enhanced federal medical assistance percentage

Every county in the state — including Genesee — has jumped on board to appeal a part of the governor’s budget that will take away funds meant to be shared with each county for Medicaid and healthcare costs.

Genesee County is looking at losing some $188,000 this year alone if the state budget is passed as is. The county Legislature voted a week ago to send a letter opposing the move, and the state Association of Counties (NYSAC) passed a resolution Tuesday during its three-day conference to do the same, Assistant County Manager Tammy Ferringer said.

“All counties unanimously voted to bring forth the resolution, the take-back of eFMAPs. So they're hoping that that will be impactful, and then it won't go away,” Ferringer said Wednesday. “Generally, just before the budget goes through, the commissioner of Social Services will receive notice that the weekly shares have changed or that this is your amount for federal participation. So it won't be until March, the end of the month. Unless the budget doesn't pass, and then it could be April and prolonged even longer.”

EFMAPs are enhanced Federal Medical Assistance Percentage funds. Counties have been receiving funding for Medicaid costs, and Gov. Kathy Hochul’s proposed 2023-24 budget would eliminate that allowance from the upcoming fiscal year.  Earlier in February, NYSAC President Michael E. Zurlo called the governor's removal of the eFMAP funds an "unprecedented shift" that will saddle local taxpayers with up to $1 billion in new Medicaid costs with the state pocketing those medical assistance funds instead. 

"Not only does this proposal harm New York's local taxpayers, but it also subverts Congress' intent that eFMAP be shared with local governments that contribute to the Medicaid program. In March of 2020, New York Senator Charles Schumer championed that 'Enhanced FMAP funds are so important because they are immediate and flexible. The state – which gets billions and the most of any state in the nation – and counties use the money they save on whatever they want,'" Zurlo said in a news release.

"At a time when New York is facing an affordability crisis, the last thing the Governor should do is burden local taxpayers with more costs that will drive up the cost of homeownership and rent, increase business expenses and make New York more unaffordable," he said.

Congresswoman Claudia Tenney has also sounded the alarm, stating that up to $1 billion in eFMAP funds could be diverted to state coffers.

“This will force counties to further raise property taxes on local taxpayers to cover the difference,” Tenney said in a news release. “This resolution clarifies that it was Congress’ intent for eFMAP funds to be shared directly with the county and local governments that cover the associated costs.”

Congress delivers federal funds directly to states to cover a share of their Medicaid programs and other healthcare initiatives. Congress intended eFMAP funds to be shared with the New York counties and local governments that sustain the Medicaid program.

“Governor Kathy Hochul’s state budget proposal amounts to an egregious theft of taxpayer dollars. She proposes that Albany Democrats steal federal funds that Congress intended to go directly to our counties. This absolutely reckless proposal will lead to a tax hike on working families across New York,” Tenney said. “Our counties shoulder a significant portion of our state’s Medicaid share, and they should therefore receive federal reimbursement. If Kathy Hochul and Albany Democrats think they are entitled to these federal funds, they should shift the burden of funding Medicaid from our counties back to our state’s capital, as every other state in the country does. New York is the only state that demands local governments cover half of the Medicaid share. It is deeply unfair, and it must end.”

The resolution put forth by Genesee County Manager Matt Landers would reverse the governor’s plan that would also increase payments to healthcare providers and require the 57 counties to cumulatively spend at least $280 million more in the 2024 budget year, he said.

That additional $188,000 for Genesee County is for this year, and that number could likely change next year, Ferringer said. Are county officials hopeful that the governor’s budget will omit the eMAP portion? It’s possible.

“But the likelihood of that doesn't seem like it's probable,” Ferringer said. “We'll probably come to a real solution before that.”

File Photo of Tammy Ferringer by Joanne Beck.