EDITORIAL: A two-pronged approach on Medicaid

Jan. 22--There is some belt-tightening, cost-shifting and some wishful thinking in Gov. Andrew M. Cuomo's proposed budget for fiscal year 2021. There is little that will shrink state government or lessen New Yorkers' tax burden.

Noting that every interest group comes to Albany asking for more every year, Cuomo said, "And this year everyone gets more ... more for every program." Whether delivering more to everyone while getting the state's deficit under control can be done is the $6.2 billion question.

Cuomo did not sidestep the fiscal challenges in his budget address Tuesday. The budget item producing the most red ink is the Medicaid health insurance program. The governor laid out a framework for taming the budgetary beast, though it had few details.

First, he will convene a new "redesign team," comprising industry stakeholders, which is assigned the task of finding $2.5 billion in cost savings. The team has until April 1 to come up with its initial recommendations. It's a potentially valuable move, though assembling the team earlier than January would have been wise.

As for counties worried about Medicaid cost increases being shifted back to them, Cuomo is proposing a compromise. The state will continue picking up the tab for counties' Medicaid costs as long as they do not increase by more than 3% in a year. If the yearly increase is below 3%, the state will still pay 3% and the counties keep the savings. For above 3%, the counties would pay the difference.

Cuomo says it gives counties "skin in the game" to help control costs and "holds local governments harmless."

Giving localities incentives to look for cost savings is fair enough on its face. Still, we're not sure counties found it harmless when the state drove up their Medicaid costs by increasing the minimum wage for health workers.

The largest single item in the annual budget is school aid. Cuomo is proposing an $826 million increase in aid, a 3% rise. Groups representing teachers and school boards were seeking $2.1 billion and will be descending on Albany to lobby for more. Bet on the figure going up.

As noted in this space before, New York can't keep pouring endless piles of money into education without a better academic return on its investment.

Legislation to legalize and regulate marijuana use fell apart at the end of the 2019 session in Albany, though a decriminalization bill passed. Cuomo wants to use the budget process, rather than a stand-alone law, to make cannabis legal. That gives him additional clout, though we're not sure it's a smart approach, given the issues.

We applauded the decriminalizing of pot possession, but have stated before that marijuana use is not something to be taken lightly. However, as more and more states open the door, legalization seems inevitable.

His plan calls for a tax on cultivating cannabis, another on retail sales, with an extra 2% tax collected in New York City. Industrial and medical marijuana, as well as that for adult use, would be overseen by a new state office.

The governor's overall plan to trim the deficit includes counting on $2 billion more in expected tax receipts, plus $1.8 billion in unspecified "targeted actions" cuts affecting local governments.

A lot is to be worked out between now and April 1, and more details to emerge, Until then, it's hard to say if this proposal does all that is necessary.

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