Senators to hammer out Medicaid plan
‘Morally wrong’ to burden counties, Rand says
By NIKIE MAYO
The Medicaid “nightmare” so familiar to North Carolina counties could be nearing an end this week if two senators can come up with a plan that is palatable to the rest of the General Assembly.
North Carolina is one of the only states in which counties bear a portion of the expenses for Medicaid, a health-insurance program for the poor and disabled. But both Rand D-Cumberland and Sen. Dan Clodfelter, D-Mecklenberg have come up with methods for the state to take over what amounts to a $500 million burden.
Rand’s plan calls for the state to take over Medicaid by taking 1 cent of each county’s sales tax back to the state level. Clodfelter’s proposal would provide total relief by transferring several county-revenue sources back to the state.
Clodfelter’s plan calls for the state to receive small portions of several local taxes, including the sales tax, food tax and corporate income tax dedicated for school construction. That swap would still cost the counties less than paying for Medicaid, according to the N.C. Association of County Commissioners.
Both the state House and Senate have passed versions of the budget that include provisions for Medicaid relief. While the House budget includes a one-time $100 million appropriation for the fiscal year that begins July 1, the Senate budget includes language expressing “the intent … to develop a method for relieving counties of (their) share … of Medicaid expenditures.” The Senate budget does not attach a dollar amount to the intended relief.
County leaders say paying for Medicaid is crippling their budgets.
Beaufort County Manager Paul Spruill told commissioners “don’t start smiling until you get recurring relief.” It’s an “untouchable” expense he said during a recent budget meeting.
Washington County Manager David Peoples called Medicaid “an absolute nightmare, especially for (poor) counties like ours.”