The Governor held the briefing in New York City with New York State Medicaid Director Jason Helgerson, President and CEO of the Greater New York Hospital Association Ken Raske, President of the Healthcare Association of New York State Bea Grause, and President of 1199SEIU George Gresham.

A rush transcript of the Governor Cuomo’s and Medicaid Director Jason Helgerson’s opening remarks are available below:

Governor Cuomo: Good afternoon. Thank you all for taking the time. We will be getting underway. I’ll make some opening comments. You’ll then hear from Jason Helgerson, the New York State Medicaid Director. You’ll then hear from Ken Raske, the President of the Greater New York Hospital Association, then you’ll hear from the President of the Healthcare Association of New York, 1199SEIU George Gresham.

We just finished having a meeting with a larger group of healthcare providers from across the state, talking about the impact of the president’s budget and the ACA replace and repeal act. It has dire consequences for New York. We went through that briefing and we want to discuss it now with you.

Let me go around the table so we can get an idea of who is here with us today.

[Attendee introductions]

My greatest fear from last year’s election has actually come true, which is you would have a rabid, conservative ideology in Washington that would tell New York to drop dead and that is exactly what is going on. You have a Paul Ryan – an ultra-conservative congress that has been talking about making dramatic changes that would be devastating to New York for a long time. President Obama, frankly, held Paul Ryan and the conservatives in check, and now Paul Ryan has been unleashed and what you are seeing is the rabid, conservative orthodoxy that he has been speaking about for years.

First, the federal budget the government is talking about passing would be devastating to the state of New York. It does everything we were afraid of. It cuts low income housing, the food stamp program, community development block grant money, but it also cuts taxes on the richest 1 percent of Americans to the tune of $150 billion.

Second, the Affordable care Act Repeal and Replace – you repeal it because it’s terrible. We were told no American would lose their insurance. That was their promise during the repeal that no American would lose their insurance. But now the Budget Office says 24 million Americans will lose insurance and 2.7 million New Yorkers would lose insurance. Then they said, “Well when we do the Affordable Care Act, we won’t hurt the states, we won’t hurt block grant money to the state so the states have flexibility. But don’t worry we won’t hurt the states and we won’t hurt the people who need help.” Well, they have. Very, very badly.

There was an expression during the President Reagan years that the Congress wanted to pass the buck without passing the bucks. What does that mean? Pass the buck, in terms of passing responsibility to the state, without passing the bucks, or without passing the resources so that the states can actually provide the care. That’s exactly what they have done here, with this cheap rhetoric of the government closest to the people knows best, they are going to defer to the states and block grant to the states to do healthcare, but then they cut the funding that New York has been getting to the tune of $4.6 billion over four years.

$4.6 billion is a devastating financial cut to the state of New York and if that wasn’t enough, there is an amendment that has been introduced by two Congresspeople – Collins and Faso. What that amendment says, is the counties no longer have to contribute their share to fund Medicaid. Historically, Medicaid was funding in this state – 50 percent federal, 25 percent state, 25 percent from the counties and the localities. This amendment says the counties don’t have to pay. That means you cut Medicaid even more when you take off the counties responsibility. It would be an additional $2.3 billion cut to Medicaid. That’s just in the areas in Upstate New York and Long Island. That’s who the amendment is affecting.

New York is the only state in the nation affected by this amendment. The only state in the nation. It is cheap politics at best because what the Congresspeople say is, well if the county doesn’t have to pay their share, then the county can reduce taxes. Yeah. What they leave out is, if the county doesn’t pay its share, there’s another $2.3 billion cut to Medicaid on top of everything else and that means less people are going to get health care assistance. That means more hospitals, more nursing homes are going to close. That’s what that means. There is no fairy that is going to float down and hand over $2.3 billion to make up the shortfall that the counties lack. If the federal representatives wanted to say, “Well, the counties share is going to be reduced, but the federal government is going to supplement,” that would have been one thing.

We are also going to also take off the county share and nobody will make up the difference. The consequences will really be devastating to this state. $4.6 billion, $2.3 billion in upstate New York and Long Island. You will literally decimate the health care industry. We’ve been working very hard in upstate New York to bring back the economy, you have no economy without a health care industry. You would lose more jobs in this proposal than have been built and brought to this state over the past five or six years. The consequences are really that dramatic. It is also inconceivable to me that these Congresspeople can justify how a federal representative goes to Washington to represent their district and actually winds up hurting the district. Between the federal budget that cuts community development money, cuts low income housing money, cuts home heating assistance, and now decimates health care for hundreds of thousands of people in this state. In Representative Collins’ district, there are 100,000 people who receive Medicaid. In Faso’s district, there are 150,000 people who get Medicaid assistance. How about that? What happened to putting people before your politics? Rather than swearing allegiance to the Ryan Radical Right, why didn’t they think about representing the people in their district? Why didn’t they think about the oath that they took and put their politics aside? That’s what this is about. They’ve declared war on New York and this is just the beginning. It started with healthcare, you’re going to see it with the budget that disproportionately hurts New York, you’re going to see it with their talk about ending state and local tax deductibility, it is nothing short of a targeted war on New York. Again, this Collins Faso amendment, there’s only one state in the United States that it impacts. That’s the state of New York. It cannot be. Jason Helgerson will give you some of the numbers and facts about the consequences for the state. Jason?

