In NY, Medicaid Reigns Supreme Among Unfunded State Mandates

A legislative column by Assemblyman Andrew Raia (R,I,C – East Northport)
January 18, 2012

Newsday recently ran an editorial on January 15, in favor of shifting Medicaid costs from the counties to the state government. The op-ed piece made points which we can no longer afford to ignore. Reforming how the Empire State finances Medicaid must now be priority number one for anyone who wants to cut the costs Albany passes on to Long Island homeowners and job creators. Our property taxpayers are losing $7.3 billion every year paying for the nation’s costliest unfunded mandate. We can no longer wait; the time to act is now.

The Facts

At roughly $53 billion a year, Medicaid spending in the Empire State is more than California’s despite covering 55 percent fewer patients, and costs taxpayers 79 percent over the national average for every Medicaid recipient.

The federal government is about to expand New York’s already generous Medicaid eligibility even more. Even if we reduce our counties’ payments to the program by 1, 2 or 3 percent a year, ObamaCare’s looming enrollment surge will outstrip any projected savings.

New York is currently only one of a handful of states that requires comparable Medicaid contribution levels between the counties and the state. This means that Washington pays 50 percent, New York State pays 25 percent and taxpayers get stuck with the remaining 25 percent. This formula is a leading cost-driver for higher taxes in Suffolk County and elsewhere.

The property tax cap that was passed in 2011 was a good start to reining in some of the highest property taxes in the nation. In 2012, we must focus on mandate relief. The Medicaid program, funded by our local property and sales taxes, is the state’s number one unfunded mandate.

A Solution

While I applaud Governor Cuomo’s leadership on this issue, slowing the rate of the entitlement program’s growth at the county level while shifting some administrative costs to Albany is not enough. A real solution to this problem would be to immediately freeze local contributions to Medicaid while gradually phasing in Albany’s assumption of the program’s costs over the next eight years. As a co-sponsor of Assembly bill 8644, legislation which would turn back the costs of Medicaid to the state, where they belong, I believe eight years is more than enough time for the Governor and Legislature to develop changes to Medicaid in order to ensure a proper safety net for our state’s poor and vulnerable citizens.

Having Albany take over the costs of Medicaid from the counties would bring substantial relief to local governments, school districts and taxpayers. If politicians in our state’s capital want to run the most generous healthcare program in the country, then they, not Suffolk County homeowners, must find a way to pay for it.