AMANDA FRIES & CAYLA HARRIS
Gov. Andrew M. Cuomo accused the federal government Monday of playing politics with New Yorkers’ health care after the state was told it would no longer receive federal funds for community-based health services.
The five-year, $8 billion federal funding stream has aided health care providers that improved service delivery and reduced emergency room visits.
But Cuomo said federal officials have stripped the state of an extra $625 million through the initiative after denying New York a one-year extension on the state’s Medicaid delivery system reform incentive payment (DSRIP) waiver, which is set to expire March 31.
“If there’s one area that you’d think should be beyond politics, it’s health care,” Cuomo said during a news conference Monday at the Capitol.
“And what the federal government is doing is hurting Democrats and Republicans; it’s not whether you’re blue or you’re red.”
State officials also had sought to extend the program for an additional $7.4 billion, three-year agreement, a request that was also denied.
It is the latest in a series of “federal horribles” against New York, Cuomo contended, accusing the Trump administration of repeatedly targeting the Empire State for its blue voting record.
He pointed to both the federal government’s denial of assistance for Halloween flooding in upstate New York and the Trump administration’s sudden announcement earlier this month that it would ban New Yorkers from participating in certain trusted travel initiatives.
The administration has blamed New York’s so-called Green Light Law, which both offers driver’s licenses to undocumented immigrants and blocks federal immigration officers from accessing motor vehicle records, for the travel rule changes.
On the Medicaid issue, federal officials said they are only honoring the original DSRIP agreement from 2014 that expires March 31.
In a letter to state officials on Friday, Calder Lynch, deputy administrator and director of the Centers for Medicare and Medicaid Services, noted that the award was “time-limited” and designed to be a one-time investment in “system transformation that [could] be sustained through ongoing reimbursement mechanisms and/or state and local initiatives.”
“CMS intends to maintain that agreement and preserve the original expiration of DSRIP’s expenditure authority as outlined in the (Medicaid Redesign Team) demonstration’s current terms and conditions,” Lynch wrote.
While the elimination of the $625 million in health care funds directly impacts providers, not the state’s budget, it comes at a time when New York is grappling with a $6.1 billion budget gap largely fueled by rising costs in Medicaid and the state’s decision to defer payments.
Cuomo has tasked a second iteration of the Medicaid Redesign Team to find $2.5 billion in Medicaid savings. Cuomo promised to work with New York’s congressional delegation to revisit the decision on DSRIP.
Democratic Sens. Kirsten Gillibrand and Charles E. Schumer both assailed the Trump administration for declining to renew the waiver, saying the move would hurt innocent New Yorkers who rely on government-regulated health care. U.S. Rep. Paul Tonko, D-Amsterdam, echoed Cuomo’s allegations of a political power play, calling the federal government’s decision to end the waiver “the latest in a spate of politically motivated attacks on our state.”
“These policies have caused lasting damage to the working men and women [President Donald Trump] claims to champion,” Tonko said in a statement.
“I will work side by side with Governor Cuomo and the entire New York delegation to fight for the restoration of these vital Medicaid funds.”
Bill Hammond, director of health policy for the Empire Center, a fiscally conservative think tank based in Albany, said neither state officials nor health care providers should have relied on future federal funding of DSRIP.
“They knew the money was running out and they should have planned on that,” he said.
CMS Administrator Seema Verma late last year had cautioned Medicaid directors that the federal government would no longer provide “open-ended, one-off DSRIP waivers.”
“We must move forward with a more unified, cohesive approach – across payers, across CMS, and across states,” Verma said during a speech for the National Association of Medicaid Directors in Washington, D.C. “Doctors on the front lines need payers to march in lock step together towards common value based care models to increase provider adoption.”
Ten states, including New York, New Jersey, Texas and Kansas, benefit from the program payments.
Greater New York Hospital Association President Kenneth E. Rask called the CMS decision not to extend the funding a “major step backwards.”
Rask said the program improved care delivery, reduced preventable hospital admissions and readmissions and achieved savings for the federal government.
“This terrible decision will severely harm numerous DSRIP focus areas, including expanding medication-assisted treatment into primary care and emergency room settings, targeting seriously mentally ill populations for enhanced supports, and addressing housing and other social determinants of health,” Rask said in an emailed statement.
“We must not let this happen. The health care of all New Yorkers is much too important.”
Emilie Munson contributed reporting.
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