Editorial — Grand larceny: State may rob counties of federal funds to pay for Medicaid

The Federal Medical Assistance Percentage program calculates rates paid to states and counties for Medicaid costs. The enhanced Federal Medical Assistance Percentage program determines rates paid to states and counties for expenses related to the federal Children’s Health Insurance Program.

While eFMAP funds were created to cover CHIP expenses, states have used them to pay for increased Medicaid enrollments. The federal Patient Protection and Affordable Care Act expanded Medicaid eligibility. It also raised eFMAP funding for states from 2015 to 2019.

The ACA required the federal government to pay 100% of state expenses for certain newly enrolled participants in Medicaid until 2016. This percentage was reduced to 90% by 2020, where it remains.

The rates paid through the FMAP and eFMAP differ. So the eFMAP rate applies when states use these funds to cover their Medicaid costs.

Hochul proposed nabbing all of New York’s eFMAP funds to pay for costs pertaining to expansions in Medicaid eligibility and benefits as well as to increase payments to health care providers. This would drive up county costs for delivering social ser-vices, the New York State Association of Counties reported.

“Jefferson County could lose up to $2.5 million in federal aid in the first full year of the interception, adding to its already $18 million annual Medicaid budget,” ac-cording to a story published March 1 by the Watertown Daily Times. “Lewis County could see a $700,000 cut compared to its $5 million annual Medicaid budget, and St. Lawrence County could see a $3.08 million cut compared to a $20.4 million an-nual Medicaid budget. Because the state operates on a different fiscal calendar than counties, there is potential that the counties would see an impact on their eFMAP allocations in this budget year, giving no opportunities to adjust budget plans to account for the extra costs. NYSAC reports that, over four years, the state’s 62 counties would see additional Medicaid costs of at least $2.5 billion.”

Regarding the percentage of Oswego County’s property tax revenue allocated for Medicaid (a total of $22,592,960 this year), Administrator Phil Church estimated that it would increase from 51% to more than 57% next year.

Enrollment in New York state’s Medicaid program is expected to increase to 8 million participants this year. It’s understandable that Hochul wants to find new revenue sources to pay for this, but stealing from counties is unacceptable.

To help relieve the financial strain on property owners, Hochul suggested that school district cut their taxes. She referenced the billions in additional assistance sent to schools by the state each year and that districts can meet their annual needs while reducing expenses.

Sorry, but most school districts are not drowning in excess funding! The reason that the state increases its assistance is because school districts need it.

For Hochul to drag school districts into this debate is absurd. Counties do not con-trol funding for school districts, and school districts have nothing to do with dispensing Medicaid services.

The state will need to take a hard look at where its spending on Medicaid can be trimmed. Rather than pilfering money allocated for counties, Albany should finally identify ways to cut waste and abuse on its end.