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Regulation and Compliance > State Regulation

Cuomo says GOP plan to win ACA overhaul votes would harm New York

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(Bloomberg) — Gov. Andrew Cuomo accused two New York Republicans in the U.S. House of selling out their constituents and risking the state’s economy with a plan to win votes for a bill to overhaul the Affordable Care Act by exempting most counties from paying for Medicaid.

The proposal crafted Monday by U.S. Reps. Chris Collins of Lancaster, near Buffalo, and John Faso of Kinderhook, near Albany, would force the state to absorb the $2.2 billion of Medicaid costs paid by counties outside New York City. Under House Speaker Paul Ryan’s struggling effort to repeal former President Obama’s universal health-insurance program, the state already stands to lose $4.6 billion over the next four years, Cuomo said.

“It is nothing short of a targeted war against New York,” the Democratic governor said of the proposal, which would affect only his state.

Related: Democrats boycott HHS and Treasury secretary pick hearings

Ryan has struggled to gain support for the health care bill from House conservatives and Senate Republicans. That prompted House GOP leaders to make a series of 11th-hour changes Monday night in a bid to secure more votes. Collins said his proposal was needed to persuade more New York Republicans in the House to back the measure.

Counties outside New York City pay an average of about 44 percent of their property tax revenue to cover Medicaid expenses, Faso and Collins said. New York should follow the practice of most other states, which don’t require local counties to contribute to Medicaid costs, they said.

In an interview, Collins questioned Cuomo’s anger, challenging the governor to find savings in his $63 billion state budget to make up for the lost county contributions.

“If he can’t do his job, I will,” Collins said.

Cuomo, during a Tuesday news conference at his Manhattan office, said the proposal would cause some 250,000 residents of the two districts represented by Collins and Faso to lose health coverage. He was joined by hospital administrators, Local 1199 United Healthcare Workers President George Gresham, and Kathryn Wylde, president of the Partnership for New York City, a group of corporate chief executives.

Currently, the federal government pays half of all Medicaid costs, with the state and local counties each contributing 25 percent. Under a state law that caps local costs, the counties Collins and Faso represent pay about 13 percent, Cuomo said.

Cuomo said Faso and Collins presented their proposal as if it would save the state’s less populated counties’ budgets hundreds of millions of dollars by absolving them from responsibility for local Medicaid costs, without explaining that nonpayment of these costs would “decimate the health care industry” and force hospitals to close in those areas.

“That two congressmen from New York could support an amendment that doubles the adverse impact of an already bad bill is unconscionable,” said Kenneth Raske, president of the Greater New York Hospital Association.

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