New York state must give local governments more flexibility to control Medicaid costs: As is, the program’s imposing an unfair and unsustainable burden.
Here in Erie County (the largest Upstate county), virtually the entire property-tax levy goes directly to the state for Medicaid services. In 2010, our local share of Medicaid was about $201 million; the county’s property-tax levy, $211 million.
Yes, Medicaid provides a vital safety net for our most vulnerable citizens — but we can maintain that while reforming it to slash costs.
Something’s got to give. This year, Erie’s Medicaid tab will rise by $6 million — and the total cost (with state and federal shares) will be more than $1.4 billion. That’s nearly $1,500 for every man, woman and child in our community.
Much of that spending isn’t mandated by the feds, but by the state — services that cost Erie taxpayers another $250 million in state and local Medicaid payments. These “optional” services are why New York is well known for having a “Cadillac” Medicaid program. But in these tough fiscal times, taxpayers are demanding a Chevy, not a Cadillac.
That’s why I am asking state lawmakers to pass “opt-out” legislation. This law would let local municipalities opt out of Medicaid services not mandated by the federal government. Through local law, approved by the local legislative body and executive, municipalities would determine which optional Medicaid programs to provide their citizens.
The results would be immediate, tangible and dramatic. In Erie County alone, taxpayers would see local property-tax bills fall by $80 million — 40 percent. Total statewide savings would be enormous — and a real pathway toward fixing our daunting financial challenges.
In his recent State of the State Address, Gov. Cuomo talked at length of the necessity to reform our Medicaid system. I’ve now sent the governor and every member of the Legislature a letter detailing this legislative proposal.
Reforming Medicaid has proven incredibly difficult, in large part, because it is nearly impossible to get all the diverse but necessary parties to agree on statewide reforms. But this solution isn’t one-size-fits-all — it lets each local government tailor a program to fit the needs of its residents, balanced against local taxpayers’ ability to foot the bill.
County governments are drowning in Medicaid costs. The least New York state can do is allow them to build their own life raft.
Chris Collins is the Erie County execu tive.