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VIEWPOINT
Why is it that New York is the only state to push Medicaid costs onto its counties?
BY GARY HUGHES For The Sunday Gazette

    Gov. David Paterson got it right when he issued an open letter to both presidential candidates recently calling on them to repair what he correctly describes as the “fractured bond between the federal government and states.”
    “This partnership was once a source of America’s strength,” Paterson wrote in the letter. “Yet time and time again, the current administration [in Washington] has hung the states out to dry.”
    We also need to repair the partnership between the state and local governments. By connecting the dots from the federal government passing costs down to the state, which in turn passes the costs down to counties, there is a clear result: 75 percent of our local tax burden comes from unfunded mandates.
    County government has little say in how these mandated programs are developed, with the state making the laws, setting policy and determining what expenses they will pay.
    The state Legislature can no longer shift the cost to our counties. Aside from federal and state aid, county revenue is generated through property and sales taxes and service fees. By shifting the costs to counties, the state is shifting the tax burden from a progressive income tax to a regressive property and sales tax.
COUNTY RESOLUTION
    Among the actions Gov. Paterson is urging is an increase in the federal share of Medicaid — the nation’s health insurance plan for its neediest citizens. A resolution that I introduced and that passed the Schenectady County Legislature unanimously this past week is in the same spirit as Gov. Paterson’s call for a stronger partnership between the states and the federal government.
    The resolution we passed calls on the governor, the state Assembly and the state Senate to form a stronger partnership with counties and to reform the way state government passes mandated costs down to county government — starting with the state assumption of the local share of Medicaid cost.
    It makes no sense to me that New York is the only state in the nation that puts half its share of the cost of Medicaid on local property taxpayers, while our state legislators profess their concern about the excessive burden carried by those same property owners. No other state in the nation funds Medicaid this way.
    Today, the cost of Medicaid in New York state is paid through a three-way split by the federal government, the state and counties.
    Originally conceived as a way to reform county spending on health care for the indigent in the 1960s, this three-way approach to paying for Medicaid has become a heavy burden for upstate property owners as the cost of health care, and with it the cost of Medicaid, has risen more sharply than anyone could have imagined then.
    Despite a state-imposed cap on local Medicaid cost increases, the actual Schenectady County cost of Medicaid has risen more than 70 percent since 2000. In real dollars, the local share of this cost to Schenectady County property owners is more than $30 million in the budget proposed to the Legislature by the county manager earlier this month.
FAIRER SOLUTION
    The intent of the resolution that I introduced and that my colleagues passed is to draw attention to the inequity of a funding scheme that forces the cost of health care for the indigent onto property owners who are already struggling to make ends meet. Many of those property owners earn only slightly more than the people who meet the income requirements for Medicaid.
    There is a better way. The state should fully fund its share of the Medicaid program. I would suggest, as I did in a second resolution that passed the county Legislature last week, that the fairer way to pay for health care for the indigent is for the state to spread the cost through the state income tax. Everyone should pay their fair share. My resolution called for an increase on the highest tax bracket — for those earning $1 million or more per year in taxable earnings. I think that is much fairer than expecting local property taxpayers to shoulder the cost of a state program. The result would be a 50 percent reduction in the Schenectady County property tax levy.
    The reality is that Schenectady County’s budget is being shaped by these state and federal mandates rather than by our own local priorities. These mandates leave the county with scarce resources to pay for programs that make it a special place to live, such as the library, county parks or the Glendale Home. Our highway department has to do more with less to maintain our county roads. Our Office for the Aging has to be more creative in providing services to our aging population.
    Schenectady County government is doing what it can to contain costs. We have seen great savings in the cost of welfare through reform and increased efficiencies. The Department of Social Services management and staff have done a remarkable job creating an efficient operation, one of the best in the state compared to other counties. This includes having the 2nd highest Medicaid efficiency rate in New York state.
    We were one of the first counties to partner with the state to purchase food for our inmates, saving county taxpayers over $50,000 per year. We have partnered with our employee unions to reduce the cost of employee and retiree health insurance, creating annual savings of more than $3 million.
RE-EXAMINE MANDATES
    Gov. Paterson asked that New York state do more with less to combat our state fiscal crisis. New York counties have been doing more with less for years.
    We need New York state to not just cut funding or pass expenses down to our counties, but to re-examine their mandates and find new and more efficient ways to administer these programs.
    If the state could find a way to fully pay for Medicaid, as every other state in this nation does, Schenectady County could cut property taxes in half.
    We in Schenectady County government understand the economic crisis facing our state. We ask Gov. Paterson and the Legislature to please not balance our state’s checkbook on the backs of local taxpayers.

