President's Perspective
Don’t give up on Medicaid relief

County officials around the state were more than a tad disappointed when the Senate released its long-awaited budget proposal in early May. The $17 billion spending plan didn’t include one dime of Medicaid relief for counties.

President's Perspective By Breeden Blackwell President's Perspective Archive

The Senate also recommended taking $50 million from the ADM Fund, monies that go to help counties pay for much-needed school construction, while promising to provide counties $70 million of lottery money as a replacement. Counties stand to gain $20 million in that scenario, but until a lottery is actually approved and signed into law, county budget officials cannot bank on that revenue. If a lottery is not approved, there is no guarantee that the $50 million would be put back in the ADM Fund. Considering that counties are in the midst of their budget season, this is not an ideal time for there to be any uncertainty over county revenues for 2005-06.

The good news is that the battle has just begun. The House now has its turn with the budget. Several proposals to relieve counties of the Medicaid burden have been introduced in that chamber, and they have received widespread, bipartisan support. County officials have been twice called to Raleigh to testify in favor of various bills during House Health Committee meetings.

With the New York Legislature’s recent decision to cap its counties’ Medicaid costs and begin a phase-down of their counties’ participation in the Medicaid services expenses, North Carolina is now the only state left that sees fit to pass along a fixed portion of the state’s Medicaid share to all counties. Counties have no say in what services will be offered, who will be eligible to receive those services, and what the provider payment rates will be. All we get is a bill.

The lack of Medicaid relief in the Senate’s budget does not end the momentum that we have built up these past few years. Instead, it should serve to crystallize our focus on this critical issue. Please continue to remain in contact with your House members as they begin deliberating the budget.

Counties can no longer afford to take no for an answer. Too many other critical local needs are going unmet because counties are asked to help the state pay its Medicaid bills. This is an arrangement that must stop.