Tioga Leg Chair Sauerbrey Says Public Needs to Know NY’s Medicaid Proposal

New Yorkers are at risk of paying higher taxes and losing vital services under the current Medicaid proposal, according to a new report released by the New York State Association of Counties. NYSAC projects state plans could squeeze local taxpayers out of between $150 million and $1.7 billion, at a time when costs are growing, and counties have limited ability to contain them.

This story was submitted to Your Hometown Station WEBO by Martha Sauerbrey, chairwoman of the Tioga County Legislature on behalf of the New York State Association of Counties. Sauerbrey said the details in this report about the county’s responsibitity to pay for a portion of  Medicaid spending in New York as  “important issues” for counties and taxpayers to discuss. The outcome of the Medicaid proposal could impact county property taxes and result in cuts to county services.

“Instead of making local taxpayers pay for new Medicaid costs, State leaders should let the Medicaid Redesign Team II do its work and make cost containment reforms that don’t punish local taxpayers,” said NYSAC President John F. Marren. “We are asking State Legislators to reject these budget proposals.”

If Part R of the Health and Mental Hygiene Article VII is passed, it will impact all New Yorkers and result in increased property taxes and cuts to county services such as:

•  public health;
•  veterans’ programs;
•  road maintenance and repair;
•  youth services;
•  public libraries;
•  meals on wheels and other senior services.

“We agree reforms need to be made in the Medicaid program to place it on a sustainable fiscal path, and we will remain a partner in that effort, but the current proposal charges counties with reigning in costs that we do not control,” said NYSAC Executive Director Stephen J. Acquario.

NYSAC said counties have limited ability to contain Medicaid costs for the following reasons.

• The state directly enrolls and determines eligibility for about 60 percent of Medicaid recipients, and outside of New York City they enroll 2 out of every 3 recipients.
• Counties do not control benefit design or eligibility income thresholds.
• The state sets all reimbursement rates paid to health care providers.
• The cost of prescription drugs, durable medical equipment and other major health care inputs are controlled by the state or the marketplace.
• Changing demographics are outside the control of counties, including the aging, longevity and disability of the population.
• Rates of illness are population and community-based and beyond the control of counties.
• Minimum wage increases are set by the state.

Adding to the pain, Cuomo’s proposal would penalize counties for any growth in Medicaid spending that exceeds the global Medicaid spending growth cap, which is currently set at 3 percent, based on the 10-year average growth in the medical care component of the consumer price index.

The proposed penalties are likely to ensnare counties in future years and drive up Medicaid costs. Historically, Medicaid costs in New York state have grown more rapidly than the global growth cap. Projections of future Medicaid cost growth, and of underlying drivers of that growth, suggest that absent fundamental changes, costs will grow more rapidly than the economy, as well as the global growth cap.

The proposal contains three separate initiatives, referred to collectively as “Medicaid Local District Spending Reforms” that would impact the Medicaid share county taxpayers pay to support the state Medicaid program. The proposals would:

1. Intercept the federal Medicaid funding to counties and transfer that funding to the state financial plan.
2. Require counties to keep local Medicaid cost increases to no more than a “global Medicaid cap” now set at 3 percent or the county will be penalized and required to pay the state for anything above that amount.
3. Require counties and NYC to adhere to the 2 percent  Property Tax Levy Cap or lose the Medicaid cap savings.

“Lawmakers need to remove Part R of the Health and Mental Hygiene Article VII, preserve the local Medicaid cap, and let the MRT II complete its cost containment work,” Marren said.