Prince William County to study costs of federal health law

By Jennifer Buske
Washington Post Staff Writer
Sunday, May 9, 2010

Prince William County supervisors have directed staff members to assess the financial impact the new Medicaid regulations outlined in the federal health-care law will have on a county budget that looks bleak for the next few years.

"We quantified the cost of illegal immigration on the county first, and that's what we are doing here," Board of County Supervisors Chairman Corey A. Stewart (R-At Large) said. "This is just good government, and it needs to be done. Other localities may wait until later, but eventually every locality will have to address the cost."

Under the new federal legislation, states will have to expand Medicaid eligibility for adults to 133 percent of the poverty level starting in 2014. Stewart said that might hurt the county budget and the current Medicaid program. Although Medicaid is state and federally funded, Prince William pays 37 percent of the administration costs associated with it.

The board passed the resolution, introduced by Stewart last month, 6 to 2 on Tuesday, with supervisors Frank J. Principi (D-Woodbridge) and John D. Jenkins (D-Neabsco) dissenting. The handful of residents who spoke at the board meeting also opposed it.

"I've received 50 e-mails in the last couple of days with people not understanding why this is being done," Jenkins said. "We are way ahead of the implementation date on this, and it seems a little folly to me to spend a lot of time and effort to visualize what it could be like in 2014. . . . I can't support this when it is going to cost us."

Stewart's resolution is a watered-down version of what he once wanted to propose. Before, he said, he wanted the county not to follow the new law. That, however, raised legal concerns.

The county attorney assured the board that the passed resolution is legal and said it does not set the county up to ignore federal mandates. Stewart, however, said the county has not precluded the possibility of challenging the mandates in court. That decision wouldn't come until details on the legislation's implementation and cost are more concrete.

"It is bizarre the chairman would propose that county staff ignore the law. What is he going to ask [the staff] to ignore next?" Prince William resident Harry Wiggins said. "From a fiscal standpoint, this is reckless and irresponsible and only to keep his name in the news."

Jenkins said the study is not only premature but also unnecessary because the left-leaning Center on Budget and Policy Priorities has released a similar study. According to the center's report, the federal government will pick up 96 percent of the costs of the Medicaid expansion over the next 10 years. The states will pay only about 1.25 percent more than what they would have spent on Medicaid from 2014 to 2019 in the absence of the health-care law, the report says.

Jenkins, along with Gainesville resident Carol Noggle, also questioned what it will cost to study the new Medicaid regulations and follow the other resolution directives, which include talking to private health-care providers, informing state and federal officials about the county's concerns and looking at the bill's impact on the health insurance Prince William offers to employees.

Jenkins suggested creating a citizen advisory committee to study it without using taxpayer money, but that idea failed. Stewart could not provide a cost estimate for implementing his resolution.

"My suggestion is it would be best to withdraw this resolution," Noggle said. "Thoroughly read through [the legislation] before asking the county staff to do more work when there is already a shortage of workers in the Social Services Department," which administers Medicaid.

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 the new law is expected to add about 15,000 residents to the rolls.

It is unclear how the new regulations will be implemented and funded, but 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. The county spent $6.5 million to administer Medicaid, food stamps and other aid programs in fiscal 2010.

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