Governor’s proposed Medicaid funding changes

Putnam County Executive MaryEllen Odell wants to voice her concern about the impact our communities would feel if the governor’s proposed Medicaid funding changes are enacted.

Gov. Andrew Cuomo announced he wants the state’s 62 counties to contribute an additional $150 million to pay for Medicaid’s skyrocketing costs. The counties enroll Medicaid recipients, but because we don’t set the eligibility guidelines, we are not responsible for the increase.

“Here in Putnam we take care of our most vulnerable citizens, and will always make sure they get the services they need,” Odell said. “But if the state shifts the cost of that care to the counties, we will have to make other cuts that will devastate our budget and hurt our communities.”

Putnam is not the only county on the brink of hardship if the funding change is enacted. Odell is in contact with Suffolk County Executive Steve Bellone, who sits on the governor’s Medicaid Redesign Team, and he has heard Putnam’s concerns from many others.

In 2012, to help counties and local governments adhere to the 2% property tax cap, Governor Cuomo and State Lawmakers enacted a zero growth Medicaid cap. The cap helped counties stabilize and, in several cases, reduce county property tax rate levies.

We are asking the governor and state legislature to keep the zero growth Medicaid cap.

“As we have always done, counties stand united behind lowering the cost of Medicaid and improving the quality of care for those in need,” said New York State Association of Counties President John F. Marren, the Ontario County Chair. “However, any state Medicaid proposal must protect local taxpayers and services by keeping the current cost control caps in place.”

State Sen. Pete Harckham who represents Putnam County as well as parts of Westchester and Dutchess counties, said the state should look for more reasonable approaches to closing the budget gap before turning to already overburdened taxpayers.

“With the share of Medicaid costs in New York State making up about half of every county’s tax bill, no one should expect our hard-working property owners to foot an even larger share in order to close the state’s budget deficit,” said Harckham, a member of the Senate’s Local Government Committee. “Not when New York’s local government already pay the highest share of Medicaid costs in the country.”


New York is one of the few states in the nation to require county funds to cover the cost of Medicaid, and the only one that required county taxpayers to fund a full half of the State’s share when it was implemented in 1966. Today, counties and New York City fund $7.6 billion of the state’s more than $70 billion Medicaid program.

It’s undeniable that Medicaid costs have increased. In Putnam alone, the costs have risen by $4 million from 2018 to 2019.

Before 2015 in Putnam County, about 5,000 residents were enrolled in Medicaid. By July, 2019 the county had 13,114 Medicaid recipients.

None of these cost or enrollment increases are the result of Putnam County policy.

The governor has suggested the counties can find the extra funds by being ferreting out waste.

Putnam County has already done that.

A few years back, the county brought in consultants who worked with the Department of Social Services to flag suspected fraud. Upon inspection, some well-to-do residents did, in fact, seem to be abusing the system. By taking reverse mortgages on expensive homes, writing off investments as losses and hiding assets in untouchable retirement accounts, they qualified for Medicaid. But here’s the surprising thing: That’s all legal.  If the state closed its gaping loopholes, it could save some money.

During Odell’s tenure, the county has adopted eight budgets that were each under the state property tax cap. Putnam officials are not spendthrifts. We look after our taxpayers’ interests by spending conservatively.

To stay below the state’s 2 percent property tax cap, Putnam can only raise its spending by $1.2 million in this fiscal year.  But if the state shifts its Medicaid costs onto our backs, it will eat up a significant portion of our spending.

The bottom line is, if this shift in Medicaid costs goes through, Putnam’s outside agencies will see funding cuts and our aging infrastructure will continue to crumble.

We ask the Governor and the state Legislature to keep the zero Medicaid growth cap and work with the counties to find a way to solve the problem.