The Trump administration’s approach to mental and behavioral health has raised alarm among experts and advocacy groups, as it includes major federal funding cuts and controversial views from Health Secretary Robert F. Kennedy Jr.   While the U.S. faces a worsening mental health and addiction crisis, recent actions, such as slashing the HHS workforce, cutting SAMHSA funding, and halting $1 billion in school mental health services, threaten existing progress. Kennedy’s push to explore environmental links to autism, viewed by many as a revival of vaccine misinformation, adds to concerns. Meanwhile, Trump has floated a return to mental institutions, and Kennedy questions the use of psychiatric drugs, proposing alternative “healing farms.” A forthcoming report from the Make America Healthy Again Commission may signal further policy shifts. (Article from Axios is here)

————————–

Empire Center Comments on Budget Deal in Albany (5/8):

As Governor Hochul and legislative leaders belatedly released details of their agreement on a state budget for fiscal year 2026, the Empire Center released a statement from its Senior Fellow for Health Policy, Bill Hammond:

“The state budget finally heading to approval in Albany was definitely not worth the wait. It calls for spending increases that would have been unsustainable even in rosier times. Given the current reality – with obvious threats to federal funding, Wall Street and the broader economy – the plan from Governor Hochul and the Legislature is nothing less than reckless.

“The governor initially proposed the biggest state-funded spending increase since the 1980s, and the final budget will add substantially to that. Most of the new money is flowing to the state share of Medicaid, which is growing by more than 17 percent even though enrollment is down.

“One of the few bright notes is an agreement to pay off a $7 billion debt in the state’s unemployment fund, saving employers from a hangover of the pandemic that never should have been laid on their shoulders.

“Already, the governor and Legislature are warning that they might have to cut the budget later this year – a confession that what they have now is neither prudent nor truly balanced.

“Contrary to their rhetoric about affordability, the governor and Legislature are compounding the already excessive burden on the state’s taxpayers and economy and worsening the long-term decline of the Empire State.”

————–

Status of NYS SFY26 Budget Bills (As of 10:00 A.M., 5/8)

1) All of the remaining budget bills required to enact a new state budget were amended late yesterday.  The Senate and Assembly have already passed:  PPGG (S.3005-C / A.3005-C), Health/Mental Hygiene (S.3007-C / A.3007-C), and TEDE (S.3008-C /A.3008-C). 

2) Here’s a rundown of what both the Senate and Assembly have left to pass: 
Appropriation Bills:
– State Operations (S.3000-D / A.3000-D) (link below)
– Legislature Judiciary (S.3001-A / A.3001-A) 
– Aid to Localities (S.3003-D / A.3003-D)  (link below)
– Capital Projects (S.3004-D / A.3004-D)  (link below)

Article VII Bills: 
– ELFA (S.3006-C / A.3006-C) (link below)
– Revenue (S.3009-C / A.3009-C (link below)

3) Links:

• A3006C/S3006C – the Education, Labor, Housing and Family Assistance (ELFA) Article VII
• A3004D/S3004D – Capital Projects Budget Bill
• A3000D/S3000D – State Operations
• A3003D/S3003D – Aid to Localities
• A3009C/S3009C – Revenue Article VI

—————

State budget provisions in the ELFA bill include the following:

(Note:  The ELFA bill hasn’t passed both chambers yet but that’s expected at some point today.)

Education, Labor, Housing and Family Assistance (ELFA)

(Source:  Capitol Confidential, 5/8)

Foundation Aid formula (Part A): The formula for how the state calculates the amount of aid distributed to each school district has been changed. Some of the major changes include:

• The formula will no longer use the outdated 2000 census poverty rate. It will instead use the most recent Census Small Area Income and Poverty estimates to measure where the need is highest.
• Free and reduced-price lunch data will also no longer be used. That will instead be replaced by economically disadvantaged data, which is calculated using a different formula.
• Data on the number of English language learners will also be factored into the aid for a district.
• The regional cost index, used to measure the cost of labor, will go up for Westchester County for the next school year.
• The formula will also allocate additional aid to districts determined to be low-wealth.
• And BOCES Aid and Special Services Aid will be changed to increase funding for what are known as the “Big 5” school districts: New York City, Yonkers, Rochester, Syracuse and Buffalo.

Statewide dual enrollment policy (Part A): The state Education Department will be tasked with adopting a statewide policy that defines and provides guidelines for dual enrollment programs, where a high school student is enrolled in college courses.

