U.S. Health and Human Services Secretary Michael Leavitt attached a series of strings to the extra money that would require the State Legislature to accept many of the reforms Pataki has proposed for Medicaid, the increasingly expensive program that helps more than 4 million elderly, disabled and low-income New Yorkers. Although the extra federal money will not trickle down directly to individual counties like Erie, it could pave the way for some sort of cap - already agreed to, though in different forms, by Pataki and legislators - on future Medicaid costs counties pay. It would also mean direct payments to area hospitals, nursing homes and home care providers in return for shaving costs.Shaving costs? Has such a phrase been uttered in the hallowed halls of the NY Capitol before?
The immediate reaction from legislative leaders was muted. Senate Majority Leader Joseph Bruno, a Republican, "hopes the additional assistance will help us bring about a budget on time," said Bruno spokesman Mark Hansen.Translation: But what about my bullet train to NY?
Assembly Speaker Sheldon Silver, a Democrat who has routinely railed against Pataki's plan to cut health services for Medicaid patients, was awaiting more details on how the federal action "would impact health care in New York State as well as the current budget process," said Silver spokeswoman Eileen Larrabee.Translation: I need to speak with my union lobbyist patrons to find out what I think about this. Sandy Beach made this point last night - the Feds are upping the ante. The unions, which have controlled the debate for so long, can't compete with this kind of offer. It seems that some sort of Medicaid reform is inevitable. But will it be enough?