County Legislature Calls for Continued Local Sharing of Federal Medicaid Dollars

The Orange County Government Center in Goshen, N.Y., on Oct. 22, 2022. (Samira Bouaou/The Epoch Times)

The legislature of Orange County, New York, has called on the state government to continue the local sharing of enhanced federal Medicaid dollars under the Affordable Care Act.

The Feb. 15 resolution from the legislature came in response to Gov. Kathy Hochul’s proposal to end the longstanding practice in the 2024 fiscal year and use the money instead for expanded state spending.

Orange County stands to lose about $9.2 million in the coming fiscal year as a result, with the statewide impact (including five counties in New York City) likely reaching $1 billion.

“That is a devastating impact on our counties,” Orange County Legislature Chairwoman Katherine Bonelli said during a Feb. 15 committee meeting. “They are proposing to keep all the money going forward—as far as the state is concerned—to cover their expenses of Medicaid eligibility and benefits and to increase their payments to the health care providers.”

On Feb. 1, Hochul proposed the largest state Medicaid funding in history, totaling $34.7 billion.

Her plan includes a 5 percent increase in reimbursement rates for hospitals and nursing homes, new primary and preventive care benefits, and an expanded buy-in program for the disabled.

One way she proposed to pay for the increased budget is to withhold all enhanced federal Medicaid dollars under the Affordable Care Act, which has traditionally been split between the state and counties since 2014 in proportion to their contributions to the Medicaid program.

In New York, Medicaid is jointly supported by federal, state, and local governments. The federal share is generally 50 percent but could go higher in times of economic hardships—the increased share is often called Enhanced Federal Medical Assistance Percentages (E-FMAP).

Historically, despite various growth caps, local governments in New York bear one of the largest Medicaid burdens in the nation, according to a 2018 report by the Citizens Budget Commission.

In fiscal year 2022, New York local governments covered nearly 10 percent, or $8 billion, of total Medicaid costs.

The proposed withholding of E-FMAP dollars will further increase the local burdens, according to Orange County Legislature Majority Leader Tom Faggione.

“I strongly disagree with the reckless spending our governor has proposed in her 2024 state budget and her plan to take the dough and leave the burden on county taxpayers,” he told The Epoch Times.

About 133,994 people in Orange County had enrolled in various Medicaid programs as of May 2022, according to the latest available data from the county government.

If the proposed state withholding comes to pass, the county likely will not feel the full effect until the calendar year 2024 because of a fiscal year discrepancy between the state and federal COVID-19 relief money, according to a Feb. 16 Human Services Committee meeting.

The state is due to pass a budget by April 1.