NC Health Care Recommendations: Medicaid

On April 11, 2006, the North Carolina House Select Committee on Health Care released recommendations for the 2006 legislative short session. Many of them will be controversial, and taken together they have the potential to significantly change the way that North Carolinians access health care and insurance (and how much we pay). Some of these topics are pretty technical, but no less important for their difficulty. I'm hoping that these posts will begin a conversation on the best course for North Carolina's efforts at healthcare reform.

I'll publish the recommendations of the six subcommittees in six posts, along with some of the background information from each report. The subcommittees are:

Right now, North Carolina is the only state that defines its counties' share of the state Medicaid bill as a fixed percentage of the total. This puts a strain on counties (especially low-growth counties with large Medicaid populations) and the concern is that other important county-level programs (like education) will have to be cut to cover growing Medicaid costs. The recommendation coming out of the subcommittee would do three things:

  • freeze county contributions at their 2005-06 dollar amount;
  • come up with money to pay for the increased cost to the state; and
  • spend $34.6 million to reduce certain counties' contributions.

$13,844,000 would be allocated among counties with a Medicaid-eligible population of 25% or more. The money would go to eligible counties according to their percentage share of the total Medicaid bill. $19,035,500 will go to counties with a Medicaid-eligible population of at least 15% but less than 25%, again, allocated by percent Medicaid-share. Finally, $1,730,500 would be split up among the remaining counties by Medicaid-share. The total amount of money used to reduce county Medicaid bills could be changed in future years, but it would have to stick to the 40%/55%/5% distribution described in this paragraph.

I really only have one critical thought on this: I assume that the percentages described above (such as 40% of reduction funds for counties with 25% or greater Medicaid-eligible population) reflect some thinking about the number of counties that satisfy the respective criteria. Why the General Assembly would be allowed to change the total amount of funds allocated without amending the law but should be tied to those percentages is beyond me.


Thanks for the committee listing

This will come in handy as the short session approaches and we go into action mode to give them some moral support. Does anybody know any of these folks?

healthcare reform

Healthcare will remain a problem and an unsustainable financial drain until the focus is turned to healthy lifestyles, individual responsibility and community commitment. Much of current healthcare costs are wasted due to lack of compliance and much of current health care costs are not needed if people would be more conscientious about their health.


I agree with you 100%, however, I do think that's easier said than done. That doesn't mean we shouldn't try.

Vote Democratic! The ass you save may be your own.