Gov. Andrew Cuomo says he's sick of paying New York City's medical bills.
In his State of the State address, the governor signaled he hoped to sooth the state's swollen $6 billion budget deficit by making City Hall and other local governments swallow $4 billion in Medicaid costs. New York's enlarged and politically sensitive low-income insurance program accounts for the majority of the shortfall projected for the coming fiscal year.
Cuomo indicated that the state could save $2 billion just by no longer covering New York City's local share of Medicaid cost increases—reversing a policy he put in place six years ago.
"We must correct for cost increases incurred when local governments were held harmless by the state for Medicaid increases," Cuomo said.
But, despite the state absorbing the year-over-year increases, expert analyses find that local governments in New York pay more toward the Medicaid program than counties in other states. In 2018, New York City kicked in $5.3 billion toward its budget.
Cuomo seemed to ignore this fact in his speech, insinuating that the state's largesse had turned irresponsible municipalities into wild spendthrifts.
"It's too easy to write a check when you don't sign it," the governor asserted. "The situation is unsustainable."
The governor vowed to "restructure" the program this year and to increase local "accountability." However, details were lacking both in his address and in his budget, leading Mayor Bill de Blasio to decline to remark directly on the proposal in his press conference after the speech.
"I don't know what the specific proposal is, because we haven't seen any details yet," he said, although he noted the state Legislature had shielded the city from Medicaid cuts in 2016. "I am concerned for sure, but I will reserve judgment until I know more.
This article was originally published in Crain's New York Business.