Electric school buses (Part A): Any new buses purchased by school districts after July 1, 2027 are supposed to be electric, though a district can ask for a two-year extension.

This will allow districts to apply for a second two-year extension for meeting that requirement as long as they’ve engaged the New York State Energy Research and Development Authority on their electrification plan.

Any entity that sells an electric school bus to a school district will also be required, starting in 2026, to provide a range estimate that accounts for different terrain and weather conditions. It also has to show the level of expected battery degradation every 10,000 miles.

Substantial equivalency standards (Part A): This will delay and change the requirements that nonpublic schools, including yeshivas, have to meet to be considered “substantially equivalent” to the quality of a public school’s education.

Those standards were set to be required by June of this year but this will allow a phase-in period for schools to meet them by the 2032-2033 school year. They will be allowed to choose the year-end tests that will measure student performance, regardless of whether it’s approved by the state.

Universal free school meals (Part B): All school districts will be required to serve breakfast and lunch to students at no cost. The rest of the language describes how they’ll be reimbursed for that expense, which is currently funded by the state and federal government.

Bell-to-bell smartphone ban (Part C): All school districts will be required to adopt a policy that prohibits students from using their smartphones during the school day. Districts will decide how and where those phones will be stored and will have to give parents a different way to reach their kids.

There are certain exceptions, like if a student needs their phone to manage their health care, but districts won’t be allowed to suspend students for breaking the rule. Districts will also have to publish an annual report on how the policy is enforced.

More part-time TAP (Part D): The number of credits college students need to be enrolled for in a semester to receive aid from the Tuition Assistance Program will drop from six to three.

Higher TAP awards (Part E): And the cap on the amount a student can receive from TAP will increase from $5,500 to the cost of in-state tuition.

Free community college for in-demand fields (Part F): Students who attend community college for an in-demand career field will have their tuition and fees paid for under certain conditions.

The student has to be at least 25 years old and, at maximum, 55 years old and they’re not eligible if they’ve already obtained a college degree. Students will also have to complete at least six credits per semester and can’t take any time off from school before they’re finished.

Substitute child care providers (Part P): This will allow the state to certify child care support centers that operate as a resource and referral program to place substitute caregivers at child care facilities, family day care homes or school age child programs.

Those substitutes would still have to meet state standards before being assigned as a substitute caregiver.

One-time benefit for new parents (Part Q): A small section will be added to the Social Services Law to allow for a one-time benefit to be given to public assistance recipients upon the birth of a new child. That will be based on state regulations.

Higher allowances for people in care (Part R): This increases the amount of monthly allowances for people receiving family care, residential care or care in a school for people with developmental disabilities. There are several increases so it’ll be easier for you to read it if you’re interested.

Airport worker wages (Part T): Airport workers at LaGuardia and JFK will be paid at least as much as an “applicable standard rate” designated by the state Department of Labor. This was already the case for some workers but the new language is broader.

Wage theft enforcement (Part V): This gives the Department of Labor more teeth in seeking unpaid wages for employees, including the ability to issue a court order allowing the county sheriff to levy and sell an employer’s property to recoup that money.

Child labor penalties (Part W): People found to have broken the state’s child labor laws will now be held to much higher penalties.

The first violation will result in a penalty of up to $10,000 (up from $1,000), the second will be at least $2,000 but less than $25,000 (up from $2,000) and the third will increase to $55,000 (up from $3,000).

Minor employment database (Part X): Among other things, this section will require the Department of Labor to create a database for minors employed in the state. Every employer that hires minors and any minor who plans to work will have to register with the database and provide information.

Annuity for families of killed service members (Part Y): The law that allows parents of veterans who died in the line of duty to receive an annual annuity of $500 will now be extended to provide the same benefit for spouses and any minor children of the veteran.

State Museum report (Part AA): The state Education Department will be required to publish a report this September on the usage, budgeting, staffing, assets and functions of the State Museum.

New York City child care funding (Part CC): New York City will be required to spend at least $328 million on child care assistance moving forward. That has to be pulled from local revenue.

Masked criminals (Part DD): This is the final result of Hochul’s push to penalize people who commit crimes while wearing a mask.

If someone conceals their identity while committing a felony or class A misdemeanor, a separate charge for evading arrest by concealment of their identity can be tacked on as well. That’s a class B misdemeanor, meaning it can add to the person’s sentence if they’re convicted.

