Dear Neighbor,

The explosive growth in Medicaid spending in recent years has not only jeopardized state finances, but those of localities as well. New York is one of only a small number of states that requires counties to pay a share of Medicaid costs (about 20 percent on average). However, counties are given no authority to choose which medical services to provide under their locally administered programs, as all such decisions are made in Albany.

Medicaid costs to counties soared 32 percent on average between 1999 and 2002 – and up to 70 percent or more in some cases – and double digit growth is expected in each of the next two years.

In some cases, counties’ entire local property tax levy is consumed by Albany-mandated Medicaid costs. Counties have little choice but to pass these higher costs onto local property taxpayers in the form of higher tax levies or reduced local services.

Even as long-term reforms are contemplated for the $40 billion Medicaid program, it is clear that county governments need immediate relief to help avoid property tax increases that could cripple our state’s economy.

Emergency Medicaid Relief – I favor providing emergency relief to counties through a $200 million Emergency Medicaid Relief Program. These funds could be used to lower property taxes and restore cuts in vital services. This relief would save Fulton County $1.7 million; Herkimer County $1.6 million; and Otsego County $1.1 million.

Five-year state Medicaid takeover – The best relief for local taxpayers must include a state takeover of the local share of Medicaid program costs. I continue to believe the state has an obligation to cover the costs for programs that it mandates, like Medicaid.