Medicaid expansion could cost county $700,000

Jul. 9--ASHEBORO -- If North Carolina chose to expand Medicaid cover under the Affordable Care Act, that could mean as much as $702,072 in additional costs to Randolph County.

That was the bottom line presented to the Randolph County Board of Commissioners Monday night by Tracie Murphy, director of the county's Department of Social Services (DSS). Murphy and her staff did the research after the commissioners asked that she assess the financial impact on the county.

Medicaid is a federal program that provides health insurance to low-income individuals using both federal and state funds. Under the Affordable Care Act, the federal government pledges to cover 90 percent of the expansion costs. So far, 36 states have expanded Medicaid for people with household incomes below 138 percent of the federal poverty line, which comes out to $29,435 for a family of three.

Under those guidelines, Murphy said, some 10,800 more Randolph County residents would become eligible for Medicaid. But expansion would lead to additional costs to DSS.

"Planning to support those new beneficiaries would require a minimum 32 new DSS staff members at a total cost of $1,768,916," Murphy said. "Costs to support the office space for those 32 staff members would be an additional $112,000, and that includes essential office equipment such as a computer, desk, chair and phone. It does not include actual office space."

Murphy said that current costs of Medicaid are divided between the state and the federal government, with the feds paying 67 percent. Expanding Medicaid includes the federal government's pledge to pick up 90 percent of the costs.

Murphy said her research shows that expansion would require an additional 32 staff members to support the added caseload. Total cost of those new jobs would be an estimated $1,768,916 with the county's share being $702,072 based on the current cost share model.

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