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Bill Samuels intends to travel the state between now and Election Day to push Gov. Andrew Cuomo on issues in which he claims the first-term leader has fallen short of his progressive promise. First up: the state’s five-decade practice of having localities fund a significant chunk of the non-federal cost of Medicaid, the health care program for the needy.
“We have put ourselves in a position that is not competitive,” Samuels said in an interview Tuesday, citing New York as the only state that requires its counties to cover 15 percent of Medicaid costs — an annual sum he pegs at $8.4 billion. Upstate, most of the revenue to cover that cost comes from county property taxes.
Samuels’ advocacy group, EffectiveNY, has prepared a report, “Lift the Burden Now,” that recommends the state phase in the takeover and centralization of the full non-federal cost of Medicaid over the next eight years.
This is not a new idea — indeed, the report says that Cuomo’s father, former Gov. Mario M. Cuomo, called in 1991 for a state takeover. More recently, concerned citizens including former Lt. Gov. Richard Ravitch have singled out the heavy burden the local contribution places on revenue-strapped upstate communities. The state Association of Counties has also proposed state takeover.
EffectiveNY’s report says that in 2012, Albany County spent $67 million of its $76 million property tax revenue on its Medicaid share.
If the state were to absorb the full non-federal cost of Medicaid, it would have to find another way to raise the revenue to pay for it. Samuels says that mechanism would almost certainly spread out the cost more evenly — an improvement, he said, over the current system in which communities with more needy residents pick up a disproportionate care of the program’s costs while wealthy counties aren’t similarly burdened.
Since taking office, Cuomo has made numerous moves to reduce both the cost of the Medicaid program overall — estimated at $58.2 billion in the coming fiscal year — and the burden placed on the counties.
The state is absorbing the administrative costs of local programs as well as the annual growth in the local contribution, which Cuomo’s executive budget proposal says will save counties and New York City an estimated $1.2 billion over five years.
“This administration has done more to tackle local Medicaid burdens than any other in modern times,” said Cuomo spokesman Rich Azzopardi.