Collins on Medicaid Reform

Please read the following three important messages from Erie County Executive Chris Collins on the absolute necessity to enact substantive Medicaid reform.

Tuesday, January 11, 2011

Collins Pushes Medicaid Reform Legislation to Reduce Property Taxes
Legislation would give local governments
ability to ‘opt-out’ of non-mandated services

Erie County Executive Chris Collins pressed state lawmakers today to help him deliver a 40% reduction in county property taxes by giving local governments control over Medicaid spending.  Collins is asking local members of the New York State Senate and Assembly to sponsor legislation that would allow local municipalities to ‘opt-out’ of the non-federally mandated Medicaid services.  New York is one of only a handful of states that passes a share of its Medicaid burden to local governments and taxpayers.  Nearly every dime Erie County collects in property tax goes directly to New York State to pay for Medicaid services.

“The immediate and tangible results of this legislation are dramatic,” said Erie County Executive Chris Collins.   “In Erie County alone, taxpayers would see an $80 million, or 40%, reduction in their local property tax bill.  When you factor in the entire state, the savings are enormous and would provide a real pathway toward fixing the daunting challenges facing New York State.

In Erie County, the 2010 local share of Medicaid was approximately $201 million.  By comparison, Erie County’s property tax levy in 2010 was $211 million.  Nearly 96% of the County’s entire property tax levy went to pay for Medicaid costs.  In addition, Erie County’s Medicaid tab will increase by $6 million in 2011.  The entire Medicaid program cost for Erie County alone is more than $1.4 billion, including local, state and federal share.  That breaks out to nearly $1,500 for every man, woman and child in Erie County.  New York provides all but two of the federal Medicaid options.  In total, these optional services cost Erie County taxpayers alone an additional $250 million in state and local Medicaid share payments.

“These numbers are staggering, and provide a clear example of why Erie County, and all of New York State, cannot continue on this course,” continued Collins.  “These optional services are why New York is well known for having an infamous “Cadillac” Medicaid program.  In this era of tough fiscal times, taxpayers are demanding a Chevy, not a Cadillac. This is unfair and unsustainable, but this legislation is a real solution.”

Collins is calling on members of the Western New York delegation of the State Legislature to introduce the ‘opt-out’ legislation.  Through local law, passed by the local legislative body and approved by the local executive, municipalities would determine what optional Medicaid services to provide to their residents.  Collins is also outlining his proposal in a letter to Governor Andrew Cuomo, asking for his support as a way to help local property taxpayers and reduce New York’s growing deficit.

Medicaid services not mandated by the federal government, but provided in New York State include:

  • Eyeglasses
  • Optometrist services
  • Physical therapy
  • Speech therapy
  • Occupation therapy
  • Dental services
  • Dentures
  • Hearing aids
  • Private duty nursing
  • Medical supplies (bath safety equipment, wound care supplies, diabetic shoes, etc.)
  • Health clinic services (facilities not part of a hospital)

********************************

Let Local Governments Control Medicaid Spending

Hon. Chris Collins
Erie County Executive

Nearly every dime Erie County (New York’s largest Upstate county) collects in property taxes goes directly to New York State for Medicaid services.  Medicaid does provide a vital safety net for our most vulnerable citizens.  But there is no other way to describe the current program other than unfair and unsustainable for our counties and our state.  That is why I believe New York must give local governments more flexibility to control Medicaid costs and lower property taxes.

In Erie County, the 2010 local share of Medicaid was approximately $201 million.  By comparison, Erie County’s property tax levy in 2010 was $211 million.  Nearly 96% of the County’s entire property tax levy went to pay for Medicaid costs.  In addition, Erie County’s Medicaid tab will increase by $6 million in 2011.  The entire Medicaid program cost for Erie County is more than $1.4 billion, including local, state and federal share.  That breaks out to nearly $1,500 for every man, woman and child in our community.

As many of you know, in addition to the federal mandates, New York offers nearly every non-mandated Medicaid service.  The expense of these optional services costs Erie County taxpayers an additional $250 million in state and local Medicaid share payments.  These optional services are why New York is well known for having a ‘Cadillac’ Medicaid program, and in this era of tough fiscal times, taxpayers are demanding a Chevy, not a Cadillac.

That is why I am asking state lawmakers to introduce ‘opt-out’ legislation.  This legislation would allow local municipalities to ‘opt-out’ of the Medicaid services not mandated by the federal government.  Through local law, approved by the local legislative body and executive, municipalities would determine what optional Medicaid programs to provide to their citizens.