Jason Helgerson: Thank you Governor. It’s true that this act is a cynical ploy that is going to affect millions of New Yorkers and millions of Americans. Recently the congressional budget office came out, official score of this act and the numbers are staggering. Twenty-four million Americans will lose health insurance access as a result of this. The biggest single step back in health care access in our country’s history. 2.7 million of them will be our fellow New Yorkers. What’s also unfortunate about this particular act is that it will fall hardest on the individuals who are greatest need in our communities. It will fall hardest on those who are older, and it will fall hardest on those who are sick. Just to give a couple of examples of what this Ryan plan means is that for those individuals who are in those groups – the older, the sicker – they will see their insurance premiums skyrocket in the coming years. I will give you a couple examples of that. At the same time that we’re going to see those individuals far worse off under this act, we are giving a massive tax cut to the wealthiest in our country. It’s in essence the reverse form of Robin Hood – We’re literally going to take from the poor and the sick in this country and this state and we’re going to give it to our wealthiest citizens.

One example is a 55 year-old nonsmoker, who will see his premium basically double under this act. One could also go to actually CVO Score, and see an example of a 64 year-old, just living just above the poverty line, who will see their premiums go from $1,700 a year under the Affordable Care Act, to $14,000 under this new law. As a result of that what we will see is there will be fewer people ensured and unfortunately we’ll see a severe humane toll as a result of this act.

So, in addition to what was in the original act, that we’ve all had a chance to look at, is the amendment that was basically released in the middle of the night last night which is the Manager’s Amendment, which includes within that this Collin’s Amendment, which basically takes away the ability for New York State and New York State alone, to be able to utilize local tax revenues as we have since the Medicaid program was created in the 1960s to support our program. That is the nature and the history of our program and the impact is $2.3 billion loss. So, it affects all of the counties outside of New York City and here are the impacts by sector. As you can see, nursing homes, home care and hospitals, all significantly affected as a result of this particular proposal.

So, when you add the $2.3 billion to the $4.6 billion number, which was the number the Governor mentioned originally, which was our initial estimate of the affect of the adds – you have an aggregate impact to the state of New York of almost $7 billion. As was mentioned, a significant percentage of the population of New York State is affected by this. You have affected no only the Medicaid population, but also those who have benefited from other programs created under the Affordable Care Act, and in the congressional districts of congressman’s Collins and Faso, its 250,000 people. As you can see, this slide gives you the breakdown of those two congressional districts.

Here are the other congressional districts in our state and you can see the numbers are staggering. Tremendous numbers of individuals. In total, 7 million New Yorkers rely on these programs every single day. That’s more than 1/3 of our total population. One in three people in our state rely on these programs that were created or fostered under the Affordable Care Act. Now, we’ll see impacts across all of those programs, some of them even eliminated under this act if it were to become law.

As the Governor mentioned, historically in New York State, this was a local and state partnership relative to how our Medicaid was structured with the federal government picking up its federal share of 50 percent, with the state and local governments spreading that cost. A lot of concern and talk over many years about that, but what has been missed is the fact that we’ve made tremendous progress in reducing the local share. Now only 13 percent of the cost of Medicaid is covered by the counties, much reduced as a result, particularly thanks to Governor Cuomo’s leadership in recent years. And so the result, while it is a part of budgets, it is capped part, in fact it is declined as because of the Affordable Care Act and that fact is really lost in all the rhetoric around this particular amendment.

The key part of this too, is that you’ll hear from some of the proponents of this that the Medicaid in New York is too big and it hasn’t done enough to become efficient and to provide more cost-effective care. Nothing could be farther from the truth. New York’s Medicaid program is nationally recognized and in fact we’ve shown that we can contain costs. In fact, over the first five years, the Medicaid redesign team convened by Governor Cuomo in 2011, we’ve lowered the total cost of the program by $34 billion. We now spend less on a per person basis on this program than we did in the year 2000. We have in fact met the cost curve and we’ve done it by not – we haven’t taken a single benefit away from New Yorkers. In fact, we’ve expanded the program and reduced out insure rate and cut out insure rate in half. So do you want to join the fight? Here’s one way to do it. And happy to answer any questions when we get to that point.

VIDEO of the briefing is available on YouTube here and in TV quality (h264 format) here.

AUDIO of the briefing is available here.

PHOTOS of the briefing are available on the Governor’s Flickr page.

POWERPOINT PRESENTATION is available here.