Stop digging

Gov. Cuomo, who once held himself up as the paragon of fiscal responsibility, has presided over serious slippage of late. The reason is a surge in state spending, especially on Medicaid. He must own the problem and attack it surgically. Last week, a 23-day-late midyear budget update revealed a $6.1 billion gap next year, driven mostly by more spending on that health-care program for the poor. Shame on Cuomo’s budget honchos for hiding the shortfall this spring by delaying planned payments from one year’s balance sheet to the next.

The governor and his staff should’ve seen the spending spike coming.

Over the years, the state’s Medicaid program, about the costliest in America, has gotten ever more generous. It now covers roughly a third of the population and costs keep growing, even though enrollment is slowing.

Meanwhile, between 2018 and 2020, New York’s own labor estimates show homehealth-aide employment is expected to grow 19%, four to five times the rate of nearly every other industry.

As a result, phase-in of the $15 minimum wage will add up to $7.5 billion in state expenses over the next four years, 51% more than budget analysts estimated just 10 months ago.

Relatedly, the state’s underregulated consumer-directed personal assistance program, which pays family members to provide longterm care to loved ones, is exploding, with costs in managed care programs rising 1,100% in just four years, to $1.2 billion in 2017. Conditions are perfect for fraud and abuse.

Cuomo has vaguely gestured toward unilateral cuts in the near future. Not good enough long term. Not by a longshot.