Merit time in state prisons (Part EE): People incarcerated in state prisons will be allowed limited time credits for completing programs of at least 18 months that qualify.

The commissioner of the Department of Corrections and Community Supervision will also be able to designate more programs and achievements that can result in merit time, which can reduce certain sentences.

Converting to condominium ownership (Part GG): This sets a comprehensive framework for the conversion of rental properties into condominium ownership in New York City for the preservation of affordable housing.

Like current conversions, a plan has to be submitted to the state attorney general’s office, which has the power to reject it if it doesn’t meet the criteria spelled out in the law. The plan also has to be accompanied by a letter of support from the relevant housing finance agency.

A lot of this law reflects the requirements already in place for condominium conversions, like an obligation to notify tenants and allow them to purchase their units. Other parts deal specifically with the intention of the offeror to preserve affordability.

Housing Access Voucher Program (Part HH): This creates a state-level pilot program that will allow people who are homeless or at immediate risk of losing their housing to receive a rental assistance voucher. Priority will be given to people who are homeless.

The pilot will be funded at $50 million. The rest of the language details how the program will function, including what’s involved in verifying someone’s income. Only low-income people will be eligible for the vouchers.

Pretrial criminal discovery changes (Part LL): We already knew the major provisions of this new law, which amends a 2019 law that overhauled criminal pretrial discovery. That’s the exchange of information and evidence between prosecutors and the defense before trial.

All discoverable materials “that relate to the subject matter of the case” have to be given to the defense. If that doesn’t happen, the defense can move for the case to be dismissed.

But if a prosecutor can show that they acted in good faith and exercised due diligence, they can avoid dismissal. As part of that, they have to show the missing discovery wasn’t prejudicial to the defendant.

———————-

FEDERAL BUDGET RECONCILIATION

Bill won’t touch portion of state Medicaid costs borne by federal government

ROLL CALL, Jessie Hellmann, Sandhya Raman, Olivia M. BridgesPosted May 6, 2025 Republicans will have to come up with alternative savings to make up for hundreds of billions of dollars in potential Medicaid cuts that GOP leaders appeared to rule out after meeting with moderates in Speaker Mike Johnson’s office Tuesday evening.Johnson, R-La., said leadership had ruled out two Medicaid policies that could go a long way toward meeting the Energy and Commerce Committee’s $880 billion, 10-year savings target but faced strong pushback from blue-state GOP centrists.First, Johnson said the emerging package wouldn’t touch the Federal Medical Assistance Percentage, or FMAP, rate — the portion of state Medicaid costs borne by the federal government — for the Medicaid expansion population, which is currently 90 percent.Johnson also poured cold water over a provision that would implement per capita caps on Medicaid benefits for enrollees in expansion states, though he wasn’t quite as definitive on that front.I think we’re ruling that out as well, but stay tuned,” he said.At least one provision remains in the mix: new work requirements for healthy adults in states that expanded Medicaid to receive the 90 percent federal match, a key provision of the 2010 health care law.“That will be part of the bill, it always has been,” Johnsonsaid on includingwork requirements.The Congressional Budget Office has scored prior Medicaid work requirement proposals as saving over $100 billion — which would still leave Republicans substantially short of what they need.
‘Listening session’About a dozen Republicans with qualms about making deep cuts to Medicaid participated in what was described as a “listening session” for nearly two hours.Several Republicans, especially those in states that expanded Medicaid, had drawn a hard line against supporting a broader slate of Medicaid cuts to try to hit the $880 billion threshold required by the fiscal 2025 budget resolution.

“It’s going to take a lot more of these kinds of conversations, ultimately, to get to an understanding that 99 percent of the House Republican Conference can agree with,” Rep. Nick LaLota, R-N.Y., said after the meeting.

The two proposals to scale down the federal government’s financial contribution to covering the Medicaid expansion population were originally floated by Energy and Commerce Chairman Brett Guthrie, R-Ky.

One would have reduced the federal government’s match rate from 90 percent to something more in line with the typical match for the non-expansion population, which ranges from 50 percent to 83 percent.

An alternative proposal emerged last week to cap Medicaid benefits per expansion enrollee, with annual growth for medical inflation.

Such a change would still result in a massive cost shift to states. According to KFF, a nonpartisan health policy research organization, it could reduce the federal match over time potentially to 69 percent by 2034. States would become responsible for any costs that exceed that cap, amounting to a cost shift of about $246 billion over ten years, according to KFF.

