GNH Lumber February 2024

EDITORIAL: How much for Medicaid?


How much for Medicaid?

JUST WHEN YOU THINK politicians never learn, they surprise you. What we voters tend to forget is that often enough what politicians learn is new ways to misbehave.

Take the case of the Columbia County Board of Supervisors meeting last week, where members of the Republican majority showed off what they’ve learned from Governor Andrew Cuomo. Did you think the little statues the GOP had of him were pincushions? Unh uh. Cuomo’s their political hardball hero.

With just a day’s notice and no meaningful chance for debate the majority adopted a resolution endorsing a bill introduced in Congress by Rep. John Faso (R-19th) that would end the counties’ obligation to help fund Medicaid. The resolution just affirms the majority’s support for the efforts of a fellow Republican, which could have been accomplished without the Cuomo-esque muscle flexing. But it may signal trouble ahead for county government.

Mr. Faso, a Kinderhook resident, has been talking about his Medicaid funding proposal for over a year. So it’s no surprise he’s introduced it and has five colleagues from around the state as cosponsors. There’s reason to consider it because why should upstate residents have to pay for a share of the program through their property taxes, when people in New York City pay through an income tax?

Medicaid provides medical care for people with low incomes or long-term disabilities. It’s a federal program but the state picks up roughly half the cost. New York is alone among states in forcing counties to pay a share of the state costs for Medicaid and aside from New York City, the local funds come from the property tax.

At the inception of Medicaid in the mid-1960s municipalities paid a quarter of the costs but as costs rose that became such a large burden on local taxpayers that the state capped the local share. But GOP supervisors said last week that Medicaid is still responsible for about 25% of the county spending. That’s a lot of money in the $142-million spending plan. But it’s odd, then, that the brief letter from Supervisor Matt Murell (R-Stockport) accompanying the 2017 budget makes no mention of this burden. Instead, the letter highlights that the budget calls for no program, service or staff cuts, how the county’s free of “fiscal stress” and building up budget surpluses.

Supervisors have a right to crow about their fiscal management, so why the big hurry to change the formula? Why not spend some time gathering the facts and debating the promised but unproven benefits of Mr. Faso’s bill?

What if handing over the responsibility for funding Medicaid to lawmakers in Albany doesn’t turn out to be a good idea? Could the change skew Medicaid reimbursements in ways that undermine Columbia Memorial Hospital, the largest private employer in Columbia County? Maybe it would have been smarter to consider unintended consequences before choking off discussion on a matter of vital importance.

And why would supervisors endorse any changes in local Medicaid funding while the GOP majority in Congress plots new ways to repeal the existing law and replace it… or not? Mr. Faso is proposing his bill in a political vacuum created by his own party. Until Congress acts on health care nobody can predict what the impact of this bill will be.

If the supervisors want to do something tangible right now about health care in Columbia County there is a crisis that requires immediate attention. The Planned Parenthood clinic in Greenport is, like all Planned Parenthood facilities, threatened by the federal government’s efforts to prohibit reimbursements for medical services that save lives. If the facility here is forced to cut back or close, women will lose access to medical screenings and young people–and the whole community–will be at greater risk from sexually transmitted diseases, to cite only two of the services offered.

No agency or private organization has the ability to replace Planned Parenthood’s healthcare lifelines. Debate that if you wish, but the facts are undeniable; without Planned Parenthood public health for many residents is at risk. If supervisors want to state their support for national policy that that benefits county communities, it’s time to stand up for Planned Parenthood.

Members of the Republican majority on the Board of Supervisors exercised their power on Mr. Faso’s behalf. That’s politics. But the way they chose to do it undermines the bipartisan cooperation that has produced effective government in this county. That’s a victory not worth the cost.

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