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The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States;
To borrow money on the credit of the United States;
To regulate commerce with foreign nations, and among the several states, and with the Indian tribes;
To establish a uniform rule of naturalization, and uniform laws on the subject of bankruptcies throughout the United States;
To coin money, regulate the value thereof, and of foreign coin, and fix the standard of weights and measures;To provide for the punishment of counterfeiting the securities and current coin of the United States;
To establish post offices and post roads;
To promote the progress of science and useful arts, by securing for limited times to authors and inventors the exclusive right to their respective writings and discoveries;
To constitute tribunals inferior to the Supreme Court;
To define and punish piracies and felonies committed on the high seas, and offenses against the law of nations;
To declare war, grant letters of marque and reprisal, and make rules concerning captures on land and water;
To raise and support armies, but no appropriation of money to that use shall be for a longer term than two years;
To provide and maintain a navy;
To make rules for the government and regulation of the land and naval forces;
To provide for calling forth the militia to execute the laws of the union, suppress insurrections and repel invasions;
To provide for organizing, arming, and disciplining, the militia, and for governing such part of them as may be employed in the service of the United States, reserving to the states respectively, the appointment of the officers, and the authority of training the militia according to the discipline prescribed by Congress;
To exercise exclusive legislation in all cases whatsoever, over such District (not exceeding ten miles square) as may, by cession of particular states, and the acceptance of Congress, become the seat of the government of the United States, and to exercise like authority over all places purchased by the consent of the legislature of the state in which the same shall be, for the erection of forts, magazines, arsenals, dockyards, and other needful buildings; — And
To make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof.
Section 9. The migration or importation of such persons as any of the states now existing shall think proper to admit, shall not be prohibited by the Congress prior to the year one thousand eight hundred and eight, but a tax or duty may be imposed on such importation, not exceeding ten dollars for each person.
The privilege of the writ of habeas corpus shall not be suspended, unless when in cases of rebellion or invasion the public safety may require it.
No bill of attainder or ex post facto Law shall be passed.
No capitation, or other direct, tax shall be laid, unless in proportion to the census or enumeration herein before directed to be taken.5
No tax or duty shall be laid on articles exported from any state.
No preference shall be given by any regulation of commerce or revenue to the ports of one state over those of another: nor shall vessels bound to, or from, one state, be obliged to enter, clear or pay duties in another.No money shall be drawn from the treasury, but in consequence of appropriations made by law; and a regular statement and account of receipts and expenditures of all public money shall be published from time to time.No title of nobility shall be granted by the United States: and no person holding any office of profit or trust under them, shall, without the consent of the Congress, accept of any present, emolument, office, or title, of any kind whatever, from any king, prince, or foreign state.
Section 10. No state shall enter into any treaty, alliance, or confederation; grant letters of marque and reprisal; coin money; emit bills of credit; make anything but gold and silver coin a tender in payment of debts; pass any bill of attainder, ex post facto law, or law impairing the obligation of contracts, or grant any title of nobility.
No state shall, without the consent of the Congress, lay any imposts or duties on imports or exports, except what may be absolutely necessary for executing it's inspection laws: and the net produce of all duties and imposts, laid by any state on imports or exports, shall be for the use of the treasury of the United States; and all such laws shall be subject to the revision and control of the Congress.No state shall, without the consent of Congress, lay any duty of tonnage, keep troops, or ships of war in time of peace, enter into any agreement or compact with another state, or with a foreign power, or engage in war, unless actually invaded, or in such imminent danger as will not admit of delay.

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State mandates drive high county taxes

    Over the years, state policy makers have mandated that county governments assume fiscal responsibility to deliver state services at the local level. What originally sounded like a good idea to state officials has evolved into a boondoggle, as county officials scramble on an annual basis to control rising property taxes from state-mandated programs.
    New York state is one state in the nation that asks counties to pay the highest percentage for delivering state programs. One would expect corresponding authority to accompany these state mandates. However, this has not been the case. County officials pay for these programs and have little input into eligibility criteria and no flexibility to improve service delivery.
    The economic crisis facing our state is projected to be severe in the immediate future and will have a lasting impact. Now more than ever, our governments must do more than communicate; we need to coordinate core services for the public. This opportunity provides a window to improve the system.
    The elected county legislators in Schenectady County care deeply about the amount of property taxes their residents pay. However, the good people of Schenectady County need to know that their county legislators have little to do with this growing systemic problem. If we want this trend reversed, our governor and state legislators must reform the state mandate system. They need to refrain from cost shifting and rather look for opportunities to reduce spending.

    STEPHEN J. ACQUARIO
    Albany
The writer is executive director for the New York State Association of Counties.

Quoted from GrahamBonnet

that's right. It is never Savage's fault. Especially since she pays dues to this outfit.

Quoted from GrahamBonnet

So let me get this straight. Things are screwed up, there are 11 democrats and 4 republicans. Vote out the last few republicans and things will go just swimmingly? I don't see the logic. If you think you should vote out this one or that one because the opponent has a nicer smile or something actually makes MORE sense!