Don’t Keep Cutting Medicaid
Albany Times Union Editorial January 4, 2020
THE ISSUE:
Facing a deficit, the governor looks at ways to save money on Medicaid.
THE STAKES:
Savings that come at the cost of people’s health or the viability of the program are shortsighted.
For all the good it does in providing people with health care coverage they could not otherwise afford, New York’s Medicaid program is ailing, and the sickness is spreading.
Gov. Andrew Cuomo can no longer hide Medicaid’s financial problems behind budgetary gimmicks. Medicaid’s structural deficit — estimated at $4 billion — threatens to metastasize into real cuts and denials of service.
As lawmakers return to Albany and the governor prepares to give his State of the State address this week, they must all be prepared to make some politically difficult choices not just to balance the budget, but to sustain one of the state’s most vital programs.
Put simply, Medicaid spends more than its budget. The state has been papering over the problem by delaying payment of billions of dollars’ worth of year-end bills until the next fiscal year, but the accumulating bills have caught up, to the tune of $4 billion.
Something has to give. Either the state has to spend less on Medicaid, or it has to budget for it realistically.
Right now, Mr. Cuomo is taking the former option, with troubling consequences. Last week, the Health Department said it will trim payments to health care providers by 1 percent to save $124 million in the final quarter of the current fiscal year, which ends March 31. If the cuts remain in place, they’re projected to save $496 million a year.
That certainly helps the state financially, but what does it do to the hospitals, nursing homes, doctors and others who provide care?
What does it mean for the Medicaid recipients, many of them children, seniors or people with disabilities, who may soon be told by their providers, sorry, we’re not taking Medicaid patients anymore?
Mr. Cuomo also just vetoed legislation that would have barred the practice of requiring doctors to get prior authorization from Medicaid before prescribing addiction treatment drugs — even as he approved a similar bill affecting private insurers. It’s well understood that putting such obstacles in the way of addicts who are ready to quit is self-defeating. The bill was projected to annually save nearly 600 lives and $52 million in emergency room and inpatient costs. But future savings, it seems, are too intangible for a governor looking at a budget shortfall right now.
This may be just the beginning if Mr. Cuomo is determined to focus only on ways to cut a program that has helped New York reduce its uninsured population from 2.6 million in his first term to about 1 million today. But there is an alternative. Mr. Cuomo could explore how to preserve and pay for this vital program, whether by reconvening the task force he assembled in his first term to dramatically reform Medicaid and save billions, or by raising targeted taxes modestly, or by rethinking the entire nature of health coverage in New York, as some suggest in proposing a single payer system.
After three terms, Mr. Cuomo may well be thinking about his legacy. If decimating Medicaid is how he’d like to be remembered, he can keep going the way he has been. If he’d rather be known for saving a program on which 6 million people depend for their health, and in some cases their lives, he needs to change course now.