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Albany's Pols Lack Will for Real Empire State Healthcare Reform

Image: Albany's Pols Lack Will for Real Empire State Healthcare Reform
In this 2015 photo, Albany Med EmUrgentCare is seen in Coxsackie, N.Y. At the time, the state was using $8 billion in projected federal savings to overhaul its Medicaid program. (AP Photo/Mike Groll)

By George J. Marlin
Monday, 27 Mar 2017 03:57 PM Current | Bio | Archive

While New York is rated dead last for states with the best economic outlook, it is ranked the number two state in Medicaid spending — just behind the bluest state, California.

This fiscal year, the Empire State will spend $63 billion of our federal, state and local tax dollars on Medicaid. That’s more than the combined spending of two of the nation’s most populous states, Florida and Texas.

Texas, with a population of 27.8 million versus New York’s 19.7 million, spends about $32 billion on Medicaid. Florida with 21 million people spends approximately $20 billion.

New York also holds the distinction of being number one in requiring local governments to shoulder a significant portion of Medicaid costs.

This unfunded mandate is driving many New York counties to the brink of insolvency.

In Western New York’s Erie County, for instance, over 80 percent of its property tax collections go to pay its share of Medicaid costs. That leaves very little money for snow removal and other essential services.

To alleviate this financial albatross, Congressman Chris Collins, R-N.Y., a former Erie County Executive, proposed an amendment to the Ryan Health Care Act that would require states to assume full costs of its Medicaid programs imposed on county governments.

While there was much cheering from New York municipal officials and their constituents, an angry Governor Andrew Cuomo condemned the proposal.

On WCNY Radio last week, Cuomo declared, "My greatest fear from last year’s election has actually come true, which is you have rabid conservative ideology in Washington that would tell New York to drop dead."

The governor went on to say, "If the counties are not going to have to pay $2.3 billion any longer, that’s got to either be made up somewhere else, and if it’s made up by increasing taxes of all New Yorkers, its going to affect my people in a negative way or it’s going to result in a cut in services."

Cuomo’s charges are ridiculous. The governor appears to have forgotten that his father, Mario Cuomo, when he was New York’s chief executive in the 1990s, called for the state to absorb local Medicaid charges. And Mario Cuomo was not a "rabid conservative."

Unfortunately, the Collin’s amendment failed to become law because the Republican Affordable Care Act did not come up for a vote on the floor of the House of Representatives. Nevertheless, that does not detract from the merits of the proposal.

To relieve county governments of $2.3 billion of Medicaid costs is not a heavy lift, despite the claims of numerous Democratic elected officials that the health care system would be damaged and that state taxes would have to go up or benefits slashed.

To finance a state takeover, the governor and the State Legislature need only slash several billion in pork spending.

Citizens Union, a good government group, in its "Spending in the Shadows" report released in March revealed that Cuomo’s proposed budget for 2016-2017 contains $14 billion in lump sum appropriations "with little detail how the money is to be spent or who controls the spending."

Of that $14 billion over $4 billion would be handed over to State legislators and other elected officials with "no specific details provided as to how and where the funds should be spent."

That $4 billion is pure pork barrel spending to finance pet projects of special interests in the home districts of elected officials.

Albany pols can easily eliminate $2.3 billion of proposed pork spending and reallocate those funds to relieve county governments of onerous and unfair Medicaid costs.

Reallocating funds seems simple enough to me.

But to implement this modest reform, it would require political backbone. Sadly, however, Albany’s jam packed with spineless wonders more concerned with tossing swag to their donors and political cronies.

George J. Marlin, a former executive director of the Port Authority of New York and New Jersey, is the author of "The American Catholic Voter: Two Hundred Years of Political Impact." He also is a columnist for TheCatholicThing.org and the Long Island Business News. Read more reports from George J. Marlin — Click Here Now.

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Albany, N.,Y. politicians can eliminate billions of proposed pork, reallocating those funds to relieve county governments of Medicaid costs. Reallocating is simple. But it requires political backbone. Sadly, Albany’s packed with spineless wonders more concerned with donors and cronies.
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