House bill renews fight over NY counties’ Medicaid costs

Call it Round 3 in the bout between Rep. John Faso and Gov. Andrew Cuomo over relieving New York counties of their share of the state’s Medicaid costs.

The conflict started in March, when Faso championed an amendment to the Obamacare replacement bill that was intended to secure the votes of balky Republicans in New York’s House delegation. The proposal would force New York to end its longstanding practice of having its counties pay part of Medicaid’s cost – an idea Faso had campaigned on in 2016 as a form of property-tax relief. It set off a bitter, week-long war of words with Cuomo, who argued the $2.3 billion in annual spending that counties would shed would simply fall to the state and result in other tax increases or cuts in Medicaid services.

That round closed with the House Republicans yanking their American Health Care Act because they had too few votes to pass it. But the freshman congressman and Democratic governor laced up their gloves again in April when Faso introduced a standalone bill to do the same thing – drop the counties’ Medicaid costs – with five New York colleagues as co-sponsors of the legislation.

The latest round was more muted, though the circumstances were potentially more consequential. The American Health Care Act, back before the House in amended form and with the New York Medicaid provision intact, passed on Thursday in a 217-213 vote. The legislation, or some version of it, must now be taken up by the Senate.

In a statement after the House vote, Faso rebutted criticism of the Republicans’ bill and concluded by touting his provision to end New York counties’ Medicaid costs by 2020.

“For a typical homeowner or commercial property owner residing in the 19th District,” he wrote, “Medicaid costs represent over 40 percent of their county property tax burden. New York’s Medicaid spending dwarfs that of most other states. For instance, New York spends more than Texas and Florida combined, even though these states have more than double our population. The provision I authored will bring much-needed property tax relief and keep people and jobs in Upstate New York.”

That is not how Cuomo saw it. His statement deploring the Republicans’ bill included this passage:

“Sadly, some representatives in New York have sold their vote and turned their backs on the very constituents they represent. This bill is a targeted assault against our values, punishing New Yorkers because we support women’s reproductive rights and including the Collins/Faso amendment which would devastate the state’s health care industry, put millions of New Yorkers at risk, and increase the total cost of this bill on New York to $6.9 billion.”

New York has shared Medicaid costs with its counties since the U.S. inaugurated its health insurance program for the poor 51 years ago. Traditionally in New York, the federal government has paid 50 percent of the bills, and the state and counties each have paid 25 percent. The counties’ share has steadily dropped since the state capped their payments in 2011 and took responsibility for any expense increases. The counties now pay about 13 percent, and the state covers 36 percent.

Cuomo and House Democrats from New York – including Rep. Sean Patrick Maloney, D-Cold Spring – have argued the federal government should reimburse the state for the counties’ Medicaid cost share if it wants to ease the property-tax burden on county taxpayers in New York. The House members introduced a bill called the Empire State Equity Act last month to have Washington give New York an additional $2.3 billion in Medicaid.


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