Medicaid reform measure doesn't go far enough
EDITORIAL
Tuesday, June 08, 2026

State Assembly Republicans, led by Albion’s Charlie Nesbitt, have put forth a plan to provide Medicaid relief for financially struggling counties. The plan proposes concrete means of giving counties desperately needed relief, but it comes up short in failing to address what really ails the system.

The GOP plan trades counties’ share of the Medicaid burden, which is fueling breathtaking local property tax increases, for 1 percent of the counties’ share of sales tax.

The proposal could provide immediate relief to cash-strapped counties like Orleans, where more than 80 percent of the county tax levy is spent feeding the social services system. The trade-off seems like a no-brainer: In exchange for giving the state $2.5 million in sales tax revenue, the county would have $8.1 million in expenses lifted off of it.

“We’d love to see it happen,” county chief administrative officer Stan Dudek said.

Short-term relief comes with a price, however. The shifting of dollars to state from county still represents the expenditure of tax money on a program whose costs are completely out of bounds.

The oft-repeated statistic says New York spends, on average, about $9,000 a year per Medicaid recipient. California and Texas, states comparable in size and population, spend $4,400 and $2,300 respectively.

“Something is seriously wrong in the state of New York,” Genesee County Manager Jay Gsell says. “You guys are spending like drunken sailors compared to the rest of the country.”

You bet, and what else is new?

Gsell and Jim Sinner, CEO of Medina Memorial Health Care Center, are concerned that the state’s response to spiraling Medicaid costs will be in part to simply reduce the amount of Medicaid reimbursement paid to hospitals and nursing homes — which already aren’t making back what they spend caring for Medicaid patients. Sinner fears health care facilities will be driven into debt or out of business trying to cover the burdens imposed by Medicaid, which, naturally in New York, offers better benefits than many private insurance plans.

We give Nesbitt and company credit for putting a plan on the table that jump starts a heretofore largely abstract discussion about the need to lift Medicaid costs off of counties. But the proposal should be seen only as a starting point in serious discussion about Medicaid reform.

The real work won’t begin until politicians find the courage to say enough’s enough, benefits have to be cut and costs controlled just as they are in the private sector, whether special interests like the various employee unions like it or not.
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