Medicaid aid for counties backed

Panel also supports smoking ban

A legislative health care committee wrapped up a year of work Wednesday by urging colleagues to continue helping counties pay for their share of the state's Medicaid costs and ban smoking in most public places.

Committee co-chairman Rep. Thomas Wright, a Democrat from New Hanover County, said he is personally opposed to broad tobacco restrictions but said the panel's recommendations were "reasonable and they are realistic."

The committee, composed of about 50 of the House's 120 members, was formed in November 2005 and has examined ways to make health care more affordable, accessible and safe in North Carolina.

The panel recommended 16 changes before this year's legislative session in May, including a proposal to cap spending by counties on Medicaid at 2005-06 levels.

Lawmakers funded the recommendation by including $27.4 million in this year's state budget, though House and Senate leaders differed over whether it was a permanent cap or a one-time benefit to counties.

The heath care committee suggested Wednesday that all 100 counties in North Carolina continue paying at 2005-06 levels until lawmakers come up with a plan to remove the counties' share of Medicaid costs, which totals about $470 million annually.

Such a cap would cost the state $185 million through mid-2009, the committee said.

North Carolina is the only state that requires counties to pay a fixed percentage of the state's share of Medicaid, the government health insurance program for the disabled, poor and elderly.

Counties have made it a top priority to eliminate paying the Medicaid costs, said Breeden Blackwell, a past president of the North Carolina Association of County Commissioners. Rural counties with narrow property tax bases are faced with Medicaid costs reaching 15 percent of their annual budgets.

"If we don't get some help, you're going to have some counties that I really believe will be in dire financial straits," Blackwell said.

The committee also recommended restricting smoking in restaurants, offices and other public places. Despite North Carolina's tobacco-growing heritage, the recommendation wasn't unexpected. The legislature banned smoking in its offices this year and increased cigarette taxes seven fold last year. Recent polls show a majority of North Carolina residents support a smoking ban in public places.

The proposal would exempt bars, private clubs, homes and designated motel rooms from the smoking ban.