Federal Medicaid changes may raise property taxes and cut local services
Any wholesale Medicaid cuts at the federal level will ultimately show up in local property tax levies and in reductions in local services, Essex County Manager Mike Mascarenas told supervisors at a Monday meeting.
Such cuts would be damaging “not only to the population that receives Medicaid, but to those who pay for it,” Mascarenas said. “I’ve been here 25 years, and what I will tell you with certainty is that the (proposed) change to Medicaid is probably the single biggest threat to property tax that I’ve ever witnessed in Essex County.”
Mascarenas’ comments came in response to a presentation by representatives of the North Country Medicaid Coalition, a nonpartisan group of physicians, Medicaid recipients and community leaders cautioning against draconian cuts to the federal program.
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Congressional Republicans are currently negotiating over a White House bill that budget analysts say would cut Medicaid — which pays health care costs for lower-income people, including children and those in nursing homes — somewhere between $600 and $800 billion over 10 years.
Mandated county contributions
In 49 states, federal and state governments share Medicaid costs. But in New York, state law requires the state’s 62 counties to pay into the system as well. That means Medicaid is dependent on local property taxes.
Essex County is required to pay $7 million annually into the system, Mascarenas said. While that sum is presently capped, the state law could be revisited in the wake of steep cuts.
“The devil will be in the details in terms of what that means,” he said. “I’m certainly not an alarmist, but I want all (department heads) to be aware that if Medicaid is not on your agenda it needs to be, regardless if you think Medicaid matters to you or not.”
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Keeping up with changes happening in Washington
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Any increase in Medicaid costs would force counties to raise taxes or shift money away from discretionary funds that they spend for things like roads, senior services and education.
“If changes are made to Medicaid and the state then removes that cap to counties, it could result in hundreds of thousands or millions of dollars that would be pushed to the locals,” Mascarenas said. “We are the government of service; we are where the rubber meets the road. So if the Highway (Superintendents) Association isn’t speaking about Medicaid, if education isn’t talking about Medicaid, there’s a big disservice being done there, because it’s going to get to all sectors of service.”
An unstable healthcare system
Speaking for the Medicaid Coalition, Dr. John Rugge, founder of Hudson Headwaters Health Network and Heidi Schempp, administrator of the Elderwood at North Creek nursing home, warned that the Adirondacks is already teetering on the edge of becoming a health care desert, and cuts to medicare threaten the institutions that provide what care there is.
“The price of care has gone up so much, and we have not seen an increase in Medicaid rates, so we’re already struggling, Schempp said. “So any type of impact to Medicaid would be devastating for the nursing home industry.”
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RELATED READING: North Country coalition speaks out on potential Medicaid cuts
Schempp said 70% of North Country nursing home residents depend on Medicaid, about 7% higher than the national average.
And for rural physicians in private practice, Rugge said, the threat to Medicaid is personal. They tend to see the faces of everyone in the community, and will be unlikely to withhold care, even if reimbursements shrink or disappear.
“From my personal experience I know you can’t live and practice in a community like this without being willing, able and happy to treat everybody who comes through your door,” he said.
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But with 28% of North Country residents on Medicaid — and Medicaid patients typically having more health problems than the general population — these private practices would be at risk, Rugge said.
Supervisors were receptive to a resolution in support of Medicaid, while Supervisors Chair Shaun Gillilland noted it is just one of a number of uncertainties in state and federal funding. “Get ready, because this rodeo is going to be a wild ride,” he said.
Photo at top from Canva.com
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