Two state Senators from Long Island have warned that a state takeover of counties' Medicaid costs could require increases in the state's income tax - an increase that could be disproportionately high for Long Island

If the state had taken over all county costs for Medicaid, Long Island taxpayers in 2002 "would have paid $1.1 billion in additional state personal income taxes that year," state Senators Dean Skelos (R-Rockville Center) and Owen Johnson (R-Babylon) wrote in an April 28 op-ed piece in Newsday. "Because of rising health-care costs, this figure would certainly grow in years to come."

In the essay, the authors estimated that middle-income Nassau County families would pay an average of $978 in additional income taxes each year, and that Suffolk County families would pay an additional $827 on average.

The analysis is based on the assumption that the state take-over of Medicaid costs would not be accompanied by any cuts in New York's overall Medicaid spending, which is by far the nation's highest.

However, the piece did note that the Senate's Medicaid Reform Task Force has identified ideas they said would produce savings in the state's program.

The Business Council has said it supports a complete state takeover of counties' Medicaid expenses - if it comes with an ironclad requirement that counties return all their savings to their taxpayers.

More fundamentally, The Council strongly advocates steps to reduce overall spending on Medicaid.

"Medicaid reform must focus not on mere burden-shifting, but on actually reducing overall expenses," said Elliott Shaw, The Council's health-care lobbyist. "New York's Medicaid spending is the nation's highest by far, about two and a half times the national average. The focus of reform must be on substantially reducing that spending."