State Assemblyman Robin Schimminger (D-Kenmore) has introduced a sweeping nine-bill Medicaid reform package that would reduce taxpayer costs, give counties relief from their Medicaid burden, and preserve quality health care for the poor.

Schimminger said his plan is designed to address his constituents' frequent requests "that the cost of the program be controlled and that the benefits of the program be brought more in line with those of private health insurance."

"We applaud Assemblyman Schimminger for taking aggressive steps to address the need for cost-cutting Medicaid reforms," said Business Council President Daniel B. Walsh. "We urge others to support the cost-cutting actions that counties, businesses, and New Yorkers need."

"It is unfair to ask the taxpayers who pay for the Medicaid program to subsidize more generous health insurance coverage for others than they themselves may have," Schimminger said. "Further, without changes Medicaid costs will simply outstrip our ability to pay."

The reform package would:

• Let counties decide which optional services and categories of eligibility will be available to their residents.
  
• Eliminate some optional services.
  
• Require co-payments at the time of service and impose some new co-payments.
  
• Increase the tax credit for New Yorkers who purchase long-term care insurance.
  
• Enroll more Medicaid patients in managed care.
  
• Institute a 90-day state residency requirement for Medicaid benefits.
  
• Standardize eligibility requirements and close long-term care eligibility loopholes.

Schimminger emphasized that enacting his proposals would not threaten the quality of New York's taxpayer-funded health care for the poor.

"Medicaid would continue to provide a sound package of benefits but more in line with the coverage most other people receive," he said. "Counties and the state would realize savings, and the state could use part of its savings to assume a greater share of counties' Medicaid costs."

A second bill (A.1604/Sweeney et al) would limit growth in the annual county share of Medicaid costs. Effective April 1, 2004, local social service districts would not be responsible for paying the state any more than they paid in fiscal year 2004. In a rare sign of bipartisan agreement on Medicaid, the bill has 42 Democratic and eight Republican sponsors.

"New York’s Medicaid program, is it is structured today, can no longer be supported at the local level, especially through regressive property and sales taxes," the bill memo notes. "Over the past two years, county property taxes have increased an average 22 percent, the residents of 23 counties have been forced to pay higher sales taxes, and the residents of all counties have gotten less value for their dollar as counties have been forced to reduce all general county services to fund the growth of this one state-controlled program."

The bill proposes no steps to reduce the state’s overall spending burden, merely to shift the burden so that it is fully borne by state taxpayers. The bill also outlines no plan for reducing that level of spending or containing the growth rate of that spending.

The Business Council has long argued that Medicaid reform must reduce the size of the overall burden, not merely shift that burden or part of it from one set of taxpayers to another. New York’s Medicaid spending is the nation’s highest by more, more than twice the national average on a per-capita basis, research by the Public Policy Institute has shown.