County officials make case for Medicaid relief

NCACC First Vice President Terry Garrison of Vance County and Wake County Manager David Cooke presented on Jan. 11 the county perspective on financing the state/federal Medicaid program to the House Select Committee on Health Care’s Medicaid Subcommittee.

First Vice President Terry Garrison of Vance County, flanked by Reps. Beverly Earle and Edd Nye, provides the county perspective on Medicaid funding. (Photo by Jason King)

North Carolina is the only state that requires counties to pay a fixed percentage (15 percent) of the non-federal Medicaid share, even though the state and federal governments make all decisions regarding eligibility, services and provider payments. The county share is estimated at $470 million for the 2005-06 fiscal year – a 78 percent increase since 2000 – and the General Assembly’s Fiscal Research Division projects that total to reach $540 million for 2006-07.

“The property tax base increases at less than 8 percent per year,” Garrison told committee members. “As a result, counties must either cut other vital services or raise property taxes to keep pace with Medicaid costs."

“Education spending is the major victim of the county Medicaid share. Fifty counties now spend more on Medicaid than on school facilities. … If education is the economic driver for the jobs of the future, how will these counties compete?”

Cooke chairs a special NCACC task force made up of county managers and finance officers that has organized to develop and recommend possible financing options to eliminate county funding of Medicaid services. Cooke outlined a range of proposals the task force is considering, including a swap of local sales taxes or other county revenue sources for the state to take over the county share of Medicaid; a cap on the county share; targeted relief for counties with the highest number of Medicaid-eligible citizens or counties that spend a large percentage of their budget on Medicaid; or a gradual phaseout of county financial participation.

More on Medicaid relief

“All counties need help,” Cooke stressed. “If Medicaid hurts one county, it hurts all counties.”

Reps. Beverly Earle (Mecklenburg) and Rep. Edd Nye (Bladen, Cumberland) co-chair the House subcommittee. Other members are: Reps. Arlie Culp (Randolph), Margaret Highsmith Dickson (Cumberland), Bob England (Cleveland, Rutherford), Julia Howard (Davie, Iredell), Bill Owens (Camden, Currituck, Pasquotank, Tyrrell), Ray Rapp (Haywood, Madison, Yancey), Ronnie Sutton (Robeson) and Trudi Walend (Henderson, Polk, Transylvania).

For more on North Carolina counties’ No. 1 legislative goal of Medicaid relief, visit www.ncacc.org/medicaidrelief.html.