cuomo-nypost-300x200-2131548The Cuomo administration’s quarterly budget update includes a warning for the state’s health-care industry: Medicaid cuts could be coming.

The report, released Tuesday, says officials are developing a plan to reduce Medicaid spending that could include “across-the-board rate reductions to health care providers and plans.”

The $79 billion health plan for the poor and disabled covers about one in three New York residents and represents a major source of revenue for hospitals, nursing homes and other health providers.

Tuesday’s announcement follows the recent revelation that the state had quietly postponed $1.7 billion in Medicaid payments from March to April – a step officials said was necessary to avoid violating a “global cap” on the program’s spending for fiscal year 2019.

That unusual maneuver signaled that expenditures on the health plan for the poor and disabled were running about 8 percent over budget – a problem that has not abated.

Medicaid spending “continues to exceed projections,” the update released Tuesday says. “As such, [the Division of the Budget and the Department of Health] are working to develop options to reduce spending within the Global Cap and/or continue to manage the timing of payments. Options to reduce spending include the execution of statutory powers granted to the Commissioner of Health to limit spending, which include across the board rate reductions to health care providers and plans.”

Under “global cap” legislation first enacted in 2011, the bulk of state spending on Medicaid is supposed to grow no more than the 10-year average of medical inflation, which is currently about 3 percent. Because of various exceptions and loopholes added over the years, the 2019 budget allowed growth of more than 6 percent – but actual spending was on track to rise 15 percent.

When spending shows signs of exceeding the cap, the law empowers the health commissioner and budget director to develop a cost-cutting plan – but they refrained from doing so last year. Last fall, meanwhile, Cuomo boosted outlays further by quietly approving rate increases for hospitals and nursing homes, a big election-year win for some of his biggest political supporters.

The fiscal year 2020 budget approved by the Legislature in March does not include a plan for addressing the Medicaid overage, which was not made public until May.

During budget negotiations this spring, however, the governor raised the possibility of reconvening the Medicaid Redesign Team, a panel of officials and industry stakeholders that helped contain Medicaid costs during Cuomo’s first term. Don’t be surprised if Cuomo revives that concept in the near future.

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

Email Confirms Early Contact Between NY Officials and CDPAP Contractor

State officials met with the ultimate winner of a $1 billion Medicaid contract two weeks before the Legislature authorized bidding on the job as part of the state's 2024-25 budget, an email obtained by the Empire Center sho Read More

From Promises to Vetoes: Hochul’s Actions Belie Her Commitment to Transparency

Governor Kathy Hochul made news this fall when she used her legislative veto power in a way that looked personal. That’s how Albany watchers and the target, Senator James Skoufis, w Read More

Budget Update Paints Less Alarming Picture of Federal Health Cuts

A new fiscal report from the state Budget Division suggests federal funding cuts will hit New York's health-care budget less severely than officials have previously warned. A relea Read More

Parsing the Impact of Mamdani’s Tax Hike Plans

The front-running candidate for New York City mayor, Zohran Mamdani, has said he can finance his costly campaign promises – including free buses and universal child care – by taxing only a sliver of the city's residents Read More

K-12 SOS. Buffalo City School District

K-12 SOS is a pilot project of the Empire Center to inform parents, politicians, and decision-makers about the state of K-12 education in New York State. Determining why certain schools perform better than others is beyond the scope of this research. Read More

DOH Ducks a Simple Question on Covid in Nursing Homes

Five years after the coronavirus pandemic, the state Department of Health is pleading ignorance about one of its most hotly debated policy choices of the crisis – a directive that sent thousands of infected patients into Read More

An Eerie Silence About the State of Education in New York

A by National Assessment of Educational Progress (NAEP) lamented the declining state of U.S. education by highlighting how scores in grade 12 math and reading have hit record lows. While Covid-19 was definitely a factor, others correctly pointed out that Read More

In the Fight Over ACA Tax Credits, the Stakes Are Lowest for New York

As Washington skirmishes over the future of enhanced tax credits under the Affordable Care Act, New York has relatively little to gain or lose. The number of New Yorkers using any A Read More