Reforming Medicaid: It’s a ‘slam dunk?’

In Columns by Hal PetersonLeave a Comment

I have to admit, I’m having a problem understanding how, in just 33 working days, Gov. Andrew Cuomo’s Medicaid Redesign Team was able to recommend 79 cost cutting measures to save $2.3 billion in the upcoming budget. I’ll address this concern from three viewpoints.

Medicaid is the United States health program for individuals and families with low incomes and resources. It is a means-tested program jointly funded by the federal government and each state. Over 4.7 million people are enrolled in New York’s program of which three-quarters are non-disabled children and adults under the age of 64. The remaining are elderly or disabled.

The program is an administrative nightmare to run, with New York spending (on a per capita basis) more than twice the national average. New York’s per-enrollee costs are the second highest in the nation. Unfortunately, we are also last among all states for avoidable hospital use and costs.

Can New York State, known for ineptitude on the grandest scale, really reform and reduce Medicaid spending? Not likely, considering the following:

The Medicaid Redesign team was hastily concocted in early January and is chaired by Mr. Jeffrey A. Sachs, a consultant with clients in health service industry. His “team” (28 in total) represents practically every special interest group in the phone book, each in their own way fighting hard to avoid serious cutbacks.

Hospital leaders however, are approaching cutbacks from a different perspective. They submit that if a Medicaid committee proposal to “limit non-economic damages in malpractice cases” became law, they could save $700 million annually, offsetting what they immediately lose from the governor’s cuts. Assembly Speaker Sheldon Silver (D-Manhattan), who works for the personal injury firm Weitz & Luxenberg, has never been in favor of tort reform and he is not likely to support this idea.

With less than a month left to balance the budget, Cuomo was proud to announce “Lo and behold, they did it.”

My last two columns, “Stop playing games with the budget deficit” (Feb. 3-9) and “Reforming Albany: Now the rest of the story” (Feb.24-March2) cited numerous examples of the game playing involved in the preparing and marketing a balanced budget. Time will only tell how much game playing is evident in the findings of this “team.”

One thing is certain — our economy is in trouble. This suggests the need for more public assistance, not less, with more than 10,000 new Medicaid applications and renewals submitted every day.

When he established the Medicaid Redesign Team , Gov. Cuomo said that it would accomplish “the most comprehensive examination of New York’s Medicaid system since its inception.” Really! Only time will tell if my skepticism is warranted. For more information you can use


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