Health Care

State budget’s proposed Medicaid cuts ‘dead on arrival’

During his State of the State and budget address, Gov. Andrew Cuomo proposed City University of New York and Medicaid cuts that budget analysts said could put New York City on the hook for at least $800 million in new costs.

New York City Mayor Bill de Blasio blasted the proposal and vowed to fight it.

“There are two items in the budget that are not fair to New York City, that are harmful to New York City, that will set us back,” de Blasio told reporters, referencing the Medicaid cuts as well as a proposal to reduce state funding for CUNY. “We will ask the assistance of both houses of the Legislature in fighting these cuts.”

In the face of criticism from de Blasio and others, Cuomo walked back his proposal and insisted that by the end of the budget process it “won’t cost New York City a penny.” But the chairmen of both the Assembly and state Senate health committees said dealing with the governor’s budget proposals will be a top priority for the 2016 legislative session.

“It’s not clear what they have proposed. They’ve muddled up the edges. They tried to take a great deal of money from the city of New York and now they’ve stated today they’re not going to take from the city of New York,” Senate Health Committee Chairman Kemp Hannon said last month. “So, they’ve left a $200 million hole in the spending plan because of that change of circumstances.”

Assembly Health Committee Chairman Richard Gottfried said Cuomo’s Medicaid cuts were “dead on arrival” in his chamber.

“I don’t know what his motive is, but it would certainly punish the 8.5 million people in New York City,” Gottfried said. “Particularly, since the growth in Medicaid spending in New York City has been much more moderate than in many other parts of the state.”

Additionally, the lawmakers said that the governor’s proposal to raise the minimum wage to $15 an hour, which is expected to be one of the more contentious issues this session, would have a significant impact on health care policy.

Hannon said he is concerned about how raising the minimum wage would affect health care workers. Hannon is a member of the Senate’s Republican majority, which has had a cool response to the proposed wage hike.

“There is no answer as to how to deal with the direct effects of a $15 wage, as well as the indirect effects of a $15 minimum wage on the providers of care to the disabled and the needy,” he said.

In contrast, Gottfried said he will be fighting to make sure the $15 minimum wage includes home health aides and other human service workers. He and his Democratic colleagues in the Assembly have embraced the push.

“I believe we need to raise their wages and raise the state reimbursement rate to their employers so that they can pay those wages,” Gottfried said.

In the Assembly, Gottfried will continue to push several pieces of legislation, including a “Safe Staffing” bill that would allow the state Health Department to set staffing levels for direct care nurses in hospitals and nursing homes; his bill for a statewide single-payer health care system; and legislation to further regulate retail health care clinics.

Though Gottfried doesn’t expect his single-payer bill to pass the Senate this year, he said he will focus on raising support throughout the state.

Another one of Gottfried’s biggest priorities will be to amend the state’s 2014 medical marijuana law to expand the list of diseases eligible for the treatment and allow for more dispensaries in the state.

The state health commissioner in early January determined there was not enough evidence to allow medical marijuana to be prescribed for PTSD, Alzheimer’s disease, muscular dystrophy, dystonia and rheumatoid arthritis. Gottfried said he would try to add those conditions by statute.

“Ideally, there should not be any list in the law. I can’t think of any other drug that has a statutory limit on what diseases it can be used for,” Gottfried said. “The law practically treats medical marijuana like it was weapons-grade plutonium. There are 20 million New Yorkers, the notion that they can be served by 20 dispensaries over 54,000 square miles makes no sense.”

In the state Senate, Hannon will push to resolve the question of untested rape kits in New York, organ donation and actions to fight the heroin epidemic. Ten years ago, Hannon sponsored legislation allowing emergency medical personnel to carry Naloxone. The Republican minority in the Assembly has also said combating heroin and opioid abuse will be a priority this year. The Assembly Minority Task Force on Heroin Addiction and Community released a report that provides recommendations to fight the epidemic.

“There needs to be sustained improvement in rehabilitation services, interventions with people who have multiple recoveries from overdoses via Naloxone,” he said. “My point would be that it’s not enough to just revive people, we need to get people out of the cycle of addiction.”