Commissioners Adopt Medicaid Resolution By Scott Nicholson The Watauga County Commissioners adopted a resolution asking the state to eventually assume all responsibility to fund Medicaid, the health care program for low-income households. The N.C. Association of County Commissioners (NCACC) had drafted the position at its annual conference last month, listing it as the top agenda item. The group generally lobbies the state on behalf of county governments, and this year Medicaid dominated the meeting, according to commissioner Winston Kinsey. Kinsey served as the county’s representative at the meeting. The Watauga board’s resolution asks the General Assembly to “provide immediate Medicaid relief to Watauga County.” The county is expected to pay $1.45 million for its share of Medicaid costs in the next fiscal year, a figure that has increased dramatically over the past few years. Medicaid costs consume about nine percent of the county’s property tax revenues. North Carolina is one of only two states that requires counties to pay a share of Medicaid costs. The Bush Administration’s latest budget proposal includes significant cuts to federal funding Medicaid. The resolution will be sent to the area’s General Assembly representatives and the Governor’s office. While the commissioners’ resolution seeks immediate relief, the NCACC proposed a five-year phase-out of county participation in footing Medicaid costs. Under the NCACC’s adopted goals, the group is asking the state to freeze the counties’ costs this year. Rep. Julia Howard (R-Davidson) is reportedly planning to introduce a bill to seek a three-percent reduction in county Medicaid share until 2009, at which time the state would fund the entire portion not covered by the federal government. Kinsey said the Medicaid stance fit a general theme of the conference: “The entity of government that passes the bill (establishing a program) should pay for it.” “Not that they’re (NCACC) against Medicaid,” Kinsey said. “There are counties that don’t even have an incorporated town. We have eight percent of people eligible for Medicaid. Some counties have 30 or 40 percent.” Commission chair Jim Deal said costs were rapidly escalating, particularly as the population ages. “In counties without a significant tax base, it eats up a large portion,” he said. The board also discussed potential revenue options, with Kinsey reporting the NCACC supports legislation that would allow counties to adopt a half-cent sales tax increase if the General Assembly allows the increase to expire. The state adopted the tax increase three years ago as a temporary way to shore up a budget shortfall, and also granted counties the authority to enact an additional half-cent sales tax. Most counties, including Watauga, adopted the increase. Kinsey characterized the sales tax as a regressive tax that “puts the burden on the poorest people,” but the only alternative was to raise state income taxes. He said the state is expecting to have a $1.2 billion shortfall in the next fiscal year, and some observers believe the state won’t let the tax expire as scheduled. An extra penny of local sales tax would generate about $1.4 million for the county. Kinsey said the NCACC also wants to do away with local teacher supplements, instead letting the costs be borne by the state. Supplements would then be the same for all counties and would reduce some of the competition in recruiting teachers. Kinsey said he was divided on the issue, because he said some schools that had a difficult time recruiting teachers wouldn’t be able to entice people to take the job unless they had flexibility in offering more money. The NCACC supported legislation that would require compensation from state agencies to counties if the state obtains interest in land through conservation or preservation efforts. That legislation would offset the loss of property tax income from those properties. Other agenda goals are to support an increase in tobacco funds to pay for educational programs and Medicaid costs. Kinsey said farmers at the meeting were angry over the taxing of tobacco, though North Carolina has one of the lowest tobacco taxes in the nation. The NCACC also supported a county option to apply an “impact tax” for people moving into the county to fund capital improvements. Other goals outlined and adopted at the NCACC meeting were: an increase in alcohol taxes to fund mental health services for people not eligible for Medicaid; phase out county responsibility for funding Special Assistance programs for adults; protection and support of private working lands as part of a state conservation plan; fund expansion budgets for community colleges; a legislative study on disposal of abandoned manufactured housing; support a housing trust fund to assist with new home ownership and affordable rentals; support legislation to provide for a statewide referendum on a bond issue to meet school construction needs caused by increased enrollment and a state-mandated reduction in class size; and exempt counties, cities, school boards and communities from paying state and local taxes on goods purchased within the state. The commissioners plan to discuss their legislative goals and focus on a list of three or four topics during their annual budget retreat next month.