Proposal to Saddle Counties with up to $1 Billion in New Medicaid Costs

As a former county official, Governor Hochul should know that any new costs imposed on New York’s local governments eventually come out of New Yorkers’ pockets in the form of higher property taxes that drive up the cost of both rent and homeownership.

Unfortunately, the Governor’s budget includes an unprecedented shift that will saddle local taxpayers with up to $1 billion in new Medicaid costs by pocketing Enhanced Federal Medical Assistance Program (eFMAP) funds that were intended to go directly to local governments to help hold costs down.

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.”[1]

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.

We sincerely hope the Governor will reconsider this misguided proposal, adhere to Congress’ intent, and continue to share this federal funding so that so we can do our part to make our state more affordable.


The New York State Association of Counties is a bipartisan municipal association serving all the counties of New York State, including the City of New York. Organized in 1925, NYSAC’s mission is to represent, educate, serve, and advocate for member counties and the elected and appointed county officials who serve the public.