Misleading on Medicaid?
The honorables continue to hear from staffers on the state budget this morning.
Today's briefing concerns Medicaid and its impact on the state budget. One of the big debates on the topic has been whether and how much counties should pay toward Medicaid, which is the joint federal-state program for the poor.
Last year, the state capped county Medicaid payments (for one year) and there was a good deal of talk about how North Carolina was the only state that made counties pay.
In fact, you can click here to read the N.C. Association of County Commissioners make that case.
So it surprised the heck out of me to hear Carol Shaw of the fiscal research staff say that a hand full of states, including New York and South Carolina, make counties pay a portion of the Medicaid costs.
Click here to listen to what she told the honorables.
Expect the honorables to remember that bit of information as they compile the budget and hear from the county lobbyists throughout this Spring.
Update (2 p.m.):So, the slides from the presentation that caused the hubbub this morning can be found here.
Check page 20 for a handy-dandy little graphic that is supposed to show how other states share their Medicaid costs. It is the six “X” marks in the “All/Most Services” column (the third one in) that we’re focused on here.
Here’s where things get tricky and/or eronious:
- North Carolina has an X and rightfully so.
- Mississippi I am told, and am trying to get this in writing, should not have an X.
- Utah also should not have an X. Counties there pay a portion of mental health costs, not a percentage of the whole Medicaid cost.
- South Carolina DOES require counties to pay 50-cent per capita figure, but the total bill doesn’t approach the nearly $500 million North Carolina’s 100 counties shell out collectively.
- New York is in the midst of phasing out its Medicaid share for counties.
- New Hampshire’s X is in the wrong column and basically a typographical error, I’m told.
So, on balance, it looks like the County Association was basically right.
What will be interesting is whether this presentation will continue to reverberate into the session. There were a lot of legislators who came out of that session feeling that they had been mislead in the past. Will they still harbor those feelings when budget decisions are made and if so, how will affect efforts by the counties to get the state to take on the Medicaid portion?
Comments (5)
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Mark,
Does it surprise you?
The NC Association of County Commissioners is a pretty sorry bunch. They have a lot of things in common with Anna Nicole Smith - Money grubbing, lazy, and not exactly honest.
They are a little like a used car salesmen showing a customer a beautiful car only to have the customer discover after looking under the hood that the car’s engine has 3 cylinders that don’t fire and hasn’t had the oil changed in 20,000 miles.
The people that ought to be really taking it to the NCACC are you and the rest of the capitol press corp. Yall are the ones that have been printing the misinformation they have disseminated as the gospel truth. (Well you personally haven’t written an article that I can find but there are a lot out there in cyberspace)
The wool has been pulled over yall’s eyes with the exception of the 'Washington Daily News'. (Do a Google search for ("Medicaid" county North Carolina only) to check for yourself.) And the Editorialists at yall's papers have been using the misinformation to flog the General Assembly to dole out more money to the Counties (see 'Charlotte Observer' 1/13/07 for example).
Makes one wonder if the papers are in league with the Commissioners - disposing of inconvenient facts to achieve an end they both desire.
Granted I don't think this is the case but it goes to show, once again, the bias of editorialists and editors when it comes to promoting things they advocate. They fail to use the jaundiced cynical eye that they use to examine things they opposed.
It seems to me that the nine elements of journalism get turned on their head when the media takes element 9 and reconstitutes it as “Its practitioners must promote their personal conscience.” Then puts it #1 above all else.
1. Journalism's first obligation is to the truth.
2. Its first loyalty is to the citizens.
3. Its essence is discipline of verification.
4. Its practitioners must maintain an independence from those they cover.
5. It must serve as an independent monitor of power.
6. It must provide a forum for public criticism and compromise.
7. It must strive to make the significant interesting and relevant.
8. It must keep the news comprehensive and proportional.
9. Its practitioners must be allowed to exercise their personal conscience.
In any event, I enjoy your blog and your willingness to take an introspective look at your work and your profession.
As for the rest of your cohorts - Tsk, Tsk, shame, shame...North Carolinians deserve better from our fourth estate.
Posted on January 31, 2007 10:47 AM
I will note for those of you coming late to this post that Cy left his comment before I had a chance to look into this further and post my update.
I don't know why Cy feels that NACC is a "sorry bunch," but in this case they appear to be in the right.
Posted on January 31, 2007 2:29 PM
Mark, come on... the slide indicates that the states information is from the National Conference of State Legislatures and is NEARLY a year old...
not that fiscal research needs to be that precise....
Posted on January 31, 2007 2:46 PM
TL: I'm not sure what you're arguing here...whether it's out of date or just wrong, it certainly had some legislators (and more than a few journalists) scratching their heads this morning.
Posted on January 31, 2007 2:52 PM
Mark- Keep us up to date on this issue, which is very important because it seems to me like another instance of the state leaning on counties more and more.
Posted on February 1, 2007 8:31 AM