Medicaid relief in House budget a ‘first step’

• Relief numbers by county: PDF | Excel

The budget proposal released by the North Carolina House of Representatives on June 16 contained a one-time, $15 million contribution to help counties with their Medicaid burden. The money was split into two equal $7.5 million amounts, with the first half going to all counties as a percent of their Medicaid costs and the second half going to the 40 counties where at least 20 percent of the population is eligible for Medicaid services.

More on Medicaid relief

“We are grateful to the members of the North Carolina House for remembering us, particularly Rep. Bill Owens, who fought for the inclusion of these funds in the House budget,” said NCACC Executive Director C. Ronald Aycock. “This is a first step in the right direction, but this is not the final answer.”

“The Medicaid issue is not going away,” said NCACC President Breeden Blackwell, a Cumberland County commissioner. “Counties are estimated to spend nearly half a billion dollars in the upcoming fiscal year on a program in which the federal and state governments make all decisions regarding services, eligibility and provider reimbursement rates. We appreciate whatever help the state will provide us, but we will keep working until the state takes over the entire non-federal share, as is done in almost every other state. Local property tax dollars should be used to fund local services that are demanded by the citizens in their communities. They should not be used to subsidize a state responsibility.”

Relieving counties of the Medicaid burden has been the No. 1 legislative goal for North Carolina counties for several years. The New York Legislature recently began phasing down its county share of Medicaid, leaving North Carolina as the only state in the nation that requires counties to pay a fixed percentage of the state’s Medicaid share. This burden is forcing many counties to raise property taxes significantly or cut services to meet their constitutional mandate to provide and maintain adequate public schools.

“We are one of the fastest growing states in the nation, and recent unfunded mandates by the General Assembly to reduce class sizes in the lower grades result in a double whammy for counties,” Blackwell said. “Counties have to build more schools and hire more support personnel to teach the additional children and to fulfill the mandates for smaller class sizes. We are grateful to all the representatives and senators who have introduced bills to relieve us of this burden.”

In 2004, the N.C. General Assembly created the Blue Ribbon Commission on Medicaid Reform. Among that bipartisan commission’s recommendations was to phase out the county share of Medicaid in five years and to cap the county costs at the 2004-05 levels. For 2004-05, the county share of Medicaid is projected to be $440 million. That amount increases to at least $470 million for 2005-06, according to preliminary figures from the N.C. Department of Health and Human Services.