Assemblyman Zebrowski: Budget Update on Medicaid

“In 2015, I helped achieve a major mandate relief victory for Rockland County taxpayers. As of that year, the Counties' share of Medicaid increases was capped, and thereafter the State has taken on cost increases. This process started three years earlier where we budgeted a phase out of the local share of Medicaid increases. This mandate relief measure has saved millions of dollars for Rockland taxpayers. In fact, taking into consideration the 3% growth cap implemented between 2005-2008, Rockland would have paid $83 million dollars more in 2019-2020, had the program continued to run at previous cost sharing levels.

These caps are vital to taxpayers, and to our County, and I oppose any rollbacks or changes that turn back the clock on this mandate relief.

Unfortunately, the Governor’s 2020 budget starts to do just that. The Governor is proposing two things: 1. If a County does not stay under the tax cap they would pick up all Medicaid increases. 2. Even if a County stays under the tax cap, any increase in Medicaid costs above 3% would be picked up by the County. Both of these proposals are unacceptable. While I would prefer the County stay under the tax cap, should they go over, I have no interest in exacerbating the cost to taxpayers by adding to the County’s costs. Second, the County cannot be blamed for Medicaid increases. They do not set eligibility rules and, to the extent they share in the administration of the program, there is not a nexus between their administration and increased costs.

Preventing any shift back onto localities will be a top priority of mine during this budget session.

In addition to this very important local tax issue, a lot of the discussion regarding the State’s projected deficit will revolve around the Medicaid program. The Department of Health (DOH) has already made an across the board 1% cut and the Governor has convened a panel to make recommendations on further efficiencies and cuts by the end of February. Those recommendations are then likely to become part of the Executive’s budget. The Governor is looking to limit the year-to-year increase in Medicaid to 3%. Without any action, the program is likely to grow by about 7%. Limiting the growth of this program is a major part of the Governor’s plan to close the projected deficit. As we continue through this budget cycle it is clear that costs need to be brought under control; the challenge will be ensuring that those agencies in Rockland (and the families that depend on them), such as our wonderful not-for-profits that serve the developmentally and physically disabled, are not bearing the brunt of these cuts.”