million in county Medicaid relief from the state budget will continue to drive up local property taxes to subsidize the state’s Medicaid responsibility, according to the North Carolina Association of County Commissioners.

More on Medicaid relief

“Many of our counties are in financial trouble because of Medicaid, and yet the Legislature continues to turn a deaf ear to our pleas for help,” said Patrice Roesler, NCACC assistant executive director. “Costs of medical care cannot be matched with the property tax. When Dell Computers can get more than $200 million in tax relief to locate in a part of the state that continues to grow and prosper, why can’t Bertie County get help with this one cost that takes every bit of its revenue growth year after year?

“Rural school systems are struggling for resources that their counties can’t give them because Medicaid cost increases take every new dollar that many counties get. Our small counties will never benefit from the growth industries of the interstate corridors unless the General Assembly shows enough foresight to share that wealth.”

North Carolina is the only state that requires counties to pay a fixed percentage of the non-federal Medicaid share, even though the state and federal governments make all decisions regarding eligibility, services and reimbursement rates. The House’s version of the budget included a one-time, $15 million appropriation to help counties defray some of their Medicaid costs.

Medicaid costs have increased by more than 65 percent over the past five years. Fifteen counties spend more than 10 percent of their budget to subsidize the state Medicaid share, and 48 counties spend more on Medicaid than school construction. Counties are projected to spend more than $470 million for 2005-06.

Roesler pointed out that 86 of 120 members of the House of Representatives sponsored or co-signed one of two Medicaid relief bills (H132 and H149), and 28 of 50 members of the Senate did the same for similar bills in that chamber (S105 and S117). Either of these bills would have accomplished the counties’ No. 1 legislative goal of phasing out the county share of Medicaid.

“The Legislature doesn’t see county Medicaid relief as a priority, even though an overwhelming majority of the House and a strong majority in the Senate signed on to the various Medicaid relief proposals and assured our county commissioners they would help us,” said Roesler. “When the doors close and the negotiators have no one to look at but themselves, the promises made to county commissioners don’t matter. The 19 counties that increased property taxes by more than 10 percent this year don’t matter. The condition of the elementary schools in Bertie County doesn’t matter.

“Our leaders have heard our pleas for help on this issue for more than 20 years and have made a conscious decision to ignore them.”