Washington, D.C. — Congressman G. K. Butterfield expressed disappointed with the lack of a long-term solution in North Carolina addressing the immense and growing burden of Medicaid costs being passed along to counties.
“This problem has reached a crisis for many poor counties,” Butterfield said. “It’s reached a point where the most basic services, such as education and public safety, are suffering in the communities that can least afford to go without. Under the current system, the poorest counties will only become poorer and fall further behind.”
The North Carolina House Appropriations Committee’s latest version of the state budget released on Wednesday includes one-time relief totaling $60 million, but it fails to address the long-term issues associated with the rising burden of Medicaid costs that counties face. Under the plan, funding is split – $30 million earmarked for division among all counties and the other $30 million earmarked only for the counties where 25% or more of its residents receive Medicaid.
Butterfield said North Carolina is one of the few states that still requires counties to share the cost of Medicaid, and he said that “this is an enormous and growing burden.” He pointed out that half of North Carolina’s 100 counties now pay more for Medicaid than for their schools facilities. Butterfield also said that in three of the counties he represents – Bertie, Hertford and Vance – Medicaid represents at least 10 percents of the counties’ budgets.
Last year, the legislature provided $27.4 million in one-time relief, but Butterfield said it was very small when compared to the $487.9 million the counties paid in Medicaid costs. The North Carolina Association of County Commissioners estimates that Medicaid costs for counties could rise to well over $500 million this year.
Butterfield said that the current situation is particularly difficult for many of the poor and rural communities that he represents because local property tax revenues simply cannot keep up with the growing Medicaid costs. Butterfield also pointed out that states, unlike counties, have the ability to make changes in eligibility, covered services, and how those services are reimbursed and delivered.
In January, Butterfield introduced legislation that would prohibit states from passing along the burden to counties in order to “raise the level of debate.” Now, Butterfield said that it may be time to push the bill in Congress to “guarantee that the counties have the long-term solution that they need.”
“Medicaid costs for counties will have grown as much as 144% over the last eight years, but counties completely lack the mechanisms to meet the burden of the huge increases,” Butterfield said.
Butterfield said that he has already talked about this issue with House Committee on Oversight and Government Reform Chairman Henry Waxman, D-Calif., and Butterfield said he will now be seeking co-sponsors to help bring the issue to a vote in the House. Butterfield said that he has talked with other members of the North Carolina delegation and that there has been considerable interest from legislators from New York, where some Medicaid costs are also passed along to counties.
Traveling throughout the district, Butterfield said that local officials consistently talk first about the increasing Medicaid burden emphasizing just how much it’s impacting the quality of life in their communities.
“It’s a big problem, but one that needs to be resolved,” Butterfield said.