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How Would Proposed Shift in State’s Medicaid Program Impact Yates County?


County leaders are again calling on their state representatives in the Senate and Assembly to adopt one-house budgets that reject Governor Kathy Hochul’s proposal to shift $625 million in new costs to counties for the State’s Medicaid program.

Yates County Administrator Nonie Flynn says if approved, it would be the first change in how the assistance is handled at the state level since the Affordable Care Act was enacted in 2011.

“Historically the federal government has given assistance to states for Medicaid spending, said Flynn. “New York State is one of the few states in the country that passes the Medicaid costs onto the counties. She (Hochul) in her budget for this next year is no longer going to share this assistance from the federal government. That will cost Yates County $543,000/year or a 3.4% increase in the county’s tax levy.”

According to the Governor’s Budget proposal, the state will keep $625 million in federal Medicaid assistance that had been shared with counties since the Affordable Care Act (ACA) was enacted in 2011. The four-year impact is projected to be $3 billion in shifted costs to local taxpayers as follows:

  • $624 million – SFY 2024
  • $709 million – SFY 2025
  • $774 million – SFY 2026
  • $808 million – SFY 2027

Congress provided that a portion of this enhanced Federal Medicaid Assistance Percentage (FMAP) be shared with local governments that pay a share of a state’s Medicaid program. In New York, counties contribute $7.6 billion each year to the state’s Medicaid Program, more than all other counties in the nation combined.

“We are asking our partners in the State Senate and Assembly to reject the Governor’s proposed cost shift when they pass their one-house spending plans. This cost shift is unnecessary, unprecedented, unhelpful, and unaffordable for New York homeowners, renters, and businesses,” said New York State Association of Counties President Michael E. Zurlo. “If this plan is allowed to take effect in April, it will blow a $625 million hole in the budgets of counties and New York City, putting services like road paving and Meals-on-Wheels at risk, and marking the beginning of the end of New York’s property tax cap.

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