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An amendment adopted Thursday afternoon upped the total relief amount to $100 million. Fifty million would be distributed among all counties, $40 million between counties with at least 25 percent of their population Medicaid-eligible, (which includes Halifax and Northampton counties), and $10 million between counties whose eligible population is between 20 and 25 percent.
Delk said he's still waiting to see if the budget passes the Senate and if so, exactly how the $100 million will be divided between the counties. Depending on whether the money is divided based on population, dollars spent on Medicaid, or another criterion, the county would receive a different portion.
“I think the devil's going to be in the details,” he said.
Overall, Delk said he hopes the state Medicaid relief will at least take care of the increases in Medicaid costs for next year, which have been predicted to be about $100 million statewide.
Delk said there's no question in his mind that Halifax will receive “targeted relief,” or a share of the $40 million for counties with 25 percent of their residents eligible for Medicaid. Robeson County leads the state for Medicaid-eligible residents, with 34.5 percent, but Halifax is right behind with a little more than 33 percent.
North Carolina is the only state in the country that asks counties to contribute to Medicaid costs. In counties like Halifax and Northampton, where more than 30 percent of the population is eligible for the government program, the cost of Medicaid can be 10 percent or more of the county's budget.
As of last year, 32.1 percent of Northampton County residents were Medicaid-eligible, making it seventh in the state.
The current year's budget provided $27.4 million in Medicaid relief, which was the amount costs were projected to increase. According to Todd McGee, director of communications for the Association of County Commissioners, that number has ended up being closer to a total of $40 million.
Tight budgets
Halifax County officials, who are currently working on the 2007-2008 budget, will not know until after the state approves its budget in July how much Medicaid relief the county will receive.
The state uses a “worst-case scenario” formula to estimate each county's Medicaid costs, Delk explained, and Halifax County uses a smaller number in its budget to keep the tax rate as low as possible.
“Here in Halifax County, we have an extremely tight fiscal management policy and we as a general rule do not budget for the worst-case figures,” Delk said. “We try to maintain a high fund balance that will absorb worst-case scenarios rather than trying to budget for it every year.”
The county has used an estimate of $5.2 million for Medicaid costs for the current fiscal year.
“That estimate is unquestionably going to come up short in my mind,” Delk said, adding more Medicaid services were delivered this year than usual statewide due to a number of factors, including a bad cold and flu season.
Halifax County is using a planning figure of $5.6 million for Medicaid costs in its 2007-2008 budget, Delk said, while the state's estimate was more than $6 million.
Possible remedies
The county has been trying to relieve its own Medicaid burden by working with schools and industries to create more jobs and decrease the poverty rate. People whose jobs provide health benefits usually do not qualify for Medicaid.
“I think it would be unrealistic to think that we'll ever have no poverty here in the county, but I think we can continue to fight for jobs and to support policies that will help provide opportunities for people that will help them have a step out of poverty - I think long-term, that's our answer.”
Still, Delk said the ideal situation would be for the state to step in and cover county Medicaid costs, as all other states in the country do.
Delk said he and commissioners Rives Manning and Rachel Hux joined officials from other counties throughout the state in lobbying for Medicaid relief from the state legislature. A group in front of them was lobbying for higher Medicaid rates, Delk added, and legislators hear both sides of the argument all the time.
“They've gotta realize that every dollar we're paying for Medicaid here is a dollar that could be used for something else, including our schools,” Delk said.
Increases in Medicaid costs are a bigger problem for Halifax County than they are for the average county, so Delk is hoping the formula used to distribute the relief funding will be beneficial for the county.
“Whatever happens, if it's kind of good for most counties, it will be really good for us.”
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