Perhaps the most damning commentary on Gov. Hochul’s Medicaid spending plan — which made up roughly half of the $252 billion state budget she released Tuesday — was the silence of the attack dogs.

Last year, the hospital lobby spent millions on TV ads falsely accusing Hochul of “cutting” the state-run health plan, which covers 7 million lower-income New Yorkers.

This year, the ad campaign has gone quiet, a sign she is giving hospitals everything they could want and more.

This appeasement comes at a high price for taxpayers: The governor is proposing to jack up the state-funded portion of Medicaid by $6.4 billion, or 17%, in a single year — and that’s before the Legislature makes its inevitable additions.

This comes on top of a combined 36% increase over Hochul’s first three years as governor.

When this Medicaid budget is through, it’s likely to spend 60% more than what she inherited in 2021 — which even then was the costliest Medicaid program in the United States on a per capita basis.

Even Hochul acknowledged — in the mere eight sentences she devoted to this topic in her budget presentation — that this growth “isn’t sustainable for New York taxpayers on its current trajectory.”

Of course, she was the one who put it on that trajectory.

Her proposed solution is “to take action alongside the federal government to manage this growth.”

Maybe she hasn’t seen the headlines lately, but Republicans in Washington are preparing to squeeze trillions in savings out of Medicaid. Bailing out a spendthrift blue-state governor is not on their to-do list.

Another head-scratching note came from the governor’s budget briefing book.

After acknowledging that spending is out of control, it said the governor’s budget strategy consists of “maintaining Medicaid spending at current natural levels of growth.”

Sorry, but there is nothing “natural” about Medicaid’s current spending spike.

The state’s economy is growing, its unemployment rate is low, and the poverty rate has been trending down — all of which should mean less demand for what is meant to be a safety-net health plan for the poor and disabled.

By way of excuse, Hochul and her aides emphasized that Medicaid enrollment remains 900,000 higher than it was before the pandemic.

They didn’t mention that enrollment peaked in 2023 and has come down by 1.1 million since then. By rights, Medicaid costs should now be falling.

But they’re skyrocketing instead — because in Albany, Medicaid isn’t just about taking care of the needy, but increasingly about pumping money into the health-care industrial complex, often in ways that have nothing to do with the best interests of the poor or disabled.

One of Hochul’s recent Medicaid-funded initiatives aims to “recruit and train thousands more health care workers” — even though New York already boasts the largest health-care workforce per capita of any state.

Naturally, a chunk of that money is going to the state’s largest and most influential health-care union, 1199 SEIU.

Another growing expense consists of ongoing bailouts for financially “distressed” hospitals, which typically are losing money because patients have fled to other providers.

In effect, the state is paying failing facilities to staff and maintain their emptying wards.

The epitome of Hochul’s spendthrift approach is a newly enacted tax on managed care organizations, a gimmick to cadge an extra $3.8 billion in federal Medicaid funding over the next two years — at which point Washington is expected to shut down the loophole that makes it possible.

It’s a temporary shot of cash at best, yet Hochul is proposing to use it to hike Medicaid reimbursement rates for hospitals, nursing homes and other providers — leaving an expensive hole to fill when the money runs out.

Meanwhile, her budget fails to address the health-care system’s most urgent problems.

Where is the initiative that will finally goad New York’s hospital industry to improve their quality rankings, which sit near the bottom on national report cards? Or to shorten their average emergency-room wait time of 3 hours and 22 minutes, the fifth worst of any state?

What is her plan for cracking down on patient neglect and profiteering in nursing homes, as exposed in lawsuits filed by Attorney General Letitia James?

Speaking of affordability — a new Albany buzzword — why isn’t Hochul working to lower health-insurance premiums that rank among the highest in the country, driven largely by state-imposed taxes and regulations?

The answer isn’t hard to find: The health-care industry is the single wealthiest and best-organized lobbying force in the state.

Its forces reward politicians who give them money while punishing those who dare to question the poor return on that investment.

Hochul’s Medicaid splurge isn’t buying better care for New Yorkers. It’s buying her a reprieve from the hospital lobby’s attack ads.

Taxpayers can only imagine how much more expensive this strategy will get in 2026, when she and the entire Legislature are up for re-election.

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

NY’s own researchers warn of state’s off-the-charts school spending

What was expected to be a mundane state-ordered study into how Albany doles out cash to local school districts turns out to be required reading for New York taxpayers — and state lawmakers. Read More

New York Is a Cautionary Tale on Home Care

Fans of ’s “Medicare at Home” proposal should study up on New York’s bloated home healthcare system, which covers about 850,000 people. Its large scale and rapid growth embody a cent Read More

Hochul bows to health-worker union’s $9B senior-care power play that could bust NY’s budget

Gov. Hochul’s overhaul of the  reached a milestone last week when she named a Georgia-based company as the winning bidder to be the program’s statewide “fiscal intermediary” — and to replace  that currently handle those duties. The  dre Read More

Another Voice: Albany’s MTA congestion pricing battles have implications for Western New York

Gov. Kathy Hochul has taken blistering criticism for postponing congestion pricing, a long-planned $15 toll on drivers entering lower Manhattan meant to reduce traffic — and collect $15 tolls. Most of the drama may be playing out in New York City, but pay attention, upstate: you stand to lose — or win — in this fight. Read More

Another Voice: Money Isn’t the problem for New York schools – the lawmakers are

Anyone wondering how New York consistently has the nation’s highest public school spending but below-average student outcomes got a succinct explanation from Albany earlier this month. Read More

Court’s mail-in voting decision is a slap in the face to NY’s voters

So much for “no means no.” That’s the message from the state Court of Appeals, which ruled last week that New Yorkers don’t need an excuse to cast an absentee ballot by mail when they’re otherwise able to vote in person — even though the voters themselves have directly rejected such a measure. Read More

Hochul’s futile ‘energy summit’ can’t resolve NY’s impossible green goals

It’s a pity New York cannot power its economy on hubris, but state officials this week gave it a try. Read More

Hochul’s COVID report is too weak; do it better

A state-ordered study of New York’s pandemic response has finally appeared, and it’s shaping up as a minor disaster of its own. Read More