Medicaid Alerts

Budget doesn’t include Medicaid relief, but Senate still discussing permanent relief options (May 29)

The Senate released its own version of the 2007-09 budget May 29 with floor votes expected this week. As expected, based on conversations with Senate leadership, no Medicaid relief is included in the Senate budget. Instead, the Senate is considering separate plans for permanent Medicaid relief that will be debated outside the budget.

One plan being pushed by Sen. Dan Clodfelter (Mecklenburg) involves a limited revenue swap for a complete state takeover of the county Medicaid share coupled with additional revenue authorities for counties to help them deal with significant infrastructure needs, including school construction/renovation and water and sewer capacity. Sen. Tony Rand’s (Cumberland) plan for a 1 percent sales tax swap is also being considered.

Time is of the essence. Once the Senate adopts its budget, and the Senate and House appoint their conferees to debate the differences between the two spending plans, less than four weeks will remain in the fiscal year. It is likely they will move expeditiously to adopt the final budget. There are a lot of issues that are generating attention right now, and we need you to help keep the Legislature focused on Medicaid relief as one of its top priorities. Executive Director David F. Thompson urges county officials to contact your legislators over the next few days, but particularly your senators, to let them know that relieving counties of the Medicaid burden is an investment in North Carolina’s future because it will better enable counties to meet the infrastructure needs being caused by our rapidly growing population. Association staff continues to work toward a solution that will address the strategy adopted by the Board of Directors in February – permanent Medicaid relief, additional targeted relief and growth revenues for infrastructure.

Speaker Hackney weighs in (May 29)

During a news conference held by House leadership May 29, Speaker Joe Hackney (Orange) was asked by a reporter if counties should be given a local-option land transfer tax to help with infrastructure needs. Speaker Hackney said he believed counties should have that option, and said that the answer is part of a broader picture that includes Medicaid relief for counties and a possible statewide bond to deal with state and local infrastructure responsibilities. The Speaker said the House would work closely with the Senate to develop the final budget plan and that all the issues being discussed in the budget – including Medicaid relief and additional revenue authorities for counties – are open to negotiation. Rules Chair Rep. Bill Owens (Pasquotank) reiterated the need for Medicaid relief and state support for infrastructure needs such as water and sewer.

House budget ignores permanent county Medicaid relief yet again (Thursday, May 3)

The House is expected to unveil its budget proposal next week, and the Association has received word that a one-time appropriation of $60 million will be included for Medicaid relief for counties for 2007-08 with nothing committed for 2008-09. We are told that $50 million will be designated to provide relief for all 100 counties, and that an additional $10 million will be provided for targeted relief for the hardest-hit counties, but we still do not know how those will be defined.

This simply is not acceptable.

Three weeks ago, leadership in the House of Representatives held a press conference to announce H1424, which would permanently cap all counties Medicaid costs at 2005-06 levels and provide additional funds for targeted relief. The bill contained $90 million for the cap and $10 million for targeted relief for 2007-08 and $139 million for the cap and $15 million of targeted relief for 2008-09. This bill was signed by 119 members of the House; in other words, everybody committed to support this bill except for Speaker Joe Hackney, who does not sign bills.

Since then, the state learned that it will have an additional $260 million of unexpected revenue for the current fiscal year, giving it a total revenue surplus for 2006-07 of $1.1 billion. This does not include reversions to the state budget at year end.

Let me repeat: EVERY MEMBER of the House of Representatives signed this bill, and in the three weeks since it was introduced, the state has picked up $260 million of additional revenue, which would be enough to fund the bill for the next two years! Yet once again, our state leaders are poised to turn their backs on counties so they can continue to fund other priorities.

The Association needs you to contact your legislators and let them know that a one-time appropriation of $60 million is not acceptable. We do not need to be coming to the General Assembly every year with our hands out begging for relief. It is time for the General Assembly to address this situation. The state has the money, but they are lacking the political will to come up with a solution that provides permanent relief for counties. We need you to help them find it.

Call your legislators this weekend. Write a letter to the editor. Let them know that anything short of a solution that provides permanent relief for counties is unacceptable. The timing is critical as the House budget will come out next week.

We had nearly 300 county officials in Raleigh yesterday lobbying for Medicaid relief. It is our No. 1 priority. Your House members have said it is one of their top priorities. Let’s help them do the right thing.

David F. Thompson, Executive Director