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[MM Curator Summary]: The fight between the state Medicaid money financing masters and the local counties just trying to survive continues. Shorthand – NYC vs Albany.
BY JIMMY LAWTON
North Country This Week
CANTON –A proposal by Gov. Kathy Hochul could push $3.8 million in Medicaid expenses back to St. Lawrence County taxpayers, but legislators across the state are rallying to halt the move.
Offsetting the cost in St. Lawrence County would require a 6% hike in county taxes, which would push the county well over the state-imposed 2% cap.
A resolution passed by the St. Lawrence County Finance Committee calls on state officials and the governor to reconsider the plan.
“St. Lawrence County strongly disagrees with the need to cut county funding so deeply when the executive budget proposes to fully fund its own reserves two years ahead of schedule by depositing $5.4 billion into reserves before the end of state fiscal year 2023, while also projecting a general fund surplus of $35 billion by the end of state fiscal year 2024,” the resolution reads.
The “budget proposal would end the Affordable Care Act enhanced Federal Medical Assistance Percentage federal pass-thru to counties and New York City,” the resolution says.
The Governor is proposing to keep all of these federal savings going forward and use them to cover further expansion of Medicaid eligibility and benefits and to increase payments to health care providers, according to the resolution.
The county estimates the shift will cost the state’s 57 counties to spend an additional $280 million and approximately $1 billion when New York City is included.
The figures shared by the county match estimates my by the New York State Association of Counties.
New York State is one of the few states that pushes Medicaid expenses on to local taxpayers, in most states the expense isn’t passed down.
“It’s been a long held understanding that Congress intended these federal savings to be shared with counties promotion to the amount they contribute toward non federal Medicaid match,” the resolution. “Since 2003 New York State has shared the funds proportionally based on analysis of savings received during periods when an enhanced federal Medicaid match was enacted by congress.”
County legislators aren’t alone in their calls. Similar concerns have been raised by county legislators across the state including a unified call from NYSAC.
“In 2011, the State made a deal with local governments that said, ‘You can’t raise property taxes more than 2% a year, but to make that possible, we’ll cover any increases in the cost of Medicaid,’” said NYSAC Executive Director Stephen Acquario. “Counties kept our end of the bargain and held property tax increases in check, but now the state is shifting billions of dollars of new Medicaid costs onto counties over the next several years. New York taxpayers are already grappling with increasing costs to rent, housing, food, and utilities and can’t afford to bear the burden of rising Medicaid costs.”
State lawmakers representing the North Country are also opposing the plan.
On Tuesday Assemblyman Scott Gray (R-Watertown) joined members of The New York State Association of Counties to push against Gov. Hochul’s proposal within the Executive Budget that would withhold federal Medicaid funding from counties.
“After serving 21 years in the Jefferson County Legislature, I understand the importance of federal fund allocations,” said Gray.
Gray said that with Medicaid coverage expanding since the passage of the Affordable Care Act, counties have been setting their budgets with the funding in mind.
“New York state has increasingly relied on county revenue intercepts to disguise and support its wayward spending habits. The state has previously intercepted sales tax revenue, aid meant for distressed hospitals, passed AIM payment responsibilities onto the counties and now wants to intercept Medicaid payments intended for county-level services,” he said. “Gov. Hochul must recognize the seriousness of this issue and release these Medicaid funds to the counties as the U.S. Congress intended.”