Tuesday, March 21, 2017

Can the GOP Congress Save Upstate NY?

In an indirect way, national healthcare reform may make this a possibility. 

Ever since the reapportionment of the State Senate circa 1970, which gave Downstate interests control of state government, most places in Upstate NY have seen their populations, job numbers, and economic well-being decline. Upstate NY counties have long dominated the top 25 slots of the most-taxed counties in the nation when property tax is calculated as a percentage of property value. Yet interestingly, on that same list, Kings (a/k/a Brooklyn) and New York (a/k/a Manhattan) Counties in New York City ranked in the mid-1500's (no that is not a typo) -- among the lowest in the nation.

The cost of Medicaid, a health insurance program for people of lower income or means, is shared by the Federal Government and the States. The States manage the programs and determine the levels of benefits. New York State, unlike most other states,  passes a portion of the cost of its share down to the Counties (an "unfunded mandate") who pass it along to their tax payers usually via property taxes. Medicaid has driven much of the high taxation Upstate.

Now, as part of the GOP plan to reform health insurance, it is proposed that NYS will be prevented from passing its costs on to localities outside of New York City.

Per Syracuse.com:
In Oneida County, for example, the county's Medicaid costs account for more than 80 percent of the county's total tax levy. In Oswego County, Medicaid accounts for more than 44 percent of the tax levy.
In another article:
Medicaid is Onondaga County's most significant financial burden, accounting for 70 percent of the property tax levy -- one of the highest rates in the state.
While NYS has been generous in handing out Medicaid benefits, the method of financing these benefits has created harm to upstate localities but not to New York City (where real estate values are very high and there are many absentee foreign landowners.)  Since the NYC metro area controls the state legislature, it is unlikely the Medicaid burden will be lifted from Upstate without pressure from the Federal government.

The GOP healthcare reform, if it contains this provision, may be just what is needed to lift the Medicaid burden from local government and bring Upstate property taxes closer in line to those in other parts of the country with which we compete.  

If successful, Reps. Collins, Tenney, and other supporters of this provision would have contributed more to make Oneida County and Upstate NY more competitive with other parts of the country than perhaps all the local and state economic development efforts of the last 20 years combined.

Of course, there is much more to consider about healthcare reform than just this provision. Reform will require a careful weighing of the issues. As usual, partisanship will get in the way, and many will be tempted to dismiss the possibility of any reform. Per the OD:
Rep. Louise Slaughter, D-N.Y., called the GOP plan "a political sleight of hand" that seeks to buy GOP votes — and pay for tax cuts for the wealthy — at the expense of New Yorkers.
The Medicaid provision, however, would not be "tax cuts for the wealthy" because Upstate is poor compared to Downstate, and all this provision does is prevent the State from passing its share on to Upstate Counties.  At a potential $244 per Oneida County resident, (see Empire Center) savings could just be enough to to make Oneida County attractive to job creators.  Again, Medicaid and how it is funded is just one issue among many, but since this area has already sacrificed its economy at least in part for New York's generous Medicaid benefits, the issue of Medicaid funding vs jobs should not be dismissed as "political sleight of hand." 

The Big Question is whether the County Executive, Sen. Griffo, and Assemblymember Brindisi will get on board to support this Medicaid provision, since the state is unlikely to do it on its own. If so they will finally do something meaningful for area economic development, if only to make it an issue to be put on the State's agenda. 


Anonymous said...

This could be a huge plus for the county, however, if implemented how much relief will the taxpayer get in the end? The local politicians will find a dozen things to spend the money on and the taxpayers will probably see a miniscule amount of relief. ala Picente

Anonymous said...

Although it would be great for our area, the health care bill it's attached would result in millions of US citizens losing health insurance.

Our country is divided, in great part, I think, because of lack of concern for the "other guy."

Wouldn't getting a boon for us but harming so many others just make us part of the bigger problem?

Strikeslip said...

