The man who delayed millions of dollars in Medicaid payments to the state last year in a dispute over tardy accounts today had praise for Gov. Andrew M. Cuomo’s plan to to freeze local Medicaid spending by 2015.
Oneida County Executive Anthony J. Picente Jr. says the message about the crushing impact of state mandates is at last being heard in Albany.
"I commend the governor for the executive budget put forward," said Picente. "This budget advances a number of thoughtful and achievable reforms that will finally address many of the long-standing problems that have placed an enormous burden on county governments and local taxpayers."
As part of his larger effort to ease the strain of state mandates on municipal government, Cuomo’s budget would relieve local governments of some of the financial burden of Medicaid, the program that covers health care for the poor and disabled. New York, unlike most states, requires counties to pay a share of the program’s cost.
"I have to commend him. I do," said Picente. "He addressed some of the issues that have never been addressed."
Medicaid is a particular concern of counties because it has become a major cost driver. Oneida County’s share of the Medicaid bill this year is estimated to be $55.7 million, which is the equivalent of about 84 percent of the anticipated $65.6 million in property taxes. The total budget is $360.5 million.
But Cuomo also touched on other hot spots for counties like Early Intervention and Preschool Special Education services, and pension reform.
"Look, I can’t be critical when he’s starting to address these points," Picente said.
Although he doesn’t have precise numbers in hand, the county official figures the phased-in cap on local Medicaid spending could save the county several million dollars as it is enacted.
The state estimates counties will save $1.2 billion over the next five years if the cap is implemented.
"The governor’s proposals to provide Medicaid, Early Intervention and pension reform are serious and will provide real relief to counties in the long term," Picente said.
Counties wanted the state to take over the total cost of Medicaid, but Cuomo is pledging a compromise—the state would take over annual increases in the local cost. Counties’ Medicaid costs are now capped at 3 percent growth a year. Since 2006 the state has absorbed all growth over 3 percent.
Now, Cuomo wants the New York to phase in a 100 percent takeover of Medicaid growth. In 2013, the county cap would fall to 2 percent of Medicaid growth; in 2014, the county share would be reduced to 1 percent. Starting in 2015 and in later years, the state would pay 100 percent of the costs of Medicaid growth. That means the county’s annual Medicaid costs will be permanently capped at the 2014 level.
Assuming a 2 percent increase next year over this year’s estimated $55.7 million and 1 percent in 2014, that puts the county’s capped Medicaid amount at nearly $58 million.
"If we leave the status quo, then we will have failed," Cuomo said Tuesday in Albany. "We will have become part of the problem, and that’s not why we’re here."
Picente also said that a preliminary assessment of Cuomo’s spending plan did not show any shifting of costs from the state to local governments.
"We haven’t seen any at this point," he said. This has been an issue in the past for counties.
State. Sen. Joseph A. Griffo, R-47, Rome, said the Democrat governor’s budget is a "solid plan."
"That’s good," he said of the 2012-13 budget proposal that holds spending essentially flat at $132.5 billion while closing a deficit without new taxes and fees.
"I think it was significant," he said of the proposed mandate relief.
Cuomo’s proposal has to be approved by the state Legislature. The state’s fiscal year begins April 1.