Counties want relief from cost of N.C.'s Medicaid setup

WINSTON-SALEM -- County governments in North Carolina are working again this year to bring down their Medicaid costs, hoping to reduce an estimated $517 million price tag for the coming fiscal year.

Medicaid, a health insurance program for the poor, is paid for in most states with state and federal money. North Carolina is the only state that requires counties to pay a fixed percentage of the bill for Medicaid.

The General Assembly agreed last year on a temporary cap on Medicaid costs for the state's counties. But many say there's a need for a more permanent solution.

"One way or another, we are going to face and fix this problem this session," Gov. Mike Easley said in his State of the State speech last week.

With Medicaid costs increasing, county officials said they don't want to have to worry about setting aside money for the program. As it stands now, counties are concerned about their ability to pay for other programs.

"Every department would have to suffer" if counties' Medicaid costs keep rising, said Gloria Whisenhunt, chairwoman of the Forsyth County Board of Commissioners.

Lawmakers expect to discuss a proposal calling for a phase-out of county contributions for Medicaid. One lawmaker suggested the state use county generated sales-tax revenue to pay for additional Medicaid costs.

"This is an expense that's growing somewhere between 8 and 15 percent a year. If we don't do something about it quick, it will be so big we won't be able to do anything about it," said Sen. Tony Rand, D-Cumberland.

Rand, the Senate majority leader, suggested the sales-tax idea and said his plan would let counties raise their local sales tax to recoup some of the lost money.

Meanwhile, counties just want to be able to plan their budgets, said Joe Bartel, the director of Forsyth County's budget and management department.

"It would be nice to know the definitive word on what the state was going to do," he said.