By NICOLE CARTRETTE

The $6.3 million the county expects to spend on Medicaid next year didn’t grow to that height overnight. County officials don’t expect the state to take responsibility for the expense overnight either.

In Raleigh Wednesday, the N.C. Association of County Commissioners rallied support for a six-year phase-out of counties’ 15 percent share of state Medicaid services.

Columbus is one of five counties that spend more on Medicaid than public schools, NCACC officials said. Approximately 32 percent of residents are Medicaid eligible and one-third of property taxes go to fund a program that makes up more than 10 percent of the total county budget. North Carolina is the only state that requires local governments to pay a fixed share of Medicaid expenses.

Commissioners see the state’s $2 billion budget surplus as an opportunity for relief.

“Our legislators are aware of how much an impact this has on our county,” Commission Chairman Kipling Godwin said. “It has an impact on every county but Columbus County is one of the hardest hit.” Godwin was among 300 commissioners who lobbied for Medicaid relief at the state capital Wednesday.

House Bill 1968 proposes a cap of Medicaid costs to counties at the 2005-06 level and includes targeted relief to counties most affected.

Columbus County would benefit greatly from the legislation, Godwin said.

Under the bill, Columbus County’s share would be fixed at roughly $5.8 million, saving at least $500,000 in the coming fiscal year that begins July 1.

“The total package is $65 million in relief to all counties in the state and it seems to have huge support,” Godwin, who supports the proposal, explained.

There are multiple proposals in the Senate. “There is no clean majority behind any one,” Godwin said.

One proposal would provide $500 million in complete Medicaid relief to all counties in exchange for one-half cent of sales tax revenues being turned over to the state. Columbus County’s revenue from the one-half cent sales tax is roughly $1.4 million.

While it would be ideal for Columbus County, Godwin said it is not likely to get the approval of legislators from counties such as Wake, where the Medicaid expenditure is far less than the revenue generated from the sales tax.

“We expect to get Medicaid relief this year,” Representative Dewey Hill said.

Several different proposals are being tossed around, he indicated.

“There is talk of capping the county’s cost and providing $150 million in relief,” Hill said.

Columbus County with one of the greatest Medicaid burdens would receive additional relief under the suggestion, he said.

Many commissioners are disappointed the governor’s budget proposal did not include Medicaid relief for the counties.

“The state has revenue from income tax and sales tax. The only revenue the counties have is primarily property tax,” Godwin emphasized.
Medicaid relief is a major issue that involves millions, Sen. R.C. Soles Jr. said. “It is a high priority,” he said.

Soles indicated it is difficult this early in the session to determine how soon any action will be seen. He expects it could be months before serious Medicaid reform negotiations.

“We are just getting started,” Soles said.

County officials have no authority to regulate Medicaid services and many are asking for a cap and future elimination of the county share.

The NCACC projects Medicaid costs in Columbus County have increased by 59 percent since the year 2000.