(My Roosevelt colleague Naomi Zewde and I have an op-ed in the March 26 Daily News, criticizing Governor Cuomo’s plans to push ahead with cuts to state Medicaid spending despite the epidemic.)
Last week, as the coronavirus shut down much of New York, the state announced a bold plan to drastically cut funding for the state’s hard-pressed health care providers.
That’s right: As the coronavirus crisis escalates across New York State, Gov. Cuomo is proposing to slash funding for those at the frontlines.
Specifically, the cuts come via the Medicaid Redesign Team, appointed last month by the governor with the charge of cutting $2.5 billion from the state’s annual health spending. These cuts will not only mean an even more overstretched health care system; they will mean lost jobs.
For example, $200 million is slated to be cut from Consumer Directed Personal Assistance (CDPA), which allows elderly or disabled New Yorkers to hire their own home care assistants. As a Daily News editorial recently noted, CDPA was responsible for 36,000 new private-sector jobs in New York City in 2019, a lion’s share of all such jobs.
The biggest savings come from across-the-board cuts to health care providers, including $400 million from the state’s hospitals.
Cutting health spending in an epidemic seems like obvious lunacy. But it’s even worse than it seems.
Since the start of this epidemic, nearly one in five American households have had their hours cut or been laid off due to the virus. In New York, Cuomo said that the state has “never seen such volume” of unemployment claims.
As the economy slides over a cliff, we desperately need to keep people employed so that they can pay their bills and keep local businesses running. The proposed cuts will not only kneecap our health care system, but they will also deepen the coming recession.
But don’t we have to do something about out-of-control Medicaid spending? No, we do not. Medicaid spending is already under control.
Over the past five years, Medicaid spending in New York has risen by a steady 4% a year — exactly the same growth rate the state’s economy has had as a whole. And thanks to the Affordable Care Act, the share of total Medicaid costs paid by the state has gone down.
The apparent Medicaid crisis is entirely of the governor’s own making. When an arbitrary “global cap” on Medicaid spending turned out to be unachievable, instead of accepting reality, the state shifted a portion of the bill from fiscal year 2019-2020 to 2020-2021. This created the illusion of a big rise in this year’s costs.
Not only are there no runaway costs to rein in, but health spending is also an important economic stimulus. About 13% of New Yorkers work in health care — more than in manufacturing and finance combined. New York’s hospitals are stable sources of employment in many communities where good jobs are scarce. While many of the state’s traditional industries are in decline, health care promises to be a growth industry in the 21st century — if its growth isn’t cut off by shortsighted cutbacks.
Cutting state Medicaid spending today would be especially perverse, as the federal government appears poised to pick up a larger share of the program’s spending, just as it did in the last recession.
When private sector spending falls in a recession, the role of government is to lean against the wind, and boost public spending to fill the gap. Fiscal stimulus is primarily the responsibility of the federal government, but a state as large and rich as New York should also do its part — especially if leadership in Washington is lacking.
In normal times, trying to balance the budget through Medicaid cuts would be a mistake. Today, it is economic malpractice.