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���������� Note: Several important groups are questioning whether Governor Cuomo’s plan to close the Medicaid deficit in part by imposing controls on county spending makes sense, raising concerns whether the reconvened Medicaid Redesign Team’s proposals will include cuts to providers.

All the more reason to prepare to send large groups of self and system advocates to Albany on February 25th  to bolster ����������’ plans to hold a large demonstration to protect and expand funding for community services at ���������� Annual Legislative Day. While we typically draw over 600 participants, we’d like to support a much larger group to fight for community services, criminal justice reform and human rights. See more at

Cuomo’s Medicaid Plan Causes Fear of Service Cuts and a Hike in Health Insurance Taxes
By Dennis Slattery ���������� Daily News  January 23, 2020

ALBANY — Fiscal watchdogs and some industry insiders fear Gov. Cuomo’s plans to tackle the state’s $6 billion Medicaid-induced budget deficit could lead to service cuts and higher health insurance taxes.

Cuomo’s proposal to make the state’s Medicaid program “fiscally sustainable” by capping spending for the city and other local governments and creating a task force to find savings could have repercussions across the industry, some observers said Wednesday.

Bill Hammond of the Empire Center, a conservative think tank, said some of the language Cuomo used in his budget address presented an ominous sign that the Medicaid Redesign Team, tasked with finding $2.5 billion in saving, could shift the burden to ���������� businesses and residents in the form of health insurance taxes.

“In his remarks he mentioned that ‘industry revenue’ could be one way to close the gap… and when his budget director was asked about it, he did not rule it out,” Hammond told the Daily News.

Robert Mujica, Cuomo’s budget czar, said the task force could call on the health care industry to provide “new resources,” eliminate inefficiencies or root out waste, fraud and abuse.

“There are obviously impacts from doing certain things that drive up other costs,” Mujica said. “We’re leaving that up to the MRT and they’ll come up with whatever solutions they do to deal with it.”

Medicaid, the state-run health insurance program serving the poor, elderly and disabled, is the largest contributing factor to the state’s ballooning budget deficit thanks to growing enrollment, state-approved increases in reimbursement rates to providers and minimum wage increases.

“The Medicaid system has to be fiscally sustainable,” Cuomo said during his budget address on Tuesday. “If it is not fiscally sustainable then we accomplish nothing.”

One health care insider said that Cuomo’s language has insurance and even prescription companies on edge over possible tax hikes that could be passed on to businesses or consumers.

“It seems like a real possibility and it’s not good,” the source said. “We are concerned, after the tax on opioids last year, that the MRT is going to expand into other prescriptions.”

Eric Linzer, president of the ���������� Health Plan Association, said insurers are concerned about shouldering more of the burden, but are willing to work with the governor.

“Increasing taxes only exacerbates the challenge for employers and individuals to have access to affordable coverage and the focus really needs to be on controlling rising healthcare costs,” he said.

The other part of Cuomo’s plan, punishing local governments that exceed a 3% spending cap by making them pay the difference, has city officials nervous that they’ll be forced to pass the bill on to taxpayers.

Hammond said the move is simply passing to buck for costs the state controls.

“The state sets the rules (for Medicaid),” he said. “It’s decisions made in Albany that ultimately drive costs up, a lot more than decisions made in ���������� City or any other locality. The idea that you would penalize localities for cost increases that are beyond their control makes no sense.”

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Citizens Budget Commission Responds To Cuomo’s Spending Plan
Albany Times Union  January 23, 2020

The Citizens Budget Commission released a detailed response Wednesday to Gov. Andrew M. Cuomo’s 2020-21 executive budget. They commend the governor for restraining spending, but scold him for the state’s three-card-monte approach to delaying Medicaid payments into the following fiscal year.

“The ���������� State Fiscal Year 2021 Executive Budget closed significant fiscal year 2020 and fiscal year 2021 budget gaps without new taxes by recognizing higher revenues, restraining agency spending, counting on yet-to-be-determined Medicaid spending reductions, cutting local assistance, and continuing an unsound $1.7 billion Medicaid payment delay. While the Budget introduces some significant proposals, some important details are still unsettled and others require additional explanation and analysis.

The Governor’s decision to reconvene the Medicaid Redesign Team (MRT) to find $2.5 billion in savings is a prudent step to restore spending discipline and to bring Medicaid spending back in line with the State’s Global Cap. While a prudent course of action, it leaves a significant component of the budget unknown. The MRT will issue its recommendations by April 1. Both the savings target and the ambitious timeline make the MRT’s work extremely challenging; however, both are necessary and should be aggressively pursued. Ultimately, the MRT should recommend additional savings to eliminate the annual payment deferral.  

In addition, the budget includes a troubling proposal to “unfreeze” local Medicaid costs. Local governments and ���������� City will have to pay for all nonfederal Medicaid cost growth over 3 percent. ���������� City and local governments that increase property taxes in excess of the 2 percent property tax cap will have to pay for all excess nonfederal costs of Medicaid spending in that year. Eliminating the growth in local Medicaid costs was one of the Cuomo Administration’s most significant fiscal and policy achievements; reversing this policy would be unwise, and would once again force local governments to shoulder the fiscal burden of policies set at the State and federal level. Local governments should work with the State to identify and realize Medicaid savings, and such a joint effort would be welcome; however, localities have limited ability to bend the cost curve since the State and federal governments determine eligibility standards and the State, with federal approval, sets reimbursement rates. Among states, ���������� is alone in the significant share of Medicaid funded at the local level, and CBC has long advocated for a .