Gov. Andrew Cuomo wants New York City to contribute more toward the state’s Medicaid bills—but no city official will have a voice in how the state looks to find $2.5 billion in savings in the health care program.
The governor’s Medicaid Redesign Team won’t include any representatives from City Hall as it makes recommendations for how to help the governor close a $6 billion projected budget gap for fiscal 2021, which begins April 1.
This is the second time Cuomo has convened a redesign team. The first time, back in 2011, the governor included Linda Gibbs, who was then deputy mayor for health and human services in the Bloomberg administration.
The group will be tasked with finding ways to save money in the Medicaid program without harming beneficiaries or local governments, according to parameters set by the governor. One area that has been pointed to as a driver of higher costs is increased enrollment in long-term care services in the home by seniors and people with disabilities.
The state and city have already been feuding over a policy proposed by the governor that would require local governments that exceed a state 2% property tax increase cap to pick up the totality of the annual increase in Medicaid costs in their jurisdiction. New York City routinely exceeds the property tax increase threshold and estimates it would be on the hook for $1.1 billion in higher costs if Medicaid costs grow at about 7%, which is similar to the rate in recent years.
“The state shifts $1.1 billion onto the City for a problem they falsely claim is the City’s ‘fault’, and in the same breath, leaves us off the commission they’ve created for bringing costs down,” a spokeswoman for the mayor told Crain’s. “It seems pretty convenient that the city facing the largest share of the cuts also has no representation. The State is playing a dangerous game at the expense of New Yorkers’ health care.”
The state sees it differently. The Cuomo administration pegs the potential impact on New York City at $221 million if it exceeds the cap because it assumes Medicaid costs will only increase about 3%.
A spokesman for the state budget division noted that six of the people on the 21-person panel are from city organizations, including New York–Presbyterian CEO Dr. Steven Corwin and Pat Wang, CEO of the insurer Healthfirst.
The city has objected to paying more because it says its role in administering Medicaid is limited to checking who can participate while the state sets eligibility standards and benefit levels.
The budget spokesman noted that the state is not assuming that it will receive more money from local governments as part of its financial plan and expects them to comply with the property tax cap and a 3% cap on the growth of Medicaid costs.