The immediate and tangible results of this legislation are dramatic.  In Erie County alone, taxpayers would see an $80 million/40% reduction in their local property tax bill.  When you factor in the entire state, the savings are enormous and would provide a real pathway toward fixing the daunting financial challenges facing New York State.  In his recent State of the State address, Governor Andrew Cuomo talked at length of the necessity to reform our Medicaid system and I recently sent the Governor and every member of the State Legislature a letter detailing this legislative proposal.

Reforming Medicaid has proven incredibly difficult, in large part, because it is nearly impossible to get all the diverse, but necessary parties to agree on statewide reforms.  This legislative solution is not one size fits all, and instead, allows local governments to tailor a program to fit the needs of their residents and balance that with the ability of their taxpayers to foot the bill.  County governments are drowning in Medicaid costs.  The least New York State can do is allow these same governments to build their own life raft.

********************************

State Legislators join Collins in push for ‘Opt-Out’ Medicaid Legislation
Legislation would give counties more control over Medicaid costs,
lower property taxes

Friday, January 21, 2011

Local members of the New York State Legislature have joined Erie County Executive Chris Collins today to support legislation that would give local governments some control over Medicaid spending.  Collins is calling on Albany to pass legislation that would allow county governments, through local law, to opt-out of non-mandated Medicaid services.  Nearly every dime Erie County collects in property tax goes directly to New York State to pay for Medicaid services.  Collins says opt-out legislation would reduce county property taxes by as much as 40%.

“Currently, the Medicaid system is a one-size-fits-all approach and it is unsustainable and unfair to taxpayers,” said Collins.  “This legislative solution is not one-size-fits-all, and instead, allows local governments to tailor a program to fit the needs of their residents and balance that with the ability of their taxpayers to foot the bill.  County governments are drowning in Medicaid costs.  The least New York State can do is allow these same governments to build their own life raft.”

Senator Michael Ranzenhofer has sponsored ‘opt-out’ legislation in previous years and has recently reintroduced the legislation (S1813 2011).  There is also a companion bill in the New York State Assembly (A2285 2011).

“With all the State-required Medicaid options, Erie County is forced to spend almost all of its property tax dollars on Medicaid,” said Ranzenhofer.  “The county’s share of Medicaid costs is like Pacman eating everything in sight.  I have re-introduced legislation in the State Senate to grant counties the option to opt-out of state-required but not federally-required Medicaid services. Under the proposal, counties would decide which Medicaid programs are affordable to the taxpayer and needed to best serve residents.”

Assembly members Jane Corwin, Jim Hayes and Kevin Smardz also support ‘opt-out’ legislation.

“I am proud to join County Executive Collins and my colleagues in state government to support this responsible reform of the Medicaid system in New York State,” said Assemblywoman Corwin.  “For too long, county governments and taxpayers have been forced to subsidize billions of dollars in costly Medicaid services and other mandates handed down from Albany.  This legislation provides local governments with the opportunity to curtail a portion of the Medicaid services they provide and make fiscally responsible decisions that are accountable to taxpayers.”

Assemblyman Jim Hayes said, “Allowing counties to determine which Medicaid optional services they can afford has the potential for billions of dollars in savings to local property taxpayers in Western New York and throughout the state. The opt-out provision is an important step toward rolling back a costly state mandate that property taxpayers cannot afford.”

Assemblyman Kevin Smardz said, “Taxpayers across Western New York are looking for real property tax relief. Local costs of Medicaid account for an unsustainable portion of county property taxes and structural reforms are needed if we are to begin easing that burden. The ‘opt-out’ proposal of non-mandated services being advocated here today by County Executive Collins and my colleagues in the Western New York Delegation provide us that opportunity.

New York is one of only a handful of states that passes a share of its Medicaid burden to local governments and taxpayers.  In Erie County, the 2010 local share of Medicaid was approximately $201 million.  By comparison, Erie County’s property tax levy in 2010 was $211 million.  Nearly 96% of the County’s entire property tax levy went to pay for Medicaid costs.  In addition, Erie County’s Medicaid tab will increase by $6 million in 2011.  The entire Medicaid program cost for Erie County alone is more than $1.4 billion, including local, state and federal share.  That breaks out to nearly $1,500 for every man, woman and child in Erie County.  New York provides all but two of the federal Medicaid options.  In total, these optional services cost Erie County taxpayers alone an additional $250 million in state and local Medicaid share payments.

“Reforming Medicaid has proven incredibly difficult, in large part, because it is nearly impossible to get all the diverse, but necessary parties to agree on statewide reforms,” continued Collins. “This legislative proposal is an easier lift in Albany.  And in addition to providing significant local property tax relief, will also save the state and federal governments millions of dollars in Erie County alone.”

Examples of Medicaid services not mandated by the federal government, but provided in New York State, include: private duty nursing; eyeglasses; optometrist services; physical, speech and occupation therapy; dentures and hearing aids.

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