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Counties could lose millions in federal Medicaid funds under Hochul's budget

Tom Magnarelli
WRVO News (file photo)

County governments will lose millions of dollars in federal Medicaid funds if Governor Kathy Hochul’s proposed budget passes as is.

Onondaga County Executive Ryan McMahon was looking forward to the governor’s budget presentation, hoping to hear that the county would be in line for millions in back Medicaid payments owed the county by the state.

"So we thought we were going to get $25 million and we could invest it in more things like housing," McMahon said. "But instead what we got, 'let alone we’re not giving you the money we owe you, but we’re going to try and intercept the money the federal government gives us to give you.'"

The way it has worked in the past, the federal government passes along Medicaid funds to the state, and the state distributes them to local governments. The latest budget keeps about a billion dollars in Enhanced Federal Medical Program funds in state coffers, instead of turning them over to counties. McMahon said it is an unprecedented money grab in a budget that will hurt counties across the state.

"So for Onondaga County, it’s $14 million dollars midyear potentially as a hit," McMahon said. "Huge hit. When you look at Suffolk County in Long Island and Nassau, over $30 million."

Hochul’s release this week of a $227 billion spending plan kicks off budget season in Albany. McMahon said if these numbers hold, counties may have to get the federal government involved in the process.

"The federal government could pass a law qualifying that yes, it is our intent for you to share this with counties," McMahon said. "And we’re gonna encourage them to do that if we can’t get anywhere with our state partners to correct this."

Impacts on other county budgets include $28 million in Erie County, more than $24 million in Monroe County, and about $5 million in Broome County.

Ellen produces news reports and features related to events that occur in the greater Syracuse area and throughout Onondaga County. Her reports are heard regularly in regional updates in Morning Edition and All Things Considered.