ITHACA, N.Y. — New York is facing a $6.1 billion budget gap this year mostly due to increasing costs of the state’s Medicaid program, and the Governor’s plan to close it is leaving county officials on edge.

In his executive budget proposal released two weeks ago, the Governor proposes capping the contribution the state pays to counties towards rising Medicaid costs at 3% beginning on 2022. As a result, county leaders across the state fear they’ll have to make massive cuts elsewhere in their budgets and place more of the burden onto property taxes.

“It’s funny that Governor Cuomo paints himself as a progressive, well it’s fundamentally anti-progressive to keep pushing Medicaid costs onto counties,” Tompkins County legislator Martha Robertson said.

New York is the only state in the country that passes the expense of Medicaid onto counties. The federal government pays for between 57 and 60 percent of Medicaid programs on average and states cover the rest. In New York, the state passes on that expense to each county and in most cases, it represents a large portion of their budget. In 2019, Tompkins County’s Medicaid program costs $11.8 million per year, accounting for roughly a quarter of all spending.

Robertson and other county officials were in Albany last week as part of the New York State Association of Counties (NYSAC) conference, where they spoke with other colleagues and members of the legislature who shared in their distaste of Cuomo’s proposal. She indicated her colleagues felt the Governor was blaming them for the increasing costs of Medicaid, even though they’re just following instructions from the state.

“Everybody I’ve talked to in the Capitol said that they’re hearing all the same things from other counties. The Senate and Assembly are very much on our side on this,” Robertson told the Ithaca Voice. “They agree that is the wrong way to go.”

Ithaca Assemblywoman Barbara Lifton is one of those members in disagreement with the Governor’s proposal. She believes the state should raise taxes on high-income earners instead of passing on expenses to the counties.

“I’m very strongly opposed to this shift,” Lifton said in a statement to the Ithaca Voice. “The notion that the counties are responsible for the growth in Medicaid spending is incorrect; the counties simply abide by state mandates on Medicaid eligibility.”

In addition to the new costs on counties, the governor is assembling a Medicaid Redesign Team that will be tasked with finding ways to save money in the program before the state’s budget deadline of March 31st. The Governor hasn’t appointed anybody to the team other than two chairs and it’s unclear whether counties will have any representation. Robertson served on the last redesign team in 2012 as part of NYSAC.

That panel implemented a number of changes to the program and cut around $2.3 billion in expenses, but the process lasted nearly two years, not two months.

For now, county officials will have to wait and see how the budget process unfolds in Albany. County Administrator Jason Molino told the Voice on Tuesday morning that he will be delivering an overview of Gov. Cuomo’s proposed budget at their the Tompkins County Legislature’s meeting Tuesday evening, primarily focusing on Medicaid.

Vaughn Golden

Vaughn Golden is a freelance radio and print reporter covering politics around the southern tier and central New York. He authors the weekly "Capitol Watch" watchdog report on Ithaca's representatives...