You raise an excellent point, Anonymous 251. And you are right, there does seem to be a lack of concern for the "other guy." But is not that what has brought the entire country the Trump presidency that so many New Yorkers now complain about? What has been happening to people in the great mid-section of the country for the last 30 years has been largely overlooked by those in power in both parties. But for the Electoral College that gave these people a chance to be heard, they would continue to be overlooked. The same "overlooking" has been happening in NYS, only here our "electoral college" assurance of a voice in government - a Senate apportioned by geography - has been taken from us. While there is a concern over some people losing health insurance, where has been the concern over people actually losing health CARE because their health insurance premiums take more of their money, but deductibles have increased so much that they get no care from insurance they paid for? When NY maximized all the bells and whistles on Medicaid to maximize it's take of Federal dollars, where was the concern for the devastation caused to us "other guys" Upstate?

When the "other guy" is your family or your neighbor, is it selfish to place their need need for a job above the need of unknown "other guys" for a health insurance
Policy that may or may not be of practical use? Especially when the country already has guaranteed health coverage for everyone when their incomes and resources fall low enough?

I personally don't like the GOP plan from what I've heard and read about it, specifically because it leaves in tact the basic structure of Obamacare with mandates and penalties, and does not go far enough to create a "free market" nationally.

Claudia Tenney is in a difficult place because she will be criticized no matter what she does. If she votes for the GOP plan with the NY Medicare provision, I could forgive the negative effects on health insurance, because she will be righting a wrong done to her constituents by the NY legislature that the legislature is unwilling to correct, likely helping more of them than those who would be harmed. If she votes against the GOP plan, I could accept that too because it will either lead to a better GOP plan that addresses all issues at once instead of the ridiculous "phases" being proposed (which means they will never be implemented), or results in the continuation of Obamacare which ultimately will fail, which may make people more willing to accept an open market. And single payer is not an option. Our Veterans already have that and it won't work; healthcare is rationed in Australia; and it has proven to be financially unsustainable in Britain.

Anonymous said...

The last time I inquired about the county cost of Medicare I was told that it was about ONE MILLION dollars per week . That was the cost a few years ago.I would like to know the weekly cost now , I am sure that number must have risen given the percentage of the county budget that Medicare takes.Medicare and Social Service costs are killing the tax paying residents of this county with no end of rising costs in sight.

Anonymous said...

You mind explaining what "bells & whistles" the Medicaid program is providing? Dental & eyeglass care for kids or what? Please explain as I'm interested to know what facet of health care is now considered a "bell & whistle" as if to infer that taxpayers are footing the bill for a manicure or some other "bell & whistle" as you described it.

Strikeslip said...

How about New York State not "deeming" the income and resources of a well spouse to be available to a sick spouse to enable the sick spouse to qualify for Medicaid, Anonymous 130? Making it easier to qualify for Medicaid coverage would be a "bell and whistle". New York makes it easier for wealthier people to qualify. It also appears that NY "cooks the books" to the state's benefit when recipients are housed in state institutions. The following article is interesting reading.

Strikeslip said...

After reading the Forbes article above you have to wonder "Are Oneida County's Medicaid costs so outrageously high because Oneida County has many state institutions that house Medicaid eligible individuals?" If so, it would be a transfer of wealth from Oneida County taxpayers to the State of New York!

Anonymous said...

Gov Cuomo has stated repeatedly that the property taxes of Upstate are a problem that needs to be solved, we hear that unfunded mandates are crippling locality budgets and that economic development is a priority for this Gov, and yet ...

here comes the Feds with a plan to unburden Counties from the largest unfunded mandate they have (Medicaid) and moving it to the state where it belongs with the result being everything the Gov says he wants for Upstate and his response is to fight it tooth and nail, calling it a war on NY State!!

Andrew Cuomo is the worst type of politician there is and marks the low point we've had for Governors (and reaching that level of corruption is saying something). This is definitive proof he doesn't care about Upstate and likely doesn't even care about the whole state. We are just a means for him to reach higher office.

It's all corrupt ambition and no competence. God help the US if he reaches the Presidency

Anonymous said...

The depressing thing about the discussion and our elected representatives is the idea that we must live with an ever increasing Medicaid cost. The main discussion should be to lower Medicaid costs by good job creation. I see no creativity or grasp of local job development by any elected official on all levels.