By Staff
Would ‘expressly prohibit’ states from passing costs to counties
By NIKIE MAYO, News Editor
First District Congressman G.K. Butterfield, D-N.C., recently introduced legislation to “escalate the debate” on Medicaid relief for North Carolina counties.
Butterfield introduced the Medicaid County Protection Act in the U.S. House on Jan. 9. That legislation, if it passed, would “expressly prohibit states from passing along the costs of Medicaid,” according to a release from Butterfield’s office.
Medicaid is a federal-state program that helps pay for health care for elderly, disabled and low-income residents. North Carolina and New York are the only two states in which counties pay a portion of Medicaid costs. New York is phasing out those county-borne expenses.
The N.C. General Assembly, in passing the state’s budget, made a one-time $27 million appropriation to temporarily freeze counties’ share of the Medicaid puzzle. Butterfield characterized that move as “insufficient.”
In Beaufort County, $3.8 million is allocated annually for Medicaid payments. That’s about 9 percent of the county’s budget. Beaufort County’s Medicaid contribution has increased by 80 percent in the past seven years, Butterfield said.
One in four residents in Beaufort County is eligible for Medicaid. Combine the Medicaid-eligible population with the “low-revenue” status of the county and one is left with what Butterfield called a “double whammy.”
In Washington County, the state’s one-time cost cap created a potential savings of $200,000. But County Manager David Peoples said then that he planned to use that as rainy-day money.
Of the 23 counties in the 1st Congressional District, 16 of them put more money toward Medicaid than education, Butterfield said.
In Martin County, $2.5 million annually goes toward the Medicaid tab. It’s about 10 percent of the county’s budget.
In Hyde County, which is part of the 3rd Congressional District represented by Congressman Walter Jones, R-N.C., Medicaid is the largest budget item aside from capital projects. Capital projects include building the new courthouse.
Butterfield said the idea that North Carolina counties should pay their share of Medicaid costs might have worked 20 years ago. But the “economic landscape” has changed since then, he said. North Carolina counties pay $489 million in Medicaid-related expenses, according to his press release.
Butterfield said that cost is the result of a flawed system.