Finally a solution for Medicaid costs that Monroe County can control.
And yet should county leaders try and do it – it might bring down the political house locally.
The solution has a rather militaristic sounding name – the "intercept." And it deals with the state sales tax. It works this way (according to the Empire Center for New York State Policy): counties have a one-time option to trade their Medicaid payments to the state in exchange for the state grabbing more counties sales tax take. In other words, the state would "intercept" part of a county’s sales tax booty to assume paying that county’s Medicaid freight.
The state legislature included this solution as part of Medicaid reforms last year. This was the same set of reforms that capped the growth of Medicaid costs to the counties at 3 percent.
But here is the kicker. The report by the Empire Center (an arm of the Manhattan Institute) says that some counties ought to take the offer. The ones that don’t see a growth in the total local share of sales tax that is greater than 3 percent. The reasoning goes what those counties would give up in sales tax money is less than the increases in Medicaid.
Among the counties listed is Monroe.
This legislation gave a short window for counties to accept the "intercept" – from from mid-April 2007 to the end of September 2007.
But that didn’t stop Republican Monroe County Legislative President Wayne Zyra from announcing last week that the county would consider the "intercept."
And predictably it brought howls from local leaders. After all the local share of Monroe County’s sales tax take goes into the budgets of the city, of the towns and villages, and of suburban schools. So no wonder Republicans who run towns, those who represent suburban schools and Mayor Bob Duffy might get edgy.
Zyra’s response: The Medicaid cost is a community problem. It needs a community solution.
But even County Executive Maggie Brooks acted as if the "intercept" idea was radioactive.
This solution, however, isn’t dead. Even with the strong words by Maggie.
"I don’t like the idea of a solution that leaves other jurisdictions in the lurch," said Republican Majority Leader Bill Smith. "But if it comes down to a matter of survival, we may have to do it."
As I’ve written earlier, the county may have no choice but to tap the sales tax to balance a projected shortfall in the next two years that Brooks has estimated to be more than $102 million.
But I thought it would be a sales tax increase as so many other counties have done. Ah… but wait a minute… isn’t this "intercept" just a way to whet our whistle for a sales tax hike? Wouldn’t the threat of losing sales tax proceeds force many in the community to go in the other direction and support a sales tax increase.
Smith said that this stalking horse theory of mine doesn’t wash. Not that he dismisses a sales tax increase. He just doesn’t think that the state legislative leaders would come together to raise a sales tax for Monroe County. For, as you know, any increase in the sales tax would need Albany’s blessing.
This "intercept" puts matters directly into the county’s hands. They can approve whether to accept it or not, by a simple majority vote. This sits well with county leaders who feel as though they are either ordered by the state to accept costs… or (in the case of a sales tax hike) have to go on bended knee for a favor.
The New York State Legislature approved this measure – and put the "intercept" in the county’s hands.
And, should Monroe County really pull that trigger, then some would see them inflicting a "stuff-rolls-down-hill" kind of pain on the municipalities within the county.
Smith simply says: "Go scream at Albany."
Perhaps this is just a way to wake up the slumbering lobbying muscle of others in the county to get on the state for real Medicaid reductions.
Or maybe it’s a way to settle us in for a sales tax hike.
Or perhaps we will really see an "intercept" – and then an inter-county political skirmish that we haven’t seen here in sometime.