Medicaid & Human Services

This SFY 2021 Executive State Budget proposal includes three separate initiatives, referred to collectively as “Medicaid Local District Spending Reforms” that would impact the Medicaid local share county taxpayers pay in support of the state Medicaid program. 

  1. Cap eFMAP Federal Fiscal Benefits to Counties — Caps the amount of federal savings for counties and New York City from the Affordable Care Act. As proposed, the savings would be transferred to the benefit of the state financial plan.
  2. Require Counties and NYC to adhere to the 2% Property Tax Cap or lose the savings from the state-funded local Medicaid growth cap.
  3. Adhere to a Local Share Medicaid Costs Increase of No More than 3% — If a county’s local share and associated savings exceeds 3% in any given year, the county is required to refund any excess benefit over 3% back to the state.

NYSAC Position

Counties oppose efforts to alter the local Medicaid cost control caps that have helped counties stay under the tax cap and provide services locally. We urge the removal of Part R of the Health and Mental Hygiene Article VII language from the Final Budget, and the accompanying $150 million cost shift to county taxpayers. Counties are working with the MRT to address what is under local control and recommend solutions that are under state control.

Medicaid "Keep the Cap" Advocacy Toolkit 

Preserving the Medicaid Cap Factsheet --2/24/2020

Historical Overview and Timeline --2/25/2020

KeeptheCap Palm Card

Letter to Legislators


#KeeptheCap Fiscal Impact Calculator

Key State Lawmakers for Medicaid Advocacy

Webinar on Current Federal and State Medicaid Proposals

Medicaid Proposals: Federal and State Updates -- 2/19/2020

Preserving the Local Medicaid Cap: Top 5 Must-Read Articles

Meet the Company Reaping Big Bucks From N.Y.s Budget Busting Medicaid Surge
The City, Feb 24, 2020

Cuomo administration budget amendments detail local share Medicaid changes
Politico PRO, Feb 21, 2020

EDITORIAL: Medicaid shift is no solution​
The Daily Gazette, Feb 15, 2020

What Cuomo’s 2021 proposed Medicaid cost-shift on localities could mean
City & State, Feb 12, 2020

Cuomo’s Bad Medicine on Medicaid
New York Times Editorial, January 31, 2020 

What Others are Saying

Recommendations for Legislative Action on the FY2021 NYS Executive Budget: A Letter to the Legislature
Citizens Budget Commission, Feb 24, 2020

State, counties spar over rising Medicaid costs​
Times Herald-Record, Feb 22, 2020

How soaring enrollment, big spending, waste, fraud are boosting NY Medicaid costs​, Feb 21, 2020

Report identifies $3 billion in Medicaid savings​
Empire Center, Feb 21, 2020

An Alternate Perspective on the 2020-21 Budget
Medicaid Matters NY, Feb 14, 2020

Counties say Cuomo Medicaid plan could hit localities harder than first estimated​
Buffalo News, Feb 14, 2020

DiNapoli Report: Unknowns In State Budget​
NY State of Politics, Feb 14, 2020

Madison County's Chairman Becker on #KeeptheCap
Madison County, Feb 14, 2020

Recapping the first Medicaid Redesign Team meeting​
WCNY, Feb 13, 2020

Here’s one piece of New York’s soaring Medicaid costs puzzle​
NY Post Editorial Board, Feb 12, 2020

Governor’s proposed Medicaid funding changes would be financially ‘devastating,” says Putnam executive​
Mid Hudson News, Feb 12, 2020

Cuomo must solve his Medicaid mess, not dump it on local governments, taxpayers​
NY Post Editorial Board, Feb 11, 2020

Protest disrupts first meeting of Cuomo's Medicaid savings panel​
Times Union, Feb 11, 2020

De Blasio rips Cuomo’s Medicaid proposal as N.Y. faces $6 billion funding gap
New York Daily News, Feb 10, 2020

County lawmakers expected to ask Cuomo to reconsider Medicaid proposal
Olean Times Herald, Feb 8, 2020

Lawmakers plan to engage Cuomo’s Medicaid panel, Senate leader says
New York NOW, February 7, 2020

Lawmakers plan to engage Cuomo’s Medicaid panel, Senate leader says
Times Union, February 7, 2020

Teachers’ union boss Mike Mulgrew launches campaign against Cuomo Medicaid plan
New York Post, February 7, 2020

Lawmakers Plan to Engage Cuomo's Medicaid Panel, Senate Leader Says
New York Now, February 7, 2020

Adding Pressure On Local Governments Will Continue To Hurt Middle-Class Families​
Capitol News from the Assembly Minority Conference, February 7, 2020

Cuomo's Two-Pronged Medicaid Approac
Blame Cuomo for this budget deficit: It’s his gimmicks that brought us to this point
New York Daily News, February 7, 2020

Cuomo's Two-Pronged Medicaid Approach
NY State of Politics, February 7, 2020

County Officials unclear about governor’s Medicaid plans
Observer Today, February 4, 2020

Fact-checking Mujica’s op-ed​
Empire Center, February 4, 2020

Our Medicaid fix makes sense: New York State’s budget director defends Gov. Cuomo’s plans​
New York Daily News, February 4, 2020

Cuomo budget director defends Medicaid plan, accuses NYC of engaging in ‘scare tactics’
New York Daily News, February 4, 2020

NYC, New York state fight over who controls Medicaid program
New York Post, February 4, 2020

Confusion and Tension Over Budget Gap and Cuomo’s Proposed Medicaid Changes
City Limits, January 31, 2020 

Erie Co. Exec. on Medicaid spending and Bills stadium​
WCNY, January 31, 2020 

Westchester Frets Budget Impact Of Medicaid Plan
NY State of Politics, January 31, 2020

Fiscal Watchdog Supports County Position on Medicaid Costs
Livingston County Press Release, January 30, 2020

Lawmakers grill health officials on MRT, local share of Medicaid
Politico Pro, January 29, 2020

Cuomo officials face heat over Medicaid woes
Associated Press, January 29, 2020

Lawmakers push back against Cuomo Medicaid deficit reduction ideas
Buffalo News, January 29, 2020 

NY Medicaid hearing yields few answers for savings
Times Union, January 29, 2020

'Nothing more than political theater’: Lawmakers raise doubts about Cuomo’s $6 billion Medicaid budget gap
NY Daily News, January 29, 2020

New York City Says It Could Pay an Extra $1.1 Billion in Medicaid
Wall Street Journal, January 29, 2020

NYC might have to pay an extra $1.1B in annual Medicaid costs
New York Post, January 29, 2020

City Hall: Cuomo's Medicaid plan could cost the city $1.1B
Politico, January 29, 2020

DiNapoli tells counties rising Medicaid costs aren't fault of localities
Politico, January 27, 2020

Cuomo aims to cut Medicaid growth; some see threat to local taxes
Newsday, January 26, 2020

The Medicaid muddle: Cuomo's budget proposal creates worry and confusion
Buffalo News, January 25, 2020 

DiNapoli audits of Medicaid program find millions in savings that could help offset $6 billion budget gap

NY Daily News, January 17, 2020

County leaders baffled and worried over Cuomo's Medicaid comments
Buffalo News, January 12, 2020

Save New York's broken Medicaid program
Newsday, December 7, 2019

Still a Poor Way to Pay for Medicaid

Citizens Budget Commission, October 1, 2018

NYSAC White Papers and Reports