No lip service

Published 5:51 am Tuesday, January 30, 2007

By Staff
It’s that time of year again. The folks our votes have put in the Legislature have returned to its hallowed halls. Fresh into the session, they’re eager to talk about priorities. And they all talk about having at least one priority in common: Medicaid relief.
Rep. Arthur Williams, a Beaufort County Democrat, said Medicaid relief is on his to-do list. Rep. Bill Daughtridge, a Nash County Republican, called Medicaid “the singular thing that’s making poor counties poorer.” A spokeswoman for Senate leader Marc Basnight said Medicaid relief is “something legislators want to take a good, hard look at this session.”
Clearly, it’s a bipartisan issue and one that’s on every politician’s lips. We have just one thing to say about that: Enough talk.
It’s time to do something. Last session’s cap, which froze counties’ shares of Medicaid’s costs at their current levels, was a good start. But that’s all it was — a start. One has to wonder why, when the state had more than a billion-dollar surplus not long ago, legislators didn’t fix the Medicaid problem.
North Carolina counties have been seeking relief from the Medicaid malady for years. It’s not a new thing. And it hasn’t gotten better.
It’s a festering wound.
Medicaid is certainly a good and necessary program. It serves more than 1 million people in the state. Without it, many low-income, elderly and disabled people would not be able to afford health care.
But North Carolina is the only state in the nation whose counties must pay a fixed portion — 15 percent — of the program’s cost. 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.
In Beaufort County alone, nearly $4 million is lopped right off the top of the budget to go back to the state for Medicaid. That’s $4 million that could be used to educate the county’s children. That’s $4 million that could go toward improving the quality of life here in any of a myriad of ways. Instead, it’s $4 million we never even see.
Medicaid costs account for about 9 percent of Beaufort County’s budget and about 10 percent of Martin County’s budget. That may not sound like much, but think about this: What more could you do if your paycheck were 10 percent larger?
Fixing the counties’ shared Medicaid woe isn’t simple and it isn’t painless. And isn’t the only problem legislators must tackle. But, like any festering wound, it cannot be ignored. Handling the Medicaid burden requires state lawmakers to make difficult decisions — fish-or-cut-bait decisions — because the time for talk is over.