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Schenectady County urges state to keep Medicaid cost cap

Schenectady County urges state to keep Medicaid cost cap

Counties push issue at Capitol on Wednesday
Schenectady County urges state to keep Medicaid cost cap
Counties are urging Gov. Andrew Cuomo to retain the state's Medicaid cost cap.
Photographer: New York Times

SCHENECTADY COUNTY -- The Schenectady County Legislature is urging the state to maintain the local cap on Medicaid costs, resisting Gov. Andrew Cuomo's plan to manage the program's growing costs by having local governments potentially pay more.

A resolution unanimously approved at Tuesday's monthly meeting in Schenectady says the cap on the local share in place since 2015 has helped Schenectady and other counties keep property taxes down, "which enhances New York's economic competitiveness and improves economic opportunities for all New Yorkers."

The county believes "a plan designed to financially penalize municipalities for Medicaid cost increases above an arbitrary benchmark percentage could be devastating to certain municipalities, especially since local municipalities do not set standards to control who qualifies for Medicaid programs," the resolution states.

Local government opposition to changing the cap system is growing, as a county advocacy day on Wednesday in Albany showed.

Schenectady County Legislature Majority Leader Gary E. Hughes, D-Schenectady, said the Cuomo administration has been a great partner in economic development and other county initiatives, but "the governor simply doesn't see the issue the same way we do as a county."

State Assemblyman Phil Steck, D-Colonie, who represents Niskayuna and part of Schenectady, said he agrees with local leaders "110 percent," calling Cuomo's plan "a nonsensical proposal."

"I want to keep it exactly the way it is now," said Steck, a former Albany County legislator who believes it would be better to close the state deficit by restoring the stock transfer tax. "The county doesn't have any way of controlling the expenditures. It's a state program, and the state controls the costs."

Schenectady County now pays about $33 million annually toward the costs of Medicaid, the government medical insurance program for the poor and indigent, including many people in nursing care facilities. That's the amount that has been capped for the last five years, with the state paying any costs above that.

But with the state's costs for Medicare ballooning by the billions of dollars and the state facing a projected $6 billion deficit next year, Cuomo said the cap means that local governments don't have any incentive to control costs. Medicaid costs the state about $77 billion annually, though some of those costs are reimbursed by the federal government.

In his 2020-2021 executive budget, Cuomo proposed having counties again pick up the additional costs if the Medicaid costs in that county grow more than 3 percent annually. The local cost cap could also be lifted if a county doesn't adhere to the state's 2 percent local tax cap.

But county officials and their supporters say Medicaid cost increases are beyond their control.

"We have very few tools to control it," Hughes said. "The state sets most of the rules."

The governor's proposals are now before the state Legislature as it reviews Cuomo's proposed spending plan, and a Medicaid Redesign Team appointed by Cuomo this week began meeting to create a new plan for managing Medicaid costs.

The New York State Association of Counties organized a rally at the state Capitol in Albany on Wednesday, calling for keeping the cap in place. "Counties will work with state leaders and with the Medicaid Redesign Team to address what is under local control, but we cannot absorb additional costs without jeopardizing vital services that our residents depend on,” said NYSAC Executive Director Stephen J. Acquario.

"While we welcome the opportunity to work with the [Redesign Team] to lower Medicaid costs overall, we maintain that property taxpayers should not shoulder the burden of Medicaid cost increases that counties are not empowered to restrain. We can’t cap what we can’t control, and our taxpayers should not be penalized for that,” said Albany County Executive Dan McCoy,

The Schenectady County resolution will be sent to Cuomo, state legislative leaders, and the county's members of the state Senate and Assembly.

New York is one of the few states in the nation to require counties to cover part of the cost of Medicaid -- 25 percent each year, before the state capped the local cost.

"The cap was the promise that we would remove some of that cost burden," said state Sen. James Tedisco, R-Glenville. "Backpedaling on that promise will not only negatively impact the ability of local governments to maintain fiscal solvency in providing services, but also continue to send a message that the governor and majorities can't be trusted to live up to their word. This is an attempt to balance a deficit they created on the backs of local taxpayers."

Reach staff writer Stephen Williams at 518-395-3086, [email protected] or @gazettesteve on Twitter.


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