Proposed Rockland Bill To Transfer All County Medicaid Costs To State

Rockland County has the fourth highest property taxes in the country. To combat this, several elected officials are pushing for a new proposal to relieve taxpayers by transferring all county-level Medicaid costs over the next eight years to the state level.

Assemblywoman Amy Paulin, Assemblywoman Ellen Jaffee, Assemblyman Kenneth Zebrowski, Rockland County Executive, Scott Vanderhoef, Rockland County Legislature Chairwoman Harriet Cornell and NYS Association of Counties Executive Director Stephen Acquario announced this new legislation, co-sponsored by Senator Carlucci.

About The Legislation

1. The proposal will freeze local Medicaid costs, providing $180 million in immediate local savings statewide.
2. The proposal will eliminate the automatic three percent annual spending increase currently required by statute.

“The bill that David (Carlucci) and Kenny (Zebrowski) and others are proposing is a bill to have the state take over the Medicaid bill entirely,” added Vanderhoef.

“We’ve got to get the ball rolling to get Medicaid under control,” said Carlucci. “We have the largest expenditure in Medicaid than any other state in the nation.”

“New York and Michigan are the only two states in the nation that are required to share the cost of Medicaid with the state government,” said Cornell.

“The time is now for legislation,” said Zebrowski. “It’s certainly, at the county level, no secret that it’s Medicaid (driving up costs). This bill really puts this at the forefront of the agenda.”

“Every town is struggling,” said Vanderhoef. “As you can see in Rockland County, the Medicaid portion … alone was $65 million last year and our property taxes were $61.7 million. It’s a 110 percent so it takes all of our property taxes. In Westchester, it takes 40 percent, in some places it takes 90 or 80 percent.”

In Rockland County, Medicaid accounts for 44 percent of its mandates.  In 2011, the cost of Medicaid to Rockland County is $65,670,000.

“Several years ago, when they passed the 3 percent cap on what it could increase for the counties. That was just really just the first step,” said Zebrowski. “That, over the years, has saved over $800 million for the county. The next step really is to start this phase where the state can take over Medicaid, take over this cost and relieve the counties of this type of burden. I’m committed to pushing this bill to get it on the agenda and working with the Cuomo administration who I know are looking who are looking for ways to work with our municipalities.”

“$1 million every single week in this one county alone is going to Albany to pay for a program (Medicaid) that Rockland County residents and Rockland County elected officials have no control over,” said Acquario.

The Timeline

“What this proposition does is provide a slow, orderly transition … for the state to assume the property tax share of Medicaid,” said Acquario.

“Not immediately, but over an 8-year period,” said Vanderhoef. “In 2012, which would be important for us in our budget, the cap would be eliminated, there would be no growth in the Medicaid bill. For us that would be $2.6 million just for us in 2012. In the next seven years (after 2012), the state would eventually pick up the (Medicaid) bill.” Between 2013 and 2019, local Medicaid costs will gradually reduce as the state assumes an increasing share of the burden.

“In the first year, for 2012 fiscal year, the first three-quarters of the year, Medicaid will be frozen—currently, it’s allowed to go up 3 percent,” said Paulin. “In the last quarter of their fiscal year, it would be reduced to 5 percent. After that it will be phased out until 2019. After that, there would not be any Medicaid expense on the part of the locals.” This five percent reduction will give counties an additional $75 million—totaling $255 million in savings for county governments.

“The way we expect to pay for this is two-fold. One is from the Federal Affordable Care Act … Already this year, from the Medicaid reform team … we already have $600 million in savings,” said Paulin. “We know that this is going to only cost $255 million in our first year. So we’re only taking a little of the Medicaid savings and applying it to the locals, which is really where it needs to be applied.”

The Effect

The end result would completely eliminate Medicaid costs from county budgets, providing municipal governments with the flexibility to substantially reduce local property taxes.

“You can see what this means immediately for Rockland County property tax payers,” said Vanderhoef. “We would then be able to have a property tax reduction. At least we wouldn’t have any property tax increases. We would have other mandates, but it has an immediate, dramatic effect on Rockland County.”

“(The state) They’ll also at that point begin to look at fraud more carefully, abuse more carefully, mismanagement more carefully,” said Vanderhoef. “Once the state becomes accountable for every dollar, the program will be more efficient.”

“This is a very complex issue,” said Cornell. “When people talk about Rockland having the fourth highest property taxes in the country, the thing is, 65 percent of those taxes are school taxes. Schools are really going to benefit from (this).”

We need to do something to make sure our elders can stay in their homes after they’ve spent so long giving to the community and that we can attract young people to work here,” said Paulin.

"This bill will go a long way towards making sure municipalities can live within the tax cap while containing to provide the essential services our communities need to maintain their quality of life,” said Jaffee. “This must be part of a concerted effort to reduce or reform unfunded mandates across the board."