Stewart seeks study of county's costs in health overhaul

Board Chairman Corey A. Stewart's action could be a first step to a legal challenge.
Board Chairman Corey A. Stewart's action could be a first step to a legal challenge. (Tracy A. Woodward/the Washington Post)
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By Jennifer Buske
Thursday, April 22, 2010

In a first step to potentially challenge aspects of the new federal health-care overhaul regulations, Prince William Board of County Supervisors Chairman Corey A. Stewart (R-At Large) introduced a resolution that seeks to establish the cost of providing federal Medicaid benefits to county residents and leaves the door open to challenge the rules in court.

Supervisors will vote on the resolution May 4.

"We have a five-year budgeting plan, so we have to start accounting for these additional costs," Stewart said. "The federal government and the state are already drafting how to implement regulations, and if we don't get involved now, we will lose our opportunity to make sure they implement it in a way that is the least burdensome to the localities."

Stewart is not the first public official to raise questions about the federal health-care program. Virginia Attorney General Ken Cuccinelli II (R) filed a lawsuit and challenged aspects of the bill meant to make sweeping changes to the nation's health-care system.

Under the legislation, states will have to expand Medicaid eligibility for all adults to 133 percent of the poverty level. Stewart said that might hurt not only the county budget but also the current Medicaid program.

As of March, about 31,200 Prince William residents were in the Medicaid program, said Ric Perez, director of the Prince William Department of Social Services. Perez said that under the new regulations, Virginia is expected to add about 400,000 people to the Medicaid program, with about 11,000 of those projected to be in Prince William.

Although Medicaid is a state and federal program, Prince William pays 37 percent of the costs associated with administering the program. According to the proposed resolution, in fiscal 2010 the county's Department of Social Services spent $6.5 million to administer Medicaid, food stamps and other aid programs. Although it is unclear how the new regulations will be implemented and funded, if localities are mandated to continue administering the program, it could cost Prince William an additional $1.7 million a year, according to information from Stewart's office.

"We will comply with the law, but it doesn't stop us from filing a lawsuit or taking other actions to protect the county's finances," Stewart said, adding that the county would have to weigh the potential cost and benefits of a lawsuit.

Although there was no discussion on the proposed resolution, Supervisor John D. Jenkins (D-Neabsco) said in an interview before the meeting that he supports the new Medicaid regulations. He said he would not support anything that would challenge federal law or direct county staff not to follow federal regulations.

"The Congress has passed the law, and the president has signed it," he said. "It's the law of the land, and for us to not follow the law is pure anarchy. We can't pick and choose the laws we want to support, and we have to follow the rules established by the Constitution."

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