The Faso-Collins Amendment

Well, it's two recent posts regarding a Federal bill. At least this one is about an amendment designed to have an impact on NY counties.

The Faso-Collins Amendment, proposed by our Congressman John Faso, and Chris Collins, another upstate Congressman from western NY, purports to right a wrong. The wrong is that New York State, unlike any other state except one or two, requires Counties to contribute dollars to support Medicaid. Most other states take on the State portion of the Medicaid costs themselves, without burdening Counties. Not so in New York – Medicaid costs make up about 10% of the Otsego County annual budget.

The Faso-Collins Amendment to the ACHA that was passed by the House directs the Federal government to figure the amount of Medicaid dollars contributed by New York Counties, and reduce Medicaid payments to NYS by that amount. The assumption you are intended to make is that New York State will find that extra money and use it to bring the Medicaid funding up to full strength.

Sounds good, no? No.

I met with Congressman Faso in April, along with a number of other Otsego County professionals who were working on the question: how much will Otsego County lose if the ACHA is passed? Last we looked, it was nearly $800,000, mostly due to Medicaid reductions. During the meeting, Congressman Faso said only one thing that seemed to related to our agenda: that he felt strongly that the Federal government spends way too much on Medicaid: “Medicaid spending is out of control, and we have to reduce it.”

So – looking at the Faso-Collins Amendment through that lens, it's clear that it might be called the Faso-Collins Medicaid Support Reduction for NYS Amendment. Because it is naive and childish – something we cannot believe is true of Congressmen Faso and Collins – to believe that the Cuomo administration will make even the first move to restore the funding from State funds. Attorney General Schneiderman has already announced that he will sue the Federal government if the Faso-Collins Amendment becomes law. There has been talk in Albany of a “Faso tax,” a state tax on Counties in the exact amount of their Medicad obligation, which I think is the height of irony.

It's all in limbo, of course, until the Senate gets a bill passed, or doesn't. If it does, then the ACHA and the Senate bill goes into the Conference Committee and who knows what comes out. If this Amendment comes out intact, it will be time to make the popcorn.