Several elected officials and health care unions—including Mayor de Blasio—have criticized the absence of officials from the city’s public-health system and the unions that represent New York City Health + Hospitals employees from the task force appointed by Governor Cuomo to find ways to save billions in Medicaid costs.
The 21-member panel known as the Medicaid Redesign Team was convened by Mr. Cuomo to find ways to generate $2.5 billion in Medicaid savings before the April 1 budget deadline. Growing costs for the program that serves six million people across the state have contributed to a projected $6.1-billion deficit in the state budget.
Who Was Appointed
The Governor announced his appointees to the task force, which was first established in 2011, earlier this month. Its members include Robert Megna, the Senior Vice Chancellor and Chief Operating Officer at the State University of New York (as well as the former Budget Director for the state) and co-chair Michael Dowling, president and CEO of Northwell Health, the state’s largest health-care operator.
But District Council 37’s Local 420, headed by Carmen Charles, wrote in a Feb. 12 statement that it was “deeply disappointed” that no officials from the municipal hospital system, which serves 400,000 uninsured New Yorkers each year, or the labor unions that represent its employees were appointed to the taskforce.
“It is our belief that Governor Cuomo’s Medicaid Redesign Team II is missing a critical voice and perspective that could help redesign Medicaid in a manner that does not compromise patient care and protects the financial security of public hospitals,” the union stated. “Given the outsized role that H+H serves in providing healthcare to New Yorkers, it would have been in the best interest of the state for MRT II to include representation from NYC H+H and its labor partners.”
‘Key Players Left Out’
State Assemblyman Richard Gottfried, who chairs the Assembly Health Committee, stated that although the team “includes respected members of the health care industry, it leaves key players and sectors that are a critical to our health care delivery system out of the decision-making process,” such as medical providers, pharmacists, and safety-net hospitals like NYC H+H.
“You would think that it would be critical to include those providing a significant part of that care in a conversation on how to redesign the program,” he said. “As they say, ‘if you’re not at the table, you’re on the menu.’”
But Gabby Seay, the political director for Service Employees International Union’s Local 1199, the largest health-care union in the country, noted that there were a few key labor figures on the panel, including the union’s former president, Dennis Rivera—who headed 1199SEIU from 1989 to 2007—as its co-chair.
She called him a “long-time fighter for working people, the exceptional healthcare that allows them to raise healthy families and live with dignity in New York, and for quality services to Medicaid beneficiaries.”
State AFL-CIO Head In
Additionally, State AFL-CIO President Mario Cilento was selected as a member. “Mario Cilento will also serve as a voice for the AFL-CIO member unions that represent health-care workers. We expect to participate in the public process and advocate with the Legislature to ensure that safety net providers are protected,” Ms. Seay said.
Freeman Klopott, a spokesman for the state Budget Division, noted that several large unions representing health-care workers, including the New York State Nurses Association, the Civil Service Employees Association and the American Federation of State, County and Municipal Employees (District Council 37’s parent union) were all affiliated with the AFL-CIO.
“The MRT is a broad selection of professionals who are undeniably experts in their fields and membership is largely consistent with the first MRT convened in 2011,” he said.
Mr. Klopott added that concerns about the team’s makeup were being “pushed by people who were against the process before even began and want to criticize its conclusions before they are reached.”
A state budget proposal that would require the city and other local governments to pay for Medicaid increases exceeding three percent, beginning in 2022. The de Blasio administration has estimated that this will force the city to pay $1.1 billion annually more if Medicaid costs grow at the same rate they have in recent years. The state projected a very different figure—a $221 million increase—assuming a 3-percent growth in Medicaid spending.
A spokeswoman for Mayor de Blasio said that it seemed “pretty convenient that the city facing the largest share of the cuts also has no representation.”
“The state shifts $1.1 billion onto the City for a problem they falsely claim is the City’s ‘fault’, and in the same breath, leaves us off the commission they’ve created for bringing costs down,” she said.
Mr. de Blasio stated Feb. 10 that the projected cuts would lead to the closing of “multiple Health + Hospitals public clinics, would lead to the layoff of approximately 1,300 doctors and nurses – these are really huge, huge numbers. It cannot happen. We have to fight it.”
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