Republicans shift NY Medicaid tab; Dems call 'Buffalo Bribe'

With his abrupt decision to support the American Health Care Act, the freshman Republican congressman from Kinderhook engages in a stunning series of betrayals - of tens of thousands of his constituents, of women in his district and beyond, and of taxpayers across NY state.

"Year after year, Albany's leadership relies on counties to foot the bill for NY state's out-of-control Medicaid costs", Collins said in a statement.

As the House vote on the American Health Care Act, goes into its second day, federal, state and local officials remain spilt on an amendment to the bill that would change how NY collects its Medicaid dollars.

McCoy, the Albany county leader, is also first vice president of the County Executives of America, which a few months ago passed a resolution urging Congress to put NY state in line with the other states, which pay for Medicaid. Either, we could pass on the devastating cuts to our hospitals, nursing homes and the 40 percent of New Yorkers who now receive Medicaid and health benefits.

In an effort to round up votes for the AHCA from Republican congresspeople from New York, Rep. Chris Collins (who represents the Buffalo area) won an amendment that would effectively force New York to stop sending any part of the bill to localities except New York City.

NY hospitals and health-care organizations raised concerns about the bill, too, fearing it would lead to higher costs.

Fulton County Administrative Officer Jon Stead said the idea behind Collins-Faso seems like a logical one, since 48 other states do not have their counties pay a share of Medicaid costs. "This devastating legislation will cripple health care facilities across NY, with 14,923 jobs and 376,925 patients in jeopardy in the 21st District alone". Cuomo said when Mario Cuomo weighed that, it was tied with the state also absorbing the counties' sales tax share as well. Many county officials dislike that breakdown, claiming the mandate is a reason property taxes tend to be high in NY.

Gov. Andrew Cuomo and Democratic leaders breathed a sigh of relief Friday after the U.S. House was unable to pass a replacement for Obamacare, avoiding what Cuomo predicted would be a almost $7 billion hit to the state's budget. Cuomo states that the amendment could have a major impact on the state's healthcare system.

Collins, in a statement, responded to Cuomo's frequent news releases: "Governor Cuomo and his sidekick are using doomsday predictions to scare everyday New Yorkers into allowing Albany to continue taxing them to death". It goes before the House Rules Committee, where Rep. Louise Slaughter, D-Fairport, is the top-ranking Democrat, on Wednesday before the House votes Thursday. County officials have long pointed out how this strains their budgets and have pressed the state to take over these costs.

The legislation also contains a provision that Mr. Faso had said, repeatedly, that he would not support: the defunding of Planned Parenthood, long a target of anti-abortion activists and politicians (even though no federal dollars go to abortion services).

The change, one of several revisions to the bill, was pitched as a way to help local governments lower property taxes.

The governor is correct that this plan would shift the burden of these Medicaid costs from the counties to the state.

"It's a huge impediment on economic growth in Upstate New York", Stead said.

"Life has options, and the hard reality is that Collins and Faso are leaving NY state with only two unacceptable choices".

"Republicans leadership may have counted on the complexity of the issue to confuse the debate, but at the end of the day it's actually quite simple: This Congress tried to play the people of this nation for a fool - they were wrong, and they lost". Even if the House passes it, the Senate needs to be convinced to support this special mess - a bill that's been tweaked again and again to win support from both moderate and conservative Republicans.

NY is one of several states that has local governments contribute toward Medicaid but is being singled out in the proposed change. Upstate residents are convinced they're paying for big, expensive social programs in New York City.

Joseph Spector is chief of USA TODAY Network's Albany Bureau.

  • Zachary Reyes