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The state's proposed Health Care Reform Act will cost Niagara County $1.75 million over the next four years, county officials estimated Wednesday.

County officials could hardly contain their anger and contempt for the new legislation.

Said County Legislator Samuel P. Granieri, R-Niagara Falls: "It's ludicrous to put together a health care plan without the funds to pay for it and expect the localities to pay for it. It's irresponsible."

"This is another unfunded mandate," fumed Legislator Lee Simonson, R-Lewiston. "The county has no idea how it's going to pay for it."

The bill, which passed the Assembly on Wednesday and is expected to pass the State Senate shortly, expands access to Medicaid and institutes a new program, Family Health Plus, to provide medical coverage through managed care for otherwise uninsured single adults and families.

But unlike Child Health Plus, the state's program for uninsured children, Family Health Plus calls for the counties to pay 25 percent of the cost, the same percentage as in regular Medicaid.

Estimates supplied to Niagara County by Assemblyman Robert A. Daly, R-Niagara Falls, called for extra county costs of $44,280 in 2000; $379,543 in 2001; $778,062 in 2002; and $550,337 in the first half of 2003.

Previously existing Medicaid cost-containment measures are extended for the next three fiscal years under the Health Care Reform Act, leading Michael McKeon, a spokesman for Gov. George E. Pataki, to assert that "the counties make out in a major way."

However, Kenneth Crannell, director of intergovernmental affairs for the state Association of Counties, noted in an e-mail to Niagara County Budget Director Sharon Sacco that the counties already knew about that and were planning for it.

Crannell wrote, "Although these measures protect the current Medicaid base, they do not provide significant new savings to local governments, and offer no offset to the impact of Family Health Plus."

The news comes after counties have adopted their 2000 budgets. Niagara County has no money allocated for the expense.

"Even if we securitized the tobacco money, the interest wouldn't be enough to pay for these mandates," Simonson said.

He was referring to the Niagara Business Alliance's suggestion that the county sell its 25 years of further tobacco payments, take a lump sum and finance property tax cuts out of interest from investing the sum.

Though state officials suggested counties use their share of the settlement of the 46-state lawsuit against the tobacco companies to pay for Family Health Plus, in Niagara County that money is already spoken for.

The county allocated almost all of its first $1.47 million payment to road and bridge repairs, and the expected 2000 payments of $3.8 million have been assigned to the general fund. Without them, the county would have had a tax increase for 2000.

The state previously warned that those payments could be reduced because of declining domestic cigarette sales -- by no more than 8 percent according to the Association of Counties, by as much as 15 percent according to Attorney General Eliot Spitzer.

The state, however, is counting on funding its share of Family Health Plus by nearly doubling the excise tax on those decreasing cigarette sales. The tax would rise from 56 cents a pack to $1.11.

"The last time they raised the cigarette tax, there was a shortfall," Granieri sneered.

Simonson ripped other aspects of the Albany bill, such as its continuation of Medicaid funding of graduate medical education to students, "the vast majority of whom leave the state to practice medicine," he said.

Simonson also condemned a provision that he said allows health maintenance organization officials to determine eligibility for the Family Health Plus program they would also administer.

"That's putting the fox in charge of the chickens," he said.

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