Archives: Joseph Coletti

States have three direct policy levers to control Medicaid growth: eligibility, services, and payments. North Carolina’s mix of policies has led to some of the highest costs in the South, but the Blue Ribbon Commission on Medicaid Reform would make it even costlier. Tennessee and Mississippi, the two Southern states with higher per capita costs in 2000, have since made significant changes. Georgia and Virginia present different ways to reduce costs, while a 2001 report for the General Assembly presented largely unexploited savings.

Defenders of North Carolina’s fiscal policies over the past two years argue that the state’s massive increases in sales, income, business, and other taxes were just part of a national trend. But the available data put North Carolina near the top in tax increases over the past two years, with more than $1 billion in annual fiscal impact. The state’s quick recourse to higher taxes may be one reason why its economy has been trailing the rest of the region and nation since mid-2001.