Legislators, media latch on to Medicaid relief cause

By Todd McGee
Director of Communications

Judging by its share of media coverage in January, county Medicaid relief is one of the top issues the General Assembly will consider this year. When the newly elected Speaker of the House, Rep. Joe Hackney of Orange County, addressed the Association’s Board of Directors at its Feb. 7 meeting, it was clear he had heard the news – not only on Medicaid – but about all the Association’s legislative priorities.

Speaker of the House Joe Hackney (Orange) addressed the NCACC’s Board of Directors on Feb. 7. (Photo by Jason King)

“We want to have you involved in our decisions,” he said. “We need to work on Medicaid. It is a big problem for the state, and it’s a big problem for counties. We need to work on school construction. It’s a big problem for you – a big problem for all of us. We have some problems with respect to where you get your revenue and your options.

“I don’t come here today with any answers to any or all of those problems. We want to start the dialogue about it. We want to be constructive. We want to work together as we go through this session. We want to be open to your suggestions, your ideas and your complaints.”

The Medicaid media onslaught began last fall, when the county Medicaid share was a major issue on the campaign trail. Candidates in both parties pledged that something must be done to relieve counties of this onerous burden.

In the weeks leading up to the Jan. 24 convening of the General Assembly, legislators appeared to be in the mood to make good on their campaign promises. Numerous representatives and senators held public meetings with their constituents to discuss the coming session, and many of them spoke about Medicaid and the need to do something for counties.

During his annual meeting with the media on the eve of the session, Sen. Marc Basnight (Dare) said “it would be a bit of a failure if we leave this session without some work done in that regard (relieving counties of the Medicaid burden) – not just minor work, but some major improvement in the [counties’] responsibility (to pay for part of Medicaid).”

The sentiments of Basnight, who was elected to his eighth term as president pro tem of the Senate, and Hackney, who also mentioned Medicaid relief during his address after he was elected speaker of the House, were shared by many.

“I think Medicaid is going to be a focus,” Rep. Larry Bell (Sampson) said in the Goldsboro News-Argus in January. “I think there will be some tradeoffs, but I think you’ll see a push toward relieving the counties of that burden. I think we’ve heard enough now to do something about it.”

Legislators weren’t the only ones weighing in on the issue. Editorials in major newspapers (The Fayetteville Observer, the Star-News of Wilmington, The News & Observer of Raleigh, the Hickory Daily Record and the Washington Daily News, among others) implored legislators to remove the Medicaid burden from the backs of counties.

“North Carolina is the only state in the nation whose counties must pay a fixed portion – 15 percent – of the program’s cost,” wrote the Washington Daily News in its Jan. 30 edition. “That requirement isn’t easy for any county to swallow, but it leaves the state’s poorest counties, particularly, between a rock and a hard place.

“The poorer a county is, the more Medicaid-eligible residents it has. Thus, Medicaid-related costs are taking huge bites out of the county budgets that can least afford to support them.”

Rep. Julia Howard (Davie) filed the first piece of legislation aimed at ending the county Medicaid share – H57, “Phase Out County Medicaid Share.” Her bill would phase out the county share by 3 percent each year, with the county share becoming 0 percent effective July 1, 2011. H57 had bipartisan support, with 20 legislators signing on as co-sponsors. Reps. Becky Carney (Mecklenburg), Douglas Yongue (Scotland) and David Almond (Stanly) signed on as primary sponsors.

Tips to engage the media on the Medicaid issue

• Invite your legislators to a Board of County Commissioners meeting. Present your county’s Medicaid picture and make sure to ask for their support for Medicaid relief. Try to get them to make a commitment to support counties in their quest for permanent relief, either through sponsoring new legislation or supporting legislation already filed.
• If a legislator agrees to sponsor legislation or support an existing bill, ask for their permission to send a press release to the local media with comments from the board chair thanking the legislator for understanding county needs and supporting county issues.
• Designate your board’s chair or legislative liaison to write a letter to the editor of the local newspaper detailing your county’s Medicaid plight and the need for relief. If a legislator agrees to support the county, write a letter publicly thanking them.