New York Counties to Legislature: Keep the Cap

County officials convene for advocacy day at the State Capitol
Representatives from New York's county governments held an advocacy day at the State Capitol today to voice concerns over changes to the 
Medicaid program contained in the Executive Budget and to advocate for the maintenance of current local Medicaid caps.

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

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.

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.

"Counties will work with state leaders and with the Medicaid Redesign Team (MRT) to address what is under local control, but we cannot absorb additional costs without jeopardizing vital services that our residents depend on,” said NYSAC Executive Director Stephen J. Acquario. Counties are represented on the MRT by Suffolk County Executive Steve Bellone, who also sits on the NYSAC Board of Directors.

The Executive Budget proposal includes three separate initiatives that would impact the Medicaid local share counties pay in support of the state Medicaid program:

1. Capping eFMAP Federal Fiscal Benefits to Counties
Under this proposal the Budget proposes to cap the amount of federal savings that have been accruing to counties and New York City from the Affordable Care Act, funneling any savings to the state. This provision is effective April 1, 2020, but no fiscal impact amount is provided in the budget for this proposal.

2. Require Counties and New York City to Adhere to the 2 Percent Property Tax Cap or Lose the Benefits of the State Funded Local Medicaid Growth Cap
If a county fails to stay under the property tax cap, or if New York City's property tax levy grows more than the county property tax cap allows, then they would lose all of the savings from the local Medicaid cap in that year. This provision is effective April 1, 2020.

3. Adhere to a Local Share Medicaid Costs Increase of No More than 3 Percent
If a county's local share and associated savings exceeds three percent in any given year, county taxpayers must refund to the state any excess benefit over three percent. This provision is effective April 1, 2021.

“The Medicaid cap has been crucial in helping counties stay under the property tax cap and save local taxpayers money. While we welcome the opportunity to work with the MRT to lower Medicaid costs overall, we maintain that property taxpayers should not shoulder the burden of Medicaid cost increases that counties are not empowered to restrain. We can't cap what we can't control, and our taxpayers should not be penalized for that,” said Albany County Executive Dan McCoy, who also serves as president of the New York State County Executives' Association.

For additional information and resources related to the SF2021 Budget Medicaid Proposals visit
Contact: Mark LaVigne,