Lack of Federal Aid to New York Poses Dangerous Fiscal Ripple Effect on Medicaid Support System 

While the latest federal relief bill provides some welcome help to New York families and businesses, the absence of billions in state and local aid to New York would have a severe ripple effect on critical access services like home care and hospice if Congress doesn’t act again — and soon — with follow-up aid in the remaining few months of the state fiscal year.

Cuomo Administration officials project an unprecedented deficit next year: $14 to $15 billion in 2021, rising as high as $59 billion through 2022. The Governor has warned that, without $15 billion in federal aid, there will be no escaping major program cuts and increased taxes, putting Medicaid home and community-based services at enormous risk among other programs and services in the state budget.

HCA has been pressing for federal relief to ensure the fiscal stability of Medicaid home and community-based programs, along with the continuation of federal relief programs necessary for the overwhelming majority of New York home and community-based organizations that are coping with economic losses in the pandemic.

According to the most recent HCA data, nearly 40 percent of home care providers expect losses of 11 percent to 20 percent in 2020 due to the pandemic, with some projecting much higher impacts.

These losses are attributable to rising costs (like personal protective equipment) and a decline in service capacity that, for many agencies, has yet to rebound after the springtime surge, as we’ve now entered the midst of a new surge.

As of late October, for instance, 63 percent of home care agencies had not fully recovered their normal patient counts (i.e., census) even as demand for home care has been rising. In fact, 65 percent of home care agencies are seeing an increase in referrals to their agencies (from hospitals, physicians and family or self-referrals) but 76 percent of these agencies have been forced to delay or deny accepting these new referrals, mostly because of reduced workforce availability caused by systemic constraints as well as pandemic-related factors.

HCA is in the process of again surveying our members to account for the latest fiscal data as we head into the upcoming season of state budget negotiations. In the meantime, we urge all state elected leaders and representatives to voice support for federal relief to New York State that is necessary to avoid a cataclysmic state fiscal ripple effect on an already fragile and overburdened base of Medicaid services and supports working valiantly to meet the needs of New Yorkers in this pandemic.