Citing a $23 million dollar Medicaid burden that consumes nearly all of the county's property taxes, Chemung County Executive Thomas J. Santulli has asked Governor Pataki for a two-year exemption from Medicaid requirements imposed by the state.

Santulli said the county would use the time to begin a pilot program in which the county would decide for itself what optional benefits to offer with the goal of reducing the county's costs.

"In Chemung County, the local cost of Medicaid has nearly doubled over the last five years and now totals $23 Million," Santulli wrote Governor Pataki in a letter dated January 29.

That $23 million dollar price tag consumes nearly 100 percent of Chemung's total property tax levy, Santulli continued. The program forced property taxes to jump a record 14 percent in 2003, he said.

And despite a number of reductions in other county programs, including the closing of two libraries, reduction in employee health benefits, a pay freeze and layoffs, the county still faces another double-digit property tax increase in 2005, the letter said.

Santulli praised the Medicaid cost-containment proposals the Governor advanced in his budget, but said his Medicaid costs are increasing so rapidly that the Governor's reforms "will not even offset the annual rate of growth of this program."

There is a better and more cost-efficient way than the current delivery system to provide health care, Santulli wrote.

The idea is motivated in part, Santulli said, by feedback from participants in the program, including physicians, nurses, health care providers, hospital administrators, pharmacists, and Medicaid recipients. "They have all voiced their concerns about the magnitude of the benefits, the bureaucracy, the paperwork, the waste, and the lack of oversight and management of this program," Santulli wrote.

Santulli's letter asked the Governor to grant the waiver to Chemung County and to form a panel of private-sector health care professionals and government officials to develop the pilot Medicaid program.

The pilot program would still provide Medicaid consumers with all services mandatory under federal law, but optional services and provider rates would be determined by the panel, the letter said.

The letter reminded the Governor of lawmakers' persistent pledge to reform the Medicaid program.

"If we are successful in our efforts in partnership with the state, the end result could be quality health care for our Medicaid population at significantly less expense to the taxpayer," the letter concluded.

The Business Council has consistently argued that Medicaid costs are far too high. The Council's research affiliate, The Public Policy Institute, dedicated an entire issue of it's 2003 series, Budget Watch, to the topic.

"Our Medicaid spending on home and community care in 1999 was $4.2 billion—nearly four times the national average per capita," the report said.

"If New York could simply bring its per-capita Medicaid spending down to twice the national average, taxpayers would save more than $4 billion a year," the report noted.