EDITORIAL: On health care and ethics, Albany has the opportunity to serve entire state [The Buffalo News, N.Y.]

Mar. 21—New York State's budget for 2022-23 must be passed by next week. Presuming that Gov. Kathy Hochul and legislative leaders remain committed to the state's recent history of producing the plan by — or at least near — the April 1 deadline, there are a number of issues they need to resolve. Three involve health care, one of the state's two main cost centers — the other is education — while the fourth is about the state's perennial problem with ethics.

Ethics

New York has long been an ethical sinkhole, dating back at least to the days of Tammany Hall. It's a problem that haunts the state and one that Hochul has pledged to address.

The creation of the Joint Commission on Public Ethics — JCOPE — during the early years of the Andrew Cuomo administration had raised some hopes, but its worthlessness was made clear in a matter involving the former governor.

In July 2020, JCOPE approved Cuomo's plan to write a book about his leadership during the Covid-19 pandemic. But last November, more than a year later and after Cuomo's resignation, it reversed itself and voted to rescind that approval, later ordering Cuomo to return the profits from the book, "American Crisis: Leadership Lessons from the Covid-19 Pandemic." It says Cuomo inappropriately used state resources to write the book. He says state workers volunteered their help. The issue remains unresolved.

Much of JCOPE's problems stem from structural rules that serve to protect public officials rather than the public. For example, its voting rules allow a minority of commissioners to block the agency from taking action in any given case. It also hides behind executive sessions that shut out the public and is exempt from Freedom of Information and Open Meetings laws.

Hochul has proposed a new oversight body that would make decisions by simple majority vote, ending the ability of a minority to squelch an investigation. And while some in the Legislature are pushing for strong ethics reform, good government groups are alarmed at proposals within the Senate and Assembly to continue JCOPE in its current form.

In a letter to legislators, seven such groups, representing a range of viewpoints, observed that "A vote to continue funding JCOPE without reform is a vote for the state's failed ethics status quo."

We agree. New Yorkers should view any effort to keep this broken agency in place as purposely evasive.

Medicaid

Hochul's budget proposal includes a questionable plan to allow only five Medicaid health plans in each of the state's regions — and to do so next year. A broad range of critics, including the Buffalo Niagara Partnership, says the policy will take away choices from 5.5 million New Yorkers, harm underserved populations, create confusion for subscribers and delay the state's ability to focus on other important Medicaid reforms. And, they say, it will do all this without saving any notable amount of money.

Managed care programs constitute an important way to provide necessary health care while controlling public costs. In their one-house budget bills, the Senate and Assembly have rejected the governor's plan, drawing praise from the New York Health Plan Association, which represents 29 health plans representing 8 million New Yorkers.

Medicaid is a hugely expensive program in New York, even though Washington picks up half the cost. It bears attention and reforms, but there seems little to gain from change this fast. We hope Hochul will hear the many voices cautioning against this effort.

Immigrant health

Also in both one-house budget bills is a measure that would extend the basic version of the federal Affordable Care Act to all immigrants in New York, legal or not. It's a valuable measure that would go a long way toward providing universal health coverage at an affordable cost. Again, support is broad.

Public expenses for unauthorized immigrants can be controversial, but the argument for this is clear. Beyond its humanitarian impulses, it is also forecast to save money.

Among the proposals' backers is the state's leading business lobbying group, the Business Council of New York State, which supports the effort to expand health insurance to everyone in the state. While the plan would cost $375 million a year, it would save $700 million by providing routine care to immigrants, who often use expensive emergency room services. The Business Council also prefers it to a costlier, single-payer approach.

The Buffalo Niagara Partnership shares that view, though it has not taken a formal stand on the measure.

Home care

A long-standing problem in New York has been the state's dwindling number of home care aides, especially at a time when the population is aging. The work is hard and physical — lifting patients and bathing them, for example — while workers in less stressful jobs, such as in the fast food industry, make more money.

By raising pay to $22.50 per hour, advocates say more New Yorkers needing care will be able to stay at home, improving their quality of life while lowering the public costs associated with nursing home care and loss of income by family members who quit work to care for a relative. The results will be net benefits to taxpayers: $1 billion in the coming budget year, alone, according to an analysis by the City University of New York Graduate Center.

Among the supporters are a handful of Republican legislators, including Sen. Patrick Gallivan of Elma. This bill, or something like it, deserves support.

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