Medicaid Draining Columbus County

News Reporter One-third. It’s a number Columbus County officials bring up over and over, although they’re not fond of what it means. The county spends one-third of the peoples’ property taxes – 24 cents out of a rate of 73 cents per $100 value – just to pay its state-mandated share of Medicaid. Medicaid, the federal and state health safety net for the poor, has become a money-eater in a poor, rural county where more than one-third of the residents qualify for assistance. Worse yet, county leaders say, Columbus’ low tax base and high unemployment limit the ability to spend local tax money on other pressing needs at schools, for example. For the third year in a row, commissioners endorsed a resolution asking lawmakers to lift the Medicaid burden, which totaled more than $5 million last year and may hit $5.9 million this fiscal year. That expense is more than the county’s total local budget for public schools and the community college. North Carolina is now the only state that requires local government to pay a fixed share of state Medicaid costs – currently 15 percent. In wealthier counties, Medicaid is a less significant part of the budget. While it takes 24 cents to pay the tab in Columbus, Cumberland taxpayers spend 10 cents of their tax rate to pay their local share. Brunswick and Orange County taxpayers spend four cents to foot their bills. Per-capita Medicaid expenditures in Columbus County now total nearly $109 a year, the third-highest in the state, according to the N.C. Association of County Commissioners (NCACC). Local Medicaid costs have increased by 59 percent in the past six years, commissioners complain. NCACC’s request to the Legislature is for the state to assume Medicaid costs. In exchange, counties would give up one cent of the sales tax revenue to the state. The Legislature would then give counties the option of imposing a one-cent local sales tax to replenish the lost revenue. At their regular session Monday, commissioners also decided in principle to establish a committee to study Medicaid and suggest ways to control costs. The 11-member group would be composed of one resident from each of the seven commission districts, the Social Services director, the Health Department director, a doctor or retired physician and an accountant or retired accountant. A newspaper story provided by Chairman Kip Godwin described how one New York state county discovered fraud and waste in Medicaid expenses, in part by using a computerized database that tracked every expense. Godwin asked commissioners to consider appointments to the board and name them at a later meeting.