For a second time, Governor Cuomo has vetoed a bill that would require the state to reimburse New York City for retiree health benefits paid to former employees of the bankrupt New York City Off-Track Betting Corp. (OTB). That’s good. Unfortunately, once again, he has left the door open to signing the bill in the future. And that’s troubling.
New York State has embarked on an ambitious multi-year effort to overhaul its taxpayer-funded Medicaid program, which has long combined high costs with less than impressive health outcomes. Governor Andrew Cuomo’s “redesign” of Medicaid will be heavily focused on “complex, high-cost populations” – the roughly one million Medicaid recipients with long-term disabilities and chronic health problems such as diabetes, heart disease, substance abuse and mental illness.
New York taxpayers spend billions of dollars a year on health insurance coverage for retired state and local government employees, many of whom are too young to be eligible for Medicare. But the mounting “pay-as-you-go” bill for retiree healthcare is just the tip of a much larger iceberg.
New York is probably less affected than most states by today’s U.S. Supreme Court decision. The court effectively has said that almost all of Affordable Care Act (ACA) passes constitutional muster. This means the entire country can now experience the effects of the sort of regulatory policies (such as guaranteed issue, community rating and mandated coverages) that have done much to make health insurance so costly here...
S&P has just put out a report (no link) on the amount of money that state governments have promised to current and future retirees in “other post-employment benefits” (OPEB), mostly health.
New York’s expensive Medicaid program provides generous long-term care benefits to a large number of recipients. Although Medicaid eligibility is means-tested, with limits on both income and assets, the program nevertheless pays for most professional long-term care services in the state.
Beginning in 2014, the Patient Protection and Affordable Care Act, signed into law in March 2010, is expected to significantly extend health-insurance coverage in New York by increasing Medicaid enrollment and offering federal subsidies for the purchase of private health insurance. However, there is no guarantee that the newly insured will be able to access the health-care system in a timely fashion as new demand for services outstrips physician supply.
What's the best way to ensure that all New York State residents-adults and children alike-have access to affordable health-insurance coverage?
Governor Spitzer’s 2007-08 Executive Budget calls for a series of Medicaid cost-containment measures, including a freeze on hospital and nursing-home reimbursement rates. These steps are appropriate and justifiable-but they only scratch at the surface of the problem.
When premium increases are capped, insurance companies tend to seek rate increases closer to the limit. Tighter regulation of premiums could undermine the profitability of a company whose financial health the state is banking on to finance health care programs. The focus should be on health insurance regulations that drive up rates.
New York State has long stood alone in forcing local taxpayers to pay up to half of all Medicaid costs not reimbursed by the federal government. This divided financial responsibility is a key reason why New York easily leads the nation in Medicaid spending.
The state-funded share of Medicaid costs will escalate rapidly over the next few years as Albany assumes responsibility for a greater share of county and New York Medicaid costs, according to projections explained in a new report from the Empire Center for New York State.