County Legislature again speaks out against $1 million Medicaid cost shift

Press Release, Orleans County Legislature

ALBION – The Orleans County Legislature today advocated strongly for the elimination of a budget proposal backed by Governor Kathy Hochul that would cost local governments more than $625 million in the coming state fiscal year, and billions in subsequent years.

The proposal would end the longstanding practice of sharing federal Medicaid savings provided by the Affordable Care Act (ACA) with counties and New York City. This funding, known as eFMAP, has been critical to counties’ ability to hold property taxes in check by limiting the local financial burden of Medicaid.

“At a time when our residents are paying more for housing, food, and fuel, Gov. Hochul’s proposal will make living in this state even less affordable,” said Orleans County Chairman Lynne Johnson. “This action would strip $1,059,034 in revenue from the Orleans County budget, which will end up coming out of residents’ pockets in the form of increased property taxes or cuts to vital county services like public safety and road maintenance.”

According to the Governor’s budget materials, this proposal would shift $625 million in Medicaid costs onto local taxpayers in its first year, and the minimum four-year cost to local taxpayers is calculated at between $2.5 billion and $2.9 billion. The New York State Association of Counties estimates that by state fiscal year 2027, the fourth year of this proposal, that state cost shift from this single initiative will be equivalent to an average property tax increase of 7 percent statewide and as high as 14 percent in some counties. To make matters worse, the State is also proposing to permanently keep six years of eFMAP funds, exceeding $1 billion worth of federal assistance owed to counties from unreconciled reimbursements.

“We are concerned that this proposal undermines Congressional intent. New York’s Congressional Delegation, led by Senate Majority Leader Charles Schumer, fought hard to ensure that local taxpayers wouldn’t bear the burden of expanding Medicaid by specifically designating this funding for counties,” Johnson said. “This proposal reverses the state’s twenty-year practice of sharing these funds with counties and it’s unnecessary. Gov. Hochul must remove this disastrous proposal from her budget and work with counties to reach a compromise that does no harm to counties and maintains the cap on local contributions to Medicaid.”