Let us be polite: The four assemblymen whose letter appeared in Everybody's Column Tuesday are misstating the facts. Distorting them, even. They are telling you less than the unvarnished truth about the local costs of the Health Care Reform Act they voted for last week -- $364 million less, by one account.
That is what counties say they will have to pay for Family Health Plus, a new program designed to provide coverage for about 1 million of New York's uninsured. Because of the way this state funds Medicaid programs, the counties will be on the hook for 25 percent of the costs. But not according to Assemblymen Sam Hoyt, Robin Schimminger, Richard Smith and Paul Tokasz. We don't normally respond to letters to the editor, but we are making an exception on the grounds that this letter is from public officials who are flatly misrepresenting the truth.
Repeating their leaders' preposterous line, these gentlemen had the gall to claim that because the state had renewed an existing Medicaid cost-containment measure four months earlier, the Health Care Reform Act is actually a money-maker for the state's counties. Erie County alone will make $10 million off the deal, they wrote, apparently without embarrassment.
Well, let's see about that. Coming into 1999, Medicaid cost containment had already been in effect for several years. The program, designed to save money for counties, lapsed on June 30 as a direct result of the Legislature's failure to pass a timely budget. It was renewed in early August and until last week, was absolutely unrelated to the health-care act, as distinct from that program as lawn mowers are from mangoes.
But now, having to justify a secretly hatched plan to raid the county treasuries, the four assemblymen have retroactively bundled Medicaid cost containment into the health-care bill and thereby proclaimed a new Christmas miracle: By taking money from the counties they are enriching the counties. Soon they will be raising the dead.
The four Democratic legislators are not alone in taking this flight of fancy. It's the official government glide path, followed even by Republican Gov. George Pataki, who once believed unfunded mandates to be a plague upon the state. Those days are gone, though -- unless you happen to buy the looking-glass notion that this program bolsters the counties' bottom lines.
But it's the emperor's new clothes, a transparent attempt to dress up a naked grab for county money -- a major chunk of which will come out of the tobacco-settlement funds that counties across the state had been counting on. Imagine a tax collector coming to your door with this ripe tale: We have just raised your tax bill by $2,000, but three years ago we thought about making you demolish your garage, which would have cost you $4,000. But we like you, so we changed our minds. And guess what? You come out ahead $2,000! Now pay up."
And it gets worse, because far from saving the counties money, the Legislature took it away. Its delay in renewing Medicaid cost containment came at a price, costing Erie County more than $330,000. They took the garage door.
As we've said before, the expense of providing health insurance for the uninsured may be a cost that this state's citizens are willing to bear. It may also be that, despite the laudable goal, careful analysis might show that the economic costs will do more harm than good.
There is a lot of disagreement about the actual cost to counties of Family Health Plus, but whatever the bill turns out to be, it was imposed after secret negotiations and without consulting or even notifying the counties. This legislation by stealth was completed Tuesday when the State Senate approved the bill. The governor is expected to sign it.
Another Assembly Democrat from Erie County, Brian Higgins, has resisted the temptation to repeat the tortured explanation offered by his colleagues. A program as massive as Family Health Plus is expensive, he said. Why deny it? He voted for it, he said, because it's important and it's good for his district. You can still argue with his decision -- and we do -- but at least he's straightforward.