New York governor-elect Andrew Cuomo and the state's health care union were in quiet talks over Medicaid spending in an effort to avoid a bitter showdown next year over the state budget, The Wall Street Journal reported Friday.
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Cuomo was talking directly to George Gresham, the president of 1199 SEIU United Healthcare Workers East, a vast local union that represents hundreds of thousands of nurses, physician assistants, pharmacists, home care aides and other health care workers.
On the table was a scaling back of the state's home care program, whose costs skyrocketed in recent years even as the number of recipients declined.
Labor officials expressed support for changing the way agencies are reimbursed by Medicaid for providing home care to sick patients, shifting away from hourly rates and toward an episode-based or "bundled" payment system encompassing multiple visits.
A spokesman for Cuomo said the governor-elect was discussing "crucial reforms with all of the stakeholders involved, including 1199, hospitals and other providers."
Over the past decade, Medicaid spending in New York nearly tripled and enrollment grew by two million to 4.7 million people. A temporary, two-year boost of federal stimulus money relieved some strain. But with those dollars drying up, the state's share of Medicaid costs was expected to grow by about $6 billion, or nearly 50 percent. That increase was a major factor driving up next year's deficit, which is approaching $10 billion.
As a candidate, Cuomo said he would demand painful concessions from public sector unions. His discussions with 1199 signaled that the incoming governor might be more selective in his battles.