Guest Column: State Sen. Tom O'Mara

"Update: Medicaid reform"

ALBANY, Sept. 26 -- One thing sure has changed since the beginning of 2011, and that’s how we talk about New York State’s system of Medicaid. Many of us came into the year highlighting Medicaid’s enormous expense by noting, in what had become a popular phrase, that it was costing state taxpayers “one billion dollars a week.” But already, just 10 months down the road, we must say that Medicaid costs taxpayers more than a billion dollars a week.

That’s right, the cost has risen to more than $53 billion annually and unless we find a way to add a week or two to the calendar, that means more than a billion dollars a week.

Despite some meaningful efforts underway to control it, the Medicaid spending meter just keeps ticking higher and higher. That really shouldn’t come as a surprise to anyone paying attention. It doesn’t to me. We’ve seen the projections time and again over the past few years. According to
the Healthcare Association of New York State, one out of every four New Yorkers currently receives some form of Medicaid assistance. By all accounts, it’s projected to just keep growing for the foreseeable future.

So state policymakers keep heading back to the drawing board. This year’s state budget launched some potentially significant, long-term savings strategies. In particular, the work of the Governor Cuomo-initiated Medicaid Redesign Team, or MRT, remains ongoing. This team will hold its next meeting on Wednesday, October 5th in Albany. You can watch a webcast of the meeting and find other MRT-related information through the following website: http://www.health.ny.gov/health_care/medicaid/redesign/.

But while Medicaid gets singled out by local governments as the No. 1 mandate burden, this year’s state budget did not go nearly far enough to provide relief from it. It’s a safe bet that it will be the hot-button challenge of the 2012 legislative session. As local governments continue to face enormous burdens and must now find ways to operate under a property tax cap, all while federal stimulus funds disappear, the cry for mandate relief will be louder than ever. Which means Medicaid stays under scrutiny’s bright light. We know that, on average, Medicaid accounts for 45
percent of the local property tax levy in individual counties. It’s upwards of 90 percent in some counties.

“In some counties, Medicaid takes up the entire property tax levy. The growth in Medicaid alone for these counties exceeds the property tax cap,” the president of the New York State Association of Counties noted recently. “The only way to achieve property tax relief is to reduce state mandates, and the program to reform first is Medicaid.”

Many state legislators agree and we’re trying to build a broader consensus for reform. For example, I’ve been pushing – and will keep pushing – for:

– the more widespread use of modern computer software developed and continually fine-tuned by the Horseheads-based Salient Corporation. Salient offers a proven blueprint for effectively detecting and preventing fraud, inefficiency, mismanagement, overutilization and waste;

-- the reinstatement of the eligibility requirements for face-to-face interviews, finger-imaging and asset tests for Medicaid applicants that were once conducted by counties but that the state eliminated two years ago;

-- legislation which I introduced earlier this year with local Assemblymen Phil Palmesano and Chris Friend that would freeze local Medicaid costs by requiring the state to cover the cost of future growth; and, finally,

-- the statewide expansion of Chemung County’s Medicaid Home pilot program, which in its first year of operation is seeing better medical outcomes and significant reductions in wasteful Medicaid spending by utilizing the Salient management product to help achieve these results. I’d like to further expand this model and require mandatory participation in it.

Most recently, just last week in fact, I signed on to a renewed proposal being advanced in both houses of the Legislature by a bipartisan group of legislators for the state to completely take over the local share of Medicaid. Our plan proposes a freeze on local Medicaid costs similar to my earlier legislation. It would provide an immediate $180 million in local savings by eliminating the automatic three-percent annual spending increase required by current law. But this new plan goes even further to initiate, over an eight-year period between 2012 and 2019, a gradual phase-out of all local Medicaid costs.

The idea behind this dramatic move is that if it’s the state responsibility, then the state will become more aggressive at reining in costs, combating fraud and waste, and even more intent on redesigning the system. It’s an idea that’s been kicking around for many years in one form or another, but maybe now it’s an idea whose time has arrived.

Photo in text: State Senator Tom O'Mara

Schuyler County Officials

Legislature Members:

Top row (from left): Dennis Fagan, Thomas Gifford, Doris Karius, Glenn Larison

Bottom row: Michael A. Yuhasz, Barbara Halpin, Phil Barnes, Stewart Field

Legislature Chairman

Dennis Fagan, Tyrone 607-292-3687

Legislature Members:

Michael A. Yuhasz, 535-4967

Doris L. Karius, 546-5544

Barbara Halpin, 594-3683

Glenn R. Larison, 594-3385

Thomas M. Gifford, 535-9517

Phil Barnes, Watkins Glen 481-0482

Stewart Field, Watkins Glen 535-2335

County Clerk: Linda Compton, 535-8133

Sheriff: William Yessman, 535-8222

Undersheriff: Breck Spaulding, 535-8222

County Treasurer: Margaret Starbuck, 535-8181

District Attorney: Joseph Fazzary, 535-8383

State, Federal Officials for Schuyler County

Sen. Charles E. Schumer

United States Senate
313 Hart Senate Office Building
Washington, D.C. 20510-3201
DC Phone: 202-224-6542
DC Fax: 202-228-3027
Email Address: http://schumer.senate.gov/webform.html

Sen. Kirsten E. Gillibrand

United States Senate
478 Russell Senate Office Building
Washington, D.C. 20510
DC Phone: 202-224-4451
Website: http://gillibrand.senate.gov/

State Senator Tom O'Mara -- Chemung, Schuyler, Steuben, Yates, western Tompkins, Enfield, Ithaca (Town and City), Newfield, Ulysses(Trumansburg)

Room 812, Legislative Office Building
Albany, NY 12247
Phone: (518) 455-2091
Fax: (518) 426-6976
www.omara.nysenate.gov

Assemblyman Christopher Friend -- Chemung, Schuyler, Tioga
Room 720, Legislative Office Building
Albany, NY 12248
Phone: (518) 455-4538
Website: http://assembly.state.ny.us/mem/?ad=137