All states have been forced to spend more money to allow the Affordable Care Act (ironically named since it isn’t affordable), and more specifically changes to Medicaid, to be implemented in the states, regardless of whether the state approved expansion or not. Governor Pat McCrory recommended spending an additional $575 million on Medicaid in North Carolina, and that was after the legislature rejected expansion.  Here are some statements from the National Association of State Budget Officers about Medicaid spending in some of our neighboring states’ budgets:

  • Alabama — The Alabama Medicaid Agency accounts for nearly 40 percent of Alabama’s general fund expenditures.
  • Arkansas — The Arkansas budget includes $90million in additional Medicaid spending to help address a shortfall.
  • Florida — Health care spending continues to comprise a large portion of the state’s budget with recommended spending for the Department of Health and Human Services at $30.9 billion of which $22.5billion is dedicated for Medicaid.
  • Georgia — Medicaid remains a major cost driver for the state,prompting the governor to recommend an additional $246 million for both the current budget and next fiscal year to meet rising demand.
  • Mississippi — The proposed budget provides $878.4 million for Medicaid and notes that Medicaid spending needs may reach $921 million depending on the economy.
  • Tennessee — Much of the additional spending will be directed towards health care, including $121 million to cover Medicaid eligible patients that were not enrolled prior to the passage of the Affordable Care Act and an additional $94 million to meet the inflationary rise in health care costs.
  • West Virginia — The largest driver of budget growth is the state’s Medicaid program,which is projected to need an additional $142 million next fiscal year, while funding for all other program areas in the budget is expected to decrease by a net $21million.

So, as the North Carolina legislature continues to debate the budget and other bills that will have a fiscal impact on our state, we need to keep an eye on Medicaid spending.  The Affordable Care Act is not making the states’ jobs any easier or their budgets any smaller.