Medicaid is by far New York’s largest unfunded mandate. The total municipal share of Medicaid spending for the 2010-11 fiscal year alone totaled $8 billion. The high cost of Medicaid as well as the way Albany has chosen to fund the program is a major drain on the budgets of local governments and has led to the dramatic increase in Long Island property taxes over the past decade.
That’s why I was encouraged to see that Governor Cuomo included in his Executive Budget a proposal to freeze the local share of Medicaid’s growth rate at 2 percent, putting it in line with the cap on property taxes, which the Legislature passed last year. His proposal is a good first step in addressing the impact the state’s costly Medicaid program has on local governments’ budgets.
However, the Governor’s proposal to address this burden is not a new idea; rather, the plan to have the state pay for more of Medicaid’s outlays has been embraced by Republican lawmakers for years. I am currently a sponsor of Assembly bill 8453, which requires New York State to take over the future growth increases in the Medicaid program for local governments. My bill would provide significant and needed mandate relief to county governments and New York City.
Yet capping the local share of Medicaid growth is only the first step to address New York’s budget-busting entitlement program. To provide lasting mandate relief to local governments and ensure that Medicaid is able to meet the state’s growing health-care needs, real reforms to the way we fund the program and what New York covers under Medicaid must be implemented.
That’s why I have signed on to separate legislation to gradually shift the entire local share of the Medicaid program to the state level, a move that would save local taxpayers close to $8 billion annually. My response to the Governor’s argument that the state is unable to pick up the tab is that the Legislature must then make changes to the program to ensure that a state takeover of the program is financially viable.
Whether this means dropping coverage for the optional services which have made New York’s Medicaid program the most expensive in the nation, or dedicating new streams of funding to the Medicaid program beyond the property and sales taxes homeowners and individuals in Nassau and Suffolk counties are currently forced to pay, the bottom line is that county governments can no longer bear the enormous burden Medicaid places on their budgets.
Furthermore, requiring the state to shoulder more of the costs associated with the Medicaid program will spread these costs over a broader income-tax base, around 55 percent of New York’s total revenues every year, while forcing state government to more aggressively work to reduce the billions of dollars in annual Medicaid waste, fraud and abuse.
Medicaid is an important program that provides needed health services to millions of New Yorkers. To ensure the long-term viability of the program and make certain that it is in a position to meet our state’s growing health-care needs, the state, not local governments, must take the reins on not only funding the program, but modernizing it to make New York’s Medicaid system sustainable for generations to come.
