He Says Medicaid Mandate Unique
To NY, Unfair To Poorer Counties
By JIM KEVLIN • Special to www.AllOTSEGO.com
As the county board’s monthly meeting neared an end, the vice chair stood and distributed a sheet of numbers to his colleagues, then, rapid fire, he added meaning those numbers. A sampling:
- The 3,144 counties in the United States contribute a total $9 billion to Medicaid. Of that $9 billion, New York’s 62 counties pay $7.3 billion, and the 57 Upstate counties, $2.3 billion of that total.
- Minus New York, the 3,082 counties in other states pay only $1.7 billion – which means Upstate alone pays more than all the other 49 states combined.
- Of Otsego County’s $11.4 million tax levy, $10.2 million goes to Medicaid.
“90 percent of our county tax levy,” Frazier declared, “nine out of 10 dollars raised by property taxes goes to the state for our Medicaid costs.”
Even worse, he continued, the formula is such that richer New York State counties, because they have fewer poor people, pay less per capita than poor counties. Citing 2011 numbers from the non-partisan Citizens Budget Commission, he said Medicaid, the largest mandate, is thus also the most unjust.
The Collins-Faso Amendment was co-sponsored by Otsego County’s congressman John Faso, the Kinderhook Republican, during Congress’ discussion of the American Health Care Act that failed to pass the House in April. It would require New York to absorb Medicaid costs in the state budget, and would reduce support to the state to the degree it failed to reduce the mandate on the counties.
The amendment, Frazier said, is Otsego County’s best chance, perhaps its only chance, to overturn an unfair mandate that Albany – almost alone and to the greatest degree among the 50 states – has imposed on its counties since the 1960s.
He stopped short today of reintroducing the resolution that was withdrawn last month. But he said he may do so at next month’s board meeting.
Frazier’s presentation – it appeared to be a surprise to many of his colleagues – generated a lively debate that generally broke down along party lines.
Jim Powers, R-Butternuts, said, “I’m in favor of what you are saying.” He said the resolution shouldn’t have been withdrawn last month “because of 20 people in the back of the room.”
Andrew Marietta, D-Cooperstown/Town of Otsego, said “I don’t disagree” with Frazier’s argument, only with “the baggage that is attached to it” – the damage the Republicans’ AHCA (the failed American Health Care Act) would, as a whole, have done to local health care.
Andrew Stammel, D-Town of Oneonta, agreed the AHCA would be “extremely damaging to our local economy.”
Dan Wilber, R-Town of Burlington, pointed out that whether the AHCA were to eventually pass or not “is beyond our control … The only time that the amendment would kick in is if the AHCA passes … That’s the only way to force their hand to take it (the state’s Medicaid mandate) off our backs.”
Meg Kennedy, R-Mount Vision, said the Faso-Collins Amendment is “a vehicle for us to express our support for taking away that mandate … This is a way for us to have a voice.”
Kay Stuligross, D-Oneonta, said “I understand what Ed’s saying,” but argued that, on the whole, if AHCA were to become law, even with the Faso-Collins Amendment, “the amount to New York State would be significantly reduced. That isn’t going to help anyone.”
An alternate way to move forward was proposed by Len Carson, R-Oneonta, in that “it sounds like we have an consensus.” He proposed drafting a letter to Governor Cuomo expressing the county’s opposition to the Medicaid mandate, and to reach out to surrounding counties to make the letter a declaration of multi-county opposition.
That may be an alternative proposal to Frazier reviving the withdrawn resolution when the county board next meets on Sept. 6.
Chiming in at the end, county board Chair Kathy Clark, R-Otego, said she thinks Collins-Faso was actually an amendment to a Social Security bill, not the AHCA.