BATH -- Steuben County legislators joined state lawmakers Wednesday in a united protest against Gov. Andrew Cuomo’s plan to shift Medicaid costs back onto county taxpayers. Under the plan, the state would absorb Federal Medical Assistance Percentages (FMAP) funds that counties now receive and also force counties to pay any Medicaid expenses in excess of the state’s budgeted Medicaid cap. It also would penalize counties if the additional costs forced local budgets to exceed their state-enforced property tax caps.
The governor says the plan would reduce the state’s looming $6.1 billion budget deficit while he blamed the counties for mismanaging the state’s mandated Medicaid system -- the most extensive and expensive programs in the nation. "The counties are not to blame for the Medicaid deficit," county Manager Jack Wheeler told the county Legislature’s Human Services Health and Education Committee. "It’s the shell game and a deficit created wholly by the state. But the good news is everyone in the state (Legislature) is against it. Everyone. This has united downstate, upstate and New York City like nothing else." Steuben -- and other counties across the state -- have no choice in what Medicaid services are provided in the state’s program, which include nearly all of the 28 optional services in addition to those mandated. Nor does county staff have any say in Medicaid eligibility guidelines, which are also established by the state.
The role of the county is to verify eligibility of applicants and assist in processing, a role which is decreasing in recent years. Social Services Commissioner Kathy Muller told the committee that county staff currently processes an average of 20 percent of Medicaid applications, with state staff and contractors processing the remaining 80 percent. For local officials, it’s a matter of déjà vu all over again. When Cuomo promised in 2012 the state would take over the local share of Medicaid in return for the state-mandated 2 percent property tax cap, Steuben officials warned the governor the system in New York was badly broken -- and hoped his action would lead to a drastic reform of Medicaid. Instead, the state took over administering the program and increased eligibility. Now Steuben officials said the governor has gone back on his word. According to the New York State Association of Counties (NYSAC) Cuomo’s 2020 budget proposal:
1) Caps the amount of federal savings (FMAP) for counties and New York City from the Affordable Care Act. Instead, any savings would go the state’s general fund. In the county’s view, this funding stream was meant to offset local costs and should not be taken by the state. Should this proposal pass, it would cost county taxpayers a conservative 1.2- $1.7 million annually.
2) Requires counties to stick to the state’s 2 percent property tax cap AND limit growth of the Medicaid local share to less than 3 percent per year, or lose the savings from the state-funded local Medicaid cap. It is estimated that this proposal would cost Steuben taxpayers an additional $1.4 million in the first year alone.
"The state mandates Medicaid, the health care components/programs of Medicaid, eligibility as well as reimbursement rates to providers. This new legislation will impose a penalty to local government for increased costs associated with the State’s regulated Medicaid program for which local districts have no control," county Department of Social Services Commissioner Kathy Muller said. The additional Medicaid costs could force next year’s county budget to go over the state’s property tax cap, Wheeler warned. Instead, county officials are calling on the state to let the Medicaid Redesign Team II do their work and recommend reforms to the system. County leaders throughout the state stand ready to assist in this process, and Steuben officials have submitted a number of proposals to this team in recent weeks.
The governor says the plan would reduce the state’s looming $6.1 billion budget deficit while he blamed the counties for mismanaging the state’s mandated Medicaid system -- the most extensive and expensive programs in the nation. "The counties are not to blame for the Medicaid deficit," county Manager Jack Wheeler told the county Legislature’s Human Services Health and Education Committee. "It’s the shell game and a deficit created wholly by the state. But the good news is everyone in the state (Legislature) is against it. Everyone. This has united downstate, upstate and New York City like nothing else." Steuben -- and other counties across the state -- have no choice in what Medicaid services are provided in the state’s program, which include nearly all of the 28 optional services in addition to those mandated. Nor does county staff have any say in Medicaid eligibility guidelines, which are also established by the state.
The role of the county is to verify eligibility of applicants and assist in processing, a role which is decreasing in recent years. Social Services Commissioner Kathy Muller told the committee that county staff currently processes an average of 20 percent of Medicaid applications, with state staff and contractors processing the remaining 80 percent. For local officials, it’s a matter of déjà vu all over again. When Cuomo promised in 2012 the state would take over the local share of Medicaid in return for the state-mandated 2 percent property tax cap, Steuben officials warned the governor the system in New York was badly broken -- and hoped his action would lead to a drastic reform of Medicaid. Instead, the state took over administering the program and increased eligibility. Now Steuben officials said the governor has gone back on his word. According to the New York State Association of Counties (NYSAC) Cuomo’s 2020 budget proposal:
1) Caps the amount of federal savings (FMAP) for counties and New York City from the Affordable Care Act. Instead, any savings would go the state’s general fund. In the county’s view, this funding stream was meant to offset local costs and should not be taken by the state. Should this proposal pass, it would cost county taxpayers a conservative 1.2- $1.7 million annually.
2) Requires counties to stick to the state’s 2 percent property tax cap AND limit growth of the Medicaid local share to less than 3 percent per year, or lose the savings from the state-funded local Medicaid cap. It is estimated that this proposal would cost Steuben taxpayers an additional $1.4 million in the first year alone.
"The state mandates Medicaid, the health care components/programs of Medicaid, eligibility as well as reimbursement rates to providers. This new legislation will impose a penalty to local government for increased costs associated with the State’s regulated Medicaid program for which local districts have no control," county Department of Social Services Commissioner Kathy Muller said. The additional Medicaid costs could force next year’s county budget to go over the state’s property tax cap, Wheeler warned. Instead, county officials are calling on the state to let the Medicaid Redesign Team II do their work and recommend reforms to the system. County leaders throughout the state stand ready to assist in this process, and Steuben officials have submitted a number of proposals to this team in recent weeks.