This, on a measure from NY congressmen – an amendment to the health-care bill that would relieve upstate counties of their burdensome Medicaid costs and shift them to Albany.
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It would turn the program from a federal-state entitlement that covers all the health care costs of those who are eligible to one in which the federal government gives the states a fixed amount of money each year to cover their Medicaid-eligible residents.
Congressman John Faso (R-Kinderhook) said a proposed amendment to the new health care bill would save Upstate taxpayers $2.3 billion a year by shifting Medicaid costs from the counties to the state. Cuomo criticized this amendment, which would only be applied to NY state and said it would lead to more hospitals closing. With the administration and the congressional leadership already facing outspoken “concerns” from conservatives Rand Paul, Ted Cruz, and Mike Lee – along with opposition to anti-abortion provisions from Susan Collins and Lisa Murkowski – these and other Republican senators have set themselves up nicely to approach the bill’s sponsors for concessions large and small.
In a statement released Tuesday, Collins called the proposal a “huge win” for his constituents, saying local taxpayers could save hundreds or thousands each year on their property tax bills.
According to a Niagara County Legislature budget presentation, Medicaid accounted for $43.73 million of the county’s $77.6 million of the county’s tax levy, or more than 56 percent. The amendment only applies to New York, and does not include New York City, which has an income tax to pay for Medicaid.
New York Democrats expressed outrage at the measure, arguing it would hurt the voters Republicans claim to be helping, by hurting state Medicaid programs and rural hospitals. Those districts count among their representatives four GOP members who have shown at least some reluctance to passing the health care legislation: John Faso, Claudia Tenney, Elise Stefanik and John Katko. There was little detailing how the system would remain viable even if the President Trump-supported health care bill fails in the House or Senate. Members derisively called it the “Empire State Kickback”, “The Tammany Haul” and “The Buffalo Bribe”. “This is a guy who has the Buffalo Billion”. “Yeah. What they leave out is, if the county doesn’t pay its share, there’s another $2.3 billion cut to Medicaid on top of everything else, and that means less people are going to get health care assistance”. But some state lawmakers, including Gov. Cuomo, see it as just a tax burden shift.
He was non-comittal in describing how the state would leverage counties not having to pay Medicaid costs.
Taking away Medicaid costs would save Jefferson County about $20.5 million, according to an Empire Center report.
John Flanagan, the Senate majority leader in NY, questioned how the change would help taxpayers – saying it’s all the same state. But it doesn’t provide a penny more to the state. “You will literally decimate the health care industry”, Cuomo said at a news conference. Gray said. “It’s an unfortunate situation that we will probably have to look at where the retaliation will be”.
Critics also take issue with the perception of Medicaid being a handout for lazy, able-bodied adults.
But, Cuomo said the state won’t pick up the tab, which means hospitals and other healthcare facilities will be “devastated” without the needed funding.
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“In the plain language of the law, there is not a lot in this manager’s amendment that would change things substantially for real Americans”, she says.
