It's a question of how to run programs like Medicaid and county officials are now evaluating a little known state budget provision that may mean Medicaid will be run at the state level, instead of the local level. Our Steve Ference reports on how it could impact the program you may rely on and how it could affect everyone's tax bills too.
NEW YORK STATE -- Inside a boring looking conference room, county leaders are grappling with some big issues: the future of Medicaid, property taxes, and state versus local power, after they found a little-known provision in the state's recent budget that will change how Medicaid is administered in New York.
Talking to the group of local leaders, Stephen Acquario, NYSAC Executive Director, said, "The state must reevaluate the entire Medicaid and public program for healthcare delivery in New York State and determine how that fits into the new federal model. That's why we're here."
From Democrats like Tompkins County Legislature Chairwoman Martha Robertson who said, "This is the potential for a huge transformation in how the state does business in providing healthcare for the indigent."
To Republicans like Chemung County Executive and NYSAC President Thomas Santulli who told us, "We're just really concerned. Medicaid in New York State has just reached a billion dollars a week. I think people don't realize that this $53 billion program is bigger than the budget of 44 entire states."
These are county officials who say Medicaid, which, again, is currently administered by the counties, is unsustainable. They're skeptical of the state taking over the administrative costs of Medicaid, billed by some at the state level as creating efficiency and saving taxpayers money.
Santulli said, "I'm very suspect of a state that has a $10 billion problem that they say is going to be a $60 billion problem over the next three years, that now is going to miraculously take over a cost that they're saying is going to save counties a lot of money."
Robertson said, "I mean our local commissioner is looking at it as a way that it will save the state money and cost us more."
Acquario said, "If you have a case worker whose doing Medicaid, public assistance and food stamps for that same family, and now the state is simply going to pull out and run the Medicaid system independent of those other human services programs, that could be more inefficient for the property taxpayer."
Bottom line, Acquario says in the near future you probably won't notice any changes to Medicaid benefits. The key may be costs, costs that for good or ill, are often passed on to local taxpayers.
"The issues we are talking about today are directly related to property taxes, and how we can control those taxes and lower those taxes," said Acquario.
While several dozen county leaders work to make sense of the new rules - they have to work quickly to provide their input. The Department of Health is supposed to offer their report on how they'll handle the change by November 30th, with a five-year plan set to start in 2011.