U.S. Rep. John Faso and Gov. Andrew Cuomo have repeatedly traded barbs this week over the congressman's proposal for the federal government to force the state to take over counties' shares of Medicaid payments.
Faso, a Republican whose district includes northern Dutchess County and spans a wide swath of the upper Hudson Valley, has added the proposal as an amendment to the American Health Care Act (AHCA), which in turn is the House Republican leadership's legislation to repeal and replace the Affordable Care Act (better known as Obamacare).
Faso's amendment, which is cosponsored with upstate Republican Rep. Chris Collins, would withhold federal reimbursement for Medicaid if the state government does not comply with the takeover.
For years, county officials have blasted the payments, which they call and "unfunded mandate" that is a major cause of New York's high property taxes.
New York's payment structure, which involves three governmental layers, stands in contrast to other states, where costs are only borne by state and federal governments.
In New York, counties have been required to contribute a payment share for Medicaid for 51 years, dating back to when Nelson Rockefeller was governor; Faso referenced the long history in his announcement.
“High property taxes are crushing Upstate homeowners and businesses. Medicaid costs passed on from Albany are the primary driver of these taxes. This policy, which I’ve described as the single worst mistake from the Rockefeller era, has burdened homeowners and small businesses for decades and helps give New York State the lamentable record of having some of the highest property taxes in the nation and the worst retention rates for people and jobs over the last decade."
Faso added that the takeover would get rid of a combined $2.2 billion in property tax costs and be effective in 2020.
Cuomo blasted the proposal in statements, arguing that a takeover could mean having to raise state income taxes to offset the costs.
Cuomo, in a press release, contends that Faso's amendment, along with proposed shifts of federal Medicaid costs down to the state that would come in addition under the AHCA, would translate to a 10-percent income tax hike and cost New York $4.7 billion.
“If this bill is passed as is, our federal representatives will be responsible for massive income or sales tax increases or devastating cuts to New York’s healthcare system," Cuomo said in a statement.
The governor, a Democrat who lives in Westchester County's town of New Castle, also contends that 2.7 million people in New York, "would face substantial loss in their current health care coverage while the quality and availability of health services across the state would be jeopardized."
Cuomo also blasted the AHCA because it would freeze new enrollment the Medicaid expansion that was enacted as part of Obamacare. The freeze would take effect in 2020. Additionally, the AHCA would convert the federal Medicaid funding formula into a per-capita grant system, which critics charge, according to news reports, would amount to a de facto cut due to its focus on fixed-dollar amounts that could be outstripped by total costs.
Faso, in a statement , argued that such fears are unfounded, noting that the state could continue to enroll people in Medicaid pursuant to the expansion until 2020. Raising an argument in favor of grants, Faso contended that under the change, "the state will be afforded maximum flexibility to run its program without having to seek continual program amendments and waivers from Washington."
On the issue of a possible income-tax hike to finance a takeover, Faso argued that the effect could be mitigated by a 1.5-percent cut in state spending.