Medicaid pivotal in budget presentation

Gov. Andrew Cuomo’s annual budget proposals have a way of hitting on important and even urgent topics with dramatic effect, but imprinting question marks on the little details that provoke politically charged debates in Albany.

The governor’s $178 billion proposal increases spending around 2% over 2019, and includes legislation and funding allocated for infrastructure, environmental initiatives and Medicaid — all worthy endeavors, to be sure. Aid for schools comes in at a modest 3% increase, but at least the majority of funding is aimed at high-need schools.

In parts of the presentation Tuesday, Cuomo sounded as if he wants to have it both ways by being progressive and fiscally sound. “The answer,” the governor said, “is to reduce the level of growth, not cuts.” The greatest concern to small local governments in Greene and Columbia counties will surely be Medicaid funding, which makes up about $4 billion of the state’s projected $6.1 billion deficit, a gap Cuomo hopes to close this year. But in his Jan. 8 State of the State address, Cuomo hinted the state could potentially shift Medicaid costs back onto localities, spreading alarm and outrage among elected leaders.

New York’s $80 billion Medicaid program is shouldered by the federal government, the state and its counties. While Washington funds about 50% of the cost, localities paid a smaller share of $7.6 billion of the remaining cost in 2019, leaving the state to cover the remaining $32.4 billion. Columbia and Greene county residents are fed up with high taxes partly caused by Medicaid. It’s incumbent upon the state and the counties to keep spending under control in the coming year.