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Lawmakers back county Medicaid opt-out ; Local members agree with Collins

Local members of the State Legislature said Friday that, like Erie County Executive Chris Collins, they, too, want to let New York's counties opt out of Medicaid services not mandated by federal law.

Among the nonrequired services are vision care, dental care, dentures, hearing aids and private-duty nursing. Collins has mentioned eyeglasses and dental care as two services he would likely drop if he and the County Legislature get the chance.

"With all the state-required Medicaid options, Erie County is forced to spend almost all of its property tax dollars on Medicaid," said State Sen. Michael Ranzenhofer of Amherst, also a Republican. "The county's share of Medicaid costs is like Pacman eating everything in sight."

New York currently offers all of the options but two as it runs the nation's broadest and costliest Medicaid program. Unlike most states, New York expects its county governments -- meaning their taxpayers -- to shoulder some of the expense. Medicaid last year consumed $201 million of the $211 million in property taxes collected for Erie County operations.

In Erie County alone, Medicaid spends more than $1.4 billion -- provided by the county, state and federal governments, aides to Collins said. That breaks out to nearly $1,500 for every man, woman and child.

Ranzenhofer has sponsored a bill in the Senate to let counties opt out of nonmandated Medicaid services. Assemblyman Robin Schimminger, D-Kenmore, has sponsored such a bill in the Assembly since 2005.

Even if the opt-out legislation becomes law -- a long shot in Albany -- the bills only direct the state health commissioner to ask the federal government to waive the rule that Medicaid programs be uniform within states. Those waivers are considered even more unlikely after the March 2010 passage of federal health care reforms.

"For too long, county governments and taxpayers have been forced to subsidize billions of dollars in costly Medicaid services and other mandates handed down from Albany," said Assemblywoman Jane L. Corwin of Clarence, another Republican lawmaker who appeared Friday at a Collins-arranged news conference. "This legislation provides local governments with the opportunity to curtail a portion of the Medicaid services they provide and make fiscally responsible decisions."

Said Assemblyman Kevin S. Smardz, R-Hamburg: "Taxpayers across Western New York are looking for real property tax relief. Local costs of Medicaid account for an unsustainable portion of county property taxes, and structural reforms are needed if we are to begin easing that burden."


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