04/13/07 — Bill would put a cap on Medicaid burden

View Archive

Bill would put a cap on Medicaid burden

By Matthew Whittle
Published in News on April 13, 2007 2:06 PM

If the number of legislators sponsoring a bill is any indication, it doesn't appear that North Carolina's counties will see their Medicaid burden lifted this year, but it will continue to be capped at its 2005-06 levels.

With 119 of 120 representatives signed on -- the speaker doesn't sign bills -- state Rep. Louis Pate, R-Wayne, feels pretty confident about House Bill 1424's chances when it eventually comes to the floor for a full debate.

"It's not just a hollow bill," he said. "This is the one that's got a little bit of legs on it. We're getting some signals that the leadership agrees with it. It's something that's got to be done and this one is the one that will help out the most, other than us outright taking (the counties') share."

Other bills focused on eventually phasing out the counties' share of Medicaid have only gained a few sponsors each.

This one, according to its title, is simply intended to permanently cap the counties' share of the Medicaid burden -- a good solution, local legislators said, but not the one they'd eventually like to see.

"To me the best solution is for the state to take over all of the Medicaid burden, but that's not likely to happen," Rep. Russell Tucker, D-Duplin, said.

The proposed bill would continue to cap each county's share of the Medicaid burden to 2005-06 levels. A similar cap is currently in place.

In Wayne County, Medicaid costs about $8 million.

Across the state, the counties' share in 2005-06 was $426 million -- a number the North Carolina Association of County Commissioners expects would jump to about $517 million in 2007-08 if not capped.

In Wayne, commission chairman John Bell said, the increase is estimated to be about $2.5 million.

"That cap is very important because the number of consumers is increasing. That $2.5 million will be a great help. We can do a quite a bit with that money," he said.

After capping the counties' expenses, the bill then would allocate $90 million for fiscal year 2007-08 to help the state cover its share of Medicaid, as well as another $10 million to provide additional relief to counties with the greatest percentage of Medicaid recipients.

In fiscal year 2007-08, the General Assembly then would have the option to continue the cap and allocate another $139 million to cover the state's increased share and another $15 million to those counties with the greatest percentage of recipients.

It is unclear, however, how exactly the additional dollars would be doled out to the counties.

Still, Rep. Van Braxton, D-Lenoir, said, it is at least a start.

"We need to do more. I think what people are looking at and what they're afraid of is that taking Medicaid off the backs of the counties is going to cost a lot of money and we don't know where that's going to come from," he said. "But we've still got a lot of time (left in the session). I'm hoping we can do something to actually lower the county burden."

Fortunately, Pate added, what this bill would do is buy the counties and the state some time to figure out what would be the best solution for providing relief.

"You can't project anything beyond this year and you can't project what the next General Assembly will do," he said. "A cap is not the same as reducing (the Medicaid burden), but it's something and maybe it'll let people know we're serious about doing something about it. We realize we're one of the only states that does this to the counties, but a true study of it has not been done that I'm aware of.

"This will at least cap it for one year and give us some time to study a long-term solution."