The remarkable thing about state's multi-billion-dollar Medicaid crisis is that it is almost entirely the result of the Cuomo administration's own actions. There is no economic downturn or change in federal policy that explains the program's current $4 billion deficit, or its $3 billion projected gap in the next fiscal year, as confirmed in Friday's mid-year update to the state financial plan.
The 1199 SEIU contract that the Cuomo administration subsidized with Medicaid money last year included a potentially nine-figure payment to the union's lobbying arm, which has spent millions on TV ads praising Governor Cuomo's health policies.
At the midway point of the fiscal year, New York's Medicaid health plan has already spent 61 percent of its state-funded budget, according to the latest cash report from the comptroller's office – putting the program on track to end the year with a $2.9 billion shortfall.
The budget crisis in New York’s Medicaid program stems from the failure of a key cost-control measure adopted during Governor Cuomo’s first term. In 2011, Cuomo and the Legislature imposed a “global cap” on state Medicaid spending that was tied to the medical inflation rate. The measure showed signs of working at first, but lost its effectiveness as circumstances changed, loopholes multiplied and compliance faltered.
Federal officials are reviewing the state's expropriation of $2 billion from the sale of Fidelis Care health plan, potentially throwing a wrench into the Cuomo administration's plans for using the money.
A little-discussed hazard of creating a state-run single-payer health plan in New York would be its vulnerability to the business cycle. It would depend heavily on taxes collected from high-income New Yorkers, a source of revenue that's especially prone to booms and busts. A recession – or a downturn in the stock market – could easily open a budget hole not just in the billions of dollars, but in the tens of billions of dollars.
Bucking the national trend, New York's uninsured rate dropped for the eighth consecutive year, new data from the Census Bureau show. The share of New Yorkers lacking health coverage in 2018 was 5.4 percent in 2018, down from 5.7 percent the year before. The number of people lacking health coverage dropped by about 72,000, to just over 1 million. Both the rate and the number are roughly half what they were in 2013, the year before the Affordable Care Act went into effect.
Sen. Chuck Schumer raised the alarm Tuesday about a pending reduction in Medicaid funding for safety-net hospitals, which he said would have "devastating" effect in New York. His warning was misleading in several ways, not least because it left out an important bit of context: Schumer himself voted for the cuts he was deploring. In effect, he was taking credit for trying to clean up a mess he had helped to create.
Is the Cuomo administration disclosing its payouts from the $2 billion Health Care Transformation Fund as required law? You be the judge.
The newly posted July cash report from the comptroller's office shows that state-funded Medicaid expenditures ran over budget projections by $665 million, or almost 8 percent, through the first four months of the fiscal year. If that pattern continues, the full-year overage would approach $2 billion.
New York's employer-sponsored health insurance premiums – which were already among the steepest in the mainland United States – rose faster than the national average in 2018, pushing the state's affordability gap to new heights.
This year's state budget came with a hidden asterisk: In the final throes of his negotiations with legislative leaders, Governor Cuomo quietly postponed a month's worth of Medicaid payments from the last week of March to the first week of April – shifting $1.7 billion in spending from one fiscal year to the next.