Tightening eligibility for Medicaid home care and implementing a further across-the-board rate reduction are among 41 cost-cutting measures being contemplated by Governor Cuomo’s Medicaid Redesign Team, according to a draft executive summary and scorecard obtained by the Empire Center.


This is the latest installment in a special series of #NYCoronavirus Chronicles by Empire Center analysts, focused on New York’s state and local policy response to the Coronavirus pandemic.


It’s not clear if these proposals have been voted upon or approved by MRT members, who are due to hold their final public meeting on Thursday.

As described in the executive summary, the proposals would save the state a projected $1.6 billion for fiscal year 2021, which begins April 1. Combined with $851 million in previously announced measures, they are meant to close a $2.5 billion gap in the Medicaid program.

Medicaid’s rapidly growing long-term care expenditures were targeted by a plurality of 16 proposals seeking to save $647 million. They include capping enrollment in managed long-term care plans at an unspecified percentage, for savings of $215 million and changing the eligibility criteria for personal care services, including the Consumer Directed Personal Assistance Program, for savings of $154 million.

Other big-ticket proposals include an additional across-the-board rate reduction for health plans and providers of 0.875 percent, on top of the 1 percent reduction that took effect on Jan. 1 ($219 million in savings); overhauling the state’s dysfunctional system for financing hospital charity care ($157 million in savings), and increasing the efficiency of non-emergency transportation ($93 million in savings).

Notably absent from the list is any explicit proposal for a tax increase in health insurance, an idea floated by Cuomo himself. However, a number of measures would constrain cost-control measures used by health plans, which would likely increase their payments to providers for both Medicaid and commercial enrollees.

The summary calls for “redefining” the Medicaid Global Cap, which is meant to limit annual increases in state spending on the program based on the medical inflation rate (though enforcement has been increasingly lax). The summary says the redefinition “would increase the amount of total spending under the Global Cap through modifications in the base on which spending growth is calculated and/or a different allowable growth metric.” Further details were not provided.

Many if not all of the proposals would require approval by the Legislature. 

Cuomo has said the state needs to trim its share of Medicaid spending by $2.5 billion to balance the budget for fiscal year 2021. If the Legislature fails to approve specific cuts, his budget proposal has a fall-back plan that empowers his administration to make across-the-board cuts of its own.

Another complicating factor is a coronavirus response package pending in Congress. It includes a temporary increase in Medicaid funding for states – worth $4.5 billion or more annually to New York. However, the money would be contingent on states not changing their “eligibility standards, methodologies or procedures,” which Cuomo says would effectively block any action on the MRT proposals and make it impossible to pass a budget.

He is reportedly working with New York’s congressional delegation to modify that bill before it receives final passage.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

When COVID-19 struck, a lot of the state’s pandemic stockpile was out of date

Much of the material in the state's pandemic stockpile had passed its expiration date when the coronavirus crisis struck in March 2020, according to newly released Health Department records. Read More

The Health Department’s response to a FOIL request for nursing home data triggers 2020 déjà vu

Despite Governor Hochul's promise of transparency, the Health Department keeps responding to requests for COVID data with tactics from the Cuomo administration Read More

Hochul’s Emergency Order Imposes Insurer Restrictions Sought by Hospital Group

Buried in Governor Hochul's emergency order on health-care staffing is a temporary bar against insurance companies challenging claims submitted by hospitals–and an influential hospital association is taking credit. Read More

Home Care Agencies Project Widespread Staffing Shortages in the Next Phase of New York’s Vaccine Mandate

Agencies providing home-based care to elderly and disabled New Yorkers face a large-scale loss of employees when the next phase of the state's vaccine mandate takes effect on Oct. 7, according to a newly released industry s Read More

Remembering the scandal that brought down Health Commissioner Howard Zucker

The resignation of Dr. Howard Zucker as state health commissioner marks the end of a term marred by scandal over his role in managing the coronavirus pandemic. The much-debated compelling nursing homes to admit COVID-positive patients, though it origi Read More

As leaves turn, NY’s post-pandemic recovery still has very far to go

New York was the national epicenter of the pandemic, and Governor Cuomo's "New York State on PAUSE" business shutdowns and other restrictions led, in short order, to the loss of nearly 2 million jobs in the first full month after the infection began spreading in the New York City area. Read More

More NY job gains in August—but employment needs to rise a lot further

New York's jobs report for August looked relatively strong—but only by comparison, that is, with what was generally regarded as a disappointing national number. On a seasonally adjusted basis, New York gained 28,000 private-sector jobs last month—a growth rate of 0.4 percent, according to preliminary monthly estimates from the state Labor Department. Read More

After 10 weeks, all but five of the Empire Center’s 63 requests for pandemic data remain unfulfilled

Over the 10 days that Hochul has been in office, there has been no further progress on the Empire Center's record requests. Read More

Subscribe

Sign up to receive updates about Empire Center research, news and events in your email.

CONTACT INFORMATION

Empire Center for Public Policy
30 South Pearl St.
Suite 1210
Albany, NY 12207

Phone: 518-434-3100

General Inquiries: Info@EmpireCenter.org

Press Inquiries: Press@EmpireCenter.org

About

The Empire Center is an independent, non-partisan, non-profit think tank located in Albany, New York. Our mission is to make New York a better place to live and work by promoting public policy reforms grounded in free-market principles, personal responsibility, and the ideals of effective and accountable government.

Empire Center Logo Enjoying our work? Sign up for email alerts on our latest news and research.
Together, we can make New York a better place to live and work!