Home care Medicaid program faces cuts
ALBANY — Proposed changes to a popular Medicaid program have gained fervent opposition in the final days of state budget negotiations, and as Gov. Kathy Hochul announced a prospective agreement on a spending plan that could include a significant revamp of health care financing.
The proposals, which lawmakers in the Senate and Assembly appear to have approved, could eliminate an entire segment of health insurance companies known as fiscal intermediaries, which serve as brokers for patients with state and federal health coverage programs like Medicaid. Advocates have said it could affect more than 600 businesses that act as fiscal intermediaries in New York.
But lawmakers have long signaled that an overhaul of ballooning Medicaid costs is overdue. The joint state and federal health coverage program is one of the largest expenses in the state and ranks as one of the most costly government health spending programs in the country.
The changes reflect an attempt to streamline how New Yorkers participate in a program known as the Consumer Directed Personal Assistance Program, which allows residents with disabilities and long-term medical needs to choose their own caregivers and reimburse them through Medicaid funding. Fiscal intermediaries often facilitate those transactions.
While the program has been enormously popular with consumers, state officials say it has become expensive and unwieldy — and rampant with fraud.
On Monday, as Hochul announced a prospective budget deal, she told reporters that the changes were part of a longer term evaluation of how New York delivers and pays for Medicaid services.
Shifting to one company that would act as the state’s sole fiscal intermediary would “save us $500 million every single year and allow
proposed cuts are included in the final budget.
“I worked for months and months as aggressively as we could possibly work to lift all boats, public and private,” Fahy said. “We’ll continue to advocate.”
Horner said that while the budget details on Bundy Aid remain unknown, it is hard to say which schools will be losing out on the funding.
“We don’t know what the language is,” Horner said. “It could just be an across-the-board cut.”
Horner said the program used to get more than $200 million four decades ago, but over time that has decreased to about $34 million this year, and would drop to just over $15 million in Hochul’s proposal.
The Commission on Independent Colleges and Universities, which represents more than 100 higher education institutions in New York, declined to comment on the potential cuts until the budget deal is finalized.
Horner said that the erosion of the funding for the program is concerning. He said that it would be a “more compelling argument” if funding to
private universities with large endowments was cut and reallocated to private universities with smaller endowments, but that the cuts to the program do not include an increase for those more financially strapped colleges.
The increases in both income caps and minimum awards under the Tuition Assistance Program come with bipartisan support. Assemblyman
Robert Smullen, a Mohawk Valley Republican, celebrated the proposed changes. In March, Smullen said that having the maximum award cover the cost of SUNY tuition “should be the benchmark.”
State Sen. Peter Oberacker, an Otsego County Republican, said after the release of the Senate’s one-house budget that he was hopeful that expanded tuition assistance
funding could “open up more doors and more opportunity” for New Yorkers that want to pursue higher education and could make the state more competitive in higher education.
“If you’re fishing, you’ve got to use the right lure,” Oberacker said. “And I believe we are trying to fish in a very competitive environment for students and this is definitely going to help.”