Health Care Issues and Challenges Faced by Hillsboro County

Hillsboro started as an initiative in 1991 that simply raised the sales tax by half a cent so as to raise funds which it used to establish a health care plan to cover more than 30,000 uninsured residents in the county. By the year 1993 the plan had rolled out and within two years, the plan gained national recognition. In fact it won an award in the annual Ford Foundation for Innovations in Government. It however started facing stormy times more especially on its revenues.

Based on some changes in county government management, in 1997, coupled with malice from some quarters containing the newly elected and powerful conservative forces, the plan saw its revenue shrink to a quarter cent sales tax down from the initial half a cent sales tax. The 2001 economic showdown further placed the future of the health care plan in jeopardy because it reduced the revenue of the plan due to increased county’s Medicaid/ Medicare contribution to the state and reduction of reduction of grants the county received from the state.

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This coincidence worked together to create a decreased base thereby reducing the number of uninsured people in Hillsboro thus underscoring the initial hopes of gradual extension of eligibility through a careful fiscal management. Even as the revenue reserves were replenished by reinstatement of the half a cent sales tax in 2002, there was increases in costs per member per month and by 2004, the plan had to borrow a whopping $& million of the county’s revenue to balance the equation.

So far, thing have not changed because, just as the Medicaid and Medicare have threatened to outgrow their fiscal boundaries in future, the health care plan continue to ravage in limited revenues as it gets bedeviled by growing population of eligible beneficiaries whose cost per month increases in tandem with the national cost of medical care.

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