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Allow counties to opt out of non-mandated Medicaid


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oneilj - Posted on 04 February 2011

In Erie County, 95 percent of property taxes are needed to pay for just one bill. Of the $211 million collected in 2010, approximately $201 million pays the county’s portion of Medicaid. This statistic is not only shocking, but also somewhat unbelievable. While we know the numbers are true and Medicaid costs are crippling, it is difficult to believe a county could survive when 95 percent of its property taxes pay just one bill.


I do not believe the county will be able to survive much longer under the current system. Eventually, the taxpayers will no longer be able to sustain such burdensome costs. We are faced with a shrinking tax base and rising costs. That is why I co-sponsored a resolution, submitted at the Jan. 20 legislative session, asking state leaders to pass legislation allowing counties to opt out of non-mandated Medicaid programs and save taxpayers millions of dollars a year.


As legislator, I have a responsibility to ensure services meet federal mandates and provide certain services to Medicaid recipients. However, continuing to fund all but two non-mandated services is becoming impossible. The rising costs are forcing the county to drastically change day-to-day operations, including funding cuts to the library system and cultural organizations. To meet this required annual bill, the county was forced to make unpopular choices.


Allowing the county to prioritize what services are most important to our community will allow for vital medical services to be provided, while at the same time saving taxpayer dollars.


I think the choice for state leaders is obvious — give counties the opportunity to opt out of non-mandated programs. It has been estimated that such a change in the law could potentially save county taxpayers more than $80 million per year. WNY is overtaxed, and one way we can alleviate a large portion of that burden is having the state consider the Legislature’s resolution. It is also supported by County Executive Chris Collins, State Sen. Mike Ranzenhofer, State Assemblywoman Jane Corwin and others.


In addition to allowing counties to select optional Medicaid services, the change in the law would allow counties to set eligibility requirements. Medicaid is a program that benefits many of our most vulnerable residents but at the same time is bankrupting the county. Reform is needed, and I think this is a great first step.



One of the ways the federal government needs to reform Medicaid is by reviewing the reimbursement percentage, known as Federal Medical Assistance Percentage. States have the option of participating in Medicaid programs and those that do receive reimbursement from the federal government. However, the current formula provides New York State with less reimbursement than most states. NYS receives 50 cents for every dollar it spends on Medicaid compared to Ohio’s 63.69 or Vermont’s 58.71. If NYS received the same reimbursement as Ohio, it would save taxpayers billions of dollars.


These are two areas of Medicaid reform the County Legislature is strongly encouraging state leaders and local congressional representatives to take a serious look at.


The County Legislature requires any resolution submitted include the estimated fiscal impact. On these two recent resolutions, the fiscal impact is “positive for Erie County taxpayers.”


(Printed Feb. 3, 2011 in the East Aurora Bee and Orchard Park Bee Newspapers)