Gov. Andrew Cuomo's proposal to cap increases on Medicaid spending at 3 percent at the county level could cost Genesee County another $2.3 million over the next four years.
That's just a rough guess, said County Manager Jay Gsell.
He called Cuomo's accusation that counties are spending on Medicaid with a "blank check syndrome" since the county share of Medicaid was capped in 2012 a "lie." He said the attempt to shift the burden for increases on Medicaid to counties is "voodoo economics for 2020" and using the maneuver to shift the cost of the state's deficit spending to county taxpayers a "Ponzi scheme."
“The Medicaid system has to be fiscally sustainable,” Cuomo said during his 2021 budget address. “If it is not fiscally sustainable then we accomplish nothing.”
New York State is facing a $6.1 billion budget gap due in large part to rising costs of Medicaid, a health insurance program that serves the poor, elderly and disabled.
Since the state capped county expenses, the state's share has increased $20 billion.
“That’s the blank check syndrome,” Cuomo said Tuesday. “We are signing the check and they’re filling out the amount.”
All Medicaid expenses, Gsell said today, are the result of state mandates. The county has no control over how much Medicaid costs or how much expenses increase.
The increases are a result of NY, as mandated by Albany, offering among the most generous Medicaid benefits package in the Union, and an increase in enrollment of Medicaid-eligible residents under the Affordable Care Act.
There are now 13,300 Genesee County residents enrolled in an ACA medical plan (not all are Medicaid eligible) compared to 8,800 five years ago.
"The State about eight to 10 years ago promised to takeover Medicaid administration from the local DSS districts, which still hasn’t occurred," Gsell said. "It now appears easier to pick a 'fall guy' – NYS counties – for the ongoing quagmire since 1966 that -- unlike in 48 of the other U.S. states -- New York State has bought into lock, stock, and barrel. I have yet to be told that we NYS Counties are making up our own benefit levels for this entitlement, enrolling masses of ineligible recipients, promoting fraud, waste, and abuse and essentially not doing our jobs. That is a figment of someone’s imagination in Albany. It is a lie and convenient dodge for a problem of the State government’s own making."
Photo: File photo of Gov. Andrew Cuomo.