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Cuomo and Collins continue battle over county mandate on Medicaid

By Howard B. Owens

It's just two partisans fighting, County Manager Jay Gsell said of a proposal to shift money around so that counties in the State of New York could get relief from the unfunded mandate known as Medicaid.

Gov. Andrew Cuomo is backing legislation called the Empire State Equity Act, which would shift back to New York, some $30 billion in taxpayer money from the federal government to the state.

With that money, the state then could assume the cost of the $2.3 billion shelled out by counties now to support Medicaid, but only for counties that agreed to cut local property taxes by the amount of their current share.

That could be $277 average savings per property in Genesee County, according to a chart released by the governor's office.

Where the governor sees tax savings for county residents, Gsell sees smoke and mirrors and political rhetoric aimed at Rep. Chris Collins.

"It's a political war of words between two people, Collins and Cuomo, who seem to really dislike each other and engage in negative partisanship to the max," Gsell said.

The way Gsell sees it, the proposal is asking the feds to "artificially" adjust a funding formula for New York, which is similar to something Schumer did temporarily a few years ago, and give it the "innocent sounding phrase, 'Empire Equity,' and then only provide a cost shift."

Gsell noted the benefit level -- a cause of the state's high Medicaid expense as he sees it -- wouldn't be cut under the governer's proposal, which leaves him distrustful of the long-term effects.

He thinks many counties might pass 100 percent of the cost savings onto taxpayers in the form of lower property taxes, but he fears that is just a trap.

"Our concern, borne out of 50 years of NYS unilateral imposition of cost shifts and mandates," Gsell said, "is that just like with re-K/EI (early intervention) funding and the elimination of the counties from the AIM dollars (a state revenue share with municipalities), as the state was going to take over 75 percent of the total program cost, but they stopped at 59 percent and left the counties out to dry.

"The same can happen with the Empire Equity Act in that the state holds all the cards, all the control, and always blames we locals for the abysmal state of property taxes, and they -- and he, Gov. Cuomo -- refuse to take any responsibility for the unfunded mandates and cost shifts, creating in essence a NYS property tax 'levy' within our county budgets."

Cuomo has called New York a "donor state," in that it pays out $30 billion more in taxes to the federal government than it receives in benefits. He touted this bill as a way to "level the playing field."

The governor backed the proposal as a response to an amendment from Collins to the American Health Care Act, which was eventually pulled from a vote by Speaker Paul Ryan, that would have prohibited the State of New York from taking money from counties to help fund Medicaid. Cuomo called the Collins proposal "a fraud."

"Senator Daniel Patrick Moynihan, God rest his soul, used to talk about the unfairness that New York gave so much and got back so little," Cuomo said during a press conference on the proposal. "Second, the promises made, from Congressman Ryan to President Trump to Mr. Faso to Mr. Collins was tax relief for the working men and women of this country. Right? That’s what they all ran on. That’s what they all promised. That’s what they all said.

"Well, this actually does just that. This says, 'let’s give New York additional Medicaid money because they are a donor state, let’s reduce the inequity' and New York will then give the money to the taxpayers in property tax relief."

An aide to Collins provided this statement:

“Although late to the party, I am glad Governor Cuomo has finally seen how unsustainable it is to force hardworking property taxpayers to subsidize New York’s out of control Medicaid program,” said Congressman Chris Collins. “Unfortunately, instead of reviewing his own bloated budget for the 1.5 percent needed, the out-of-touch Governor demands more federal government for the nation's most bloated Medicaid program.

"The Governor needs to quit living a federally funded fairy tale and find savings in New York's Medicaid program which costs 44-percent more per recipient than the national average, and spends more than those of Texas and Florida combined.”

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