Medicaid and Pension Obligations Pressuring State Budgets

A new report from the “State Budget Task Force” released last week found that two issues were by far the most pressing for state and local government budgets: pensions and Medicaid. The full report can be viewed HERE.

Chaired by former New York Lieutenant Governor Richard Ravich, the group creating the report examined six states (including New York). Much focus was placed on currently unfunded New York Medicaid and pension obligations. It is unsurprising that these two issues are at the top of the list, and our New York elder law estate planning lawyers know this is even more reinforcement of the vital need for residents to plan for retirement and elder disability issues on their own.

In issuing the report, Ravitch argued that the problems extend beyond the recession. Instead, the report claims that the underlying financial concerns are far greater than a simple drop in revenues and increased need for aid services due to the economic climate. Like all similar reports of this nature, the author claims vast structural changes are needed to account for the looming fiscal crisis.

The main problem, the report declares, is that New York Medicaid spending is overcrowding all other needs. Our state is not alone in this, as various other states–particularly those with large populations–face the same challenges. New York is unique, however, in the breadth of its Medicaid program and spending. For example, the latest available data suggests that the average annual spending per enrollee is over $9,000. That is nearly 70% higher than the national average. To put that into perspective, that is more than the average spending of large states like Florida, Texas, and Michigan combined.

In the wake of the report’s release, several mayors of large cities commented on the problem and their belief that ensuring uninterrupted aid for those depending on Medicaid may require more financial support for Albany.

Yonkers Mayor Mike Spano explained, “We obviously want to grow ourselves out of the problem, and that’s what we aspire to, but if the economy doesn’t come around, we’re going to have to seek additional assistance [from the state].”

The report is not all “doom and gloom,” however. It noted that the state may be headed in the right direction, particularly considering that the Medicaid Redesign Team was able to find nearly $1 billion in savings in 2012. The study also noted, encouragingly, that the state would not face any financial problems from implementation of the Affordable Care Act, because most covered individuals will be eligible for a higher federal reimbursement rate.

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