Republican leadership is racing to find a slate of Medicaid proposals that can help pay for President Donald Trump’s “big, beautiful” reconciliation bill before a markup the Energy and Commerce Committee aims to hold next week.

That committee is charged with finding the largest share of overall savings across 11 House committees, which in total have to find at least $1.5 trillion. The money would go toward paying for a huge tax package, including extensions of Trump’s 2017 tax cuts expiring at the end of this year.

Discharge petition

The prospect of cuts to safety net programs like Medicaid in exchange for tax cuts benefiting households at the top of the income scale has given Democrats a political opening to hammer moderate Republicans whose seats are at risk next year.

House Democrats started collecting signatures on a discharge petition Tuesday to try to force a vote on a resolution they introduced earlier this year to create a point of order against any reconciliation bill that cuts Medicaid enrollment or benefits, as well as eligibility or benefits in the Supplemental Nutrition Assistance Program.

GOP Reps. Zach Nunn of Iowa, Don Bacon of Nebraska and Derrick Van Orden of Wisconsin late last week introduced their own, competing resolution that would create a similar point of order, but specifically protect from any cuts individuals under 19 or 65 and over, individuals with disabilities and those who are pregnant.

That would leave other adults who don’t fall into those categories potentially exposed. But the proposal gives vulnerable Republicans political cover to avoid signing on to the Democrats’ petition.

“Tragically, not a single Democrat wanted to join” his resolution, Nunn said Tuesday.

The three Republicans are among the party’s most vulnerable in 2026; Bacon’s and Van Orden’s races are rated Tilt Republican by Inside Elections with Nathan L. Gonzales, while Nunn’s is considered Lean Republican.

While Republicans have generally agreed on protecting the traditional Medicaid population from cuts, the GOP has stumbled over the question of how to handle Medicaid expansion.

Trump has been sensitive about cuts to Medicaid amid pressure from the “MAGA” wing of the Republican Party that is warning that cuts are deeply unpopular.

“It’s just off the table because of him [Trump], because of me, because of everybody. We just don’t like it. It’s a mistake,” said Rep. Jeff Van Drew, R-N.J., referring to the proposal to cut the federal government’s Medicaid expansion match.

Backing off on two policies to slash billions of dollars from Medicaid will likely anger conservatives who have pushed Johnson for big cuts.

“Well — I haven’t ruled it out,” Rep. Chip Roy, R-Texas, posted Tuesday evening on X, formerly Twitter. “It’s necessary to stop robbing from the vulnerable to fund the able-bodied.”

Conservatives have argued that funding for Medicaid expansion means less resources for those in the traditional Medicaid population, mainly children, people with disabilities, some low-income parents and pregnant women.

The conservative American Action Network announced a $7 million ad buy Tuesday targeting 30 congressional districts, related to reducing “waste, fraud and abuse” in health care.

The Trump administration, meanwhile, has floated savings outside of Medicaid spending, including a proposal from his first term that would peg drug prices to prices paid in other countries. So-called most favored nation policies are typically loathed by Republicans, but members said Tuesday it is under discussion.

“It’s one of the proposals that is out there,” said Rep. Earl L. “Buddy” Carter, R-Ga. on Tuesday.

“Everything’s still on the table. The only thing that’s in is [addressing] waste, fraud and abuse,” Carter said. Nothing’s out.”

Meanwhile, Sen. Josh Hawley, R-Mo., who has said he won’t support a reconciliation bill that leads to cuts to Medicaid benefits, introduced legislation that would cap retail lists prices for drugs at the average prices paid by several countries including Canada and the United Kingdom.

SNAP cuts

Meanwhile, the House Agriculture Committee, which is tasked with finding $230 billion in 10-year savings, is having its own problems coming up with the money.

Republicans on that panel met Tuesday morning to hash out SNAP cuts, particularly a controversial proposal to introduce a state-match requirement similar to how Medicaid operates. Van Orden has been a vocal opponent of the idea, which he says would force states like Wisconsin to subsidize other states with much higher overpayment error rates.

“I want to be explicitly clear, I will not vote to have the citizens of the state of Wisconsin pay 10 percent cost share to make up for other people’s just blatantly horrible management,” Van Orden said. “The only thing that’s acceptable to me is to tie it directly to the state error rate. Period.”

He proposed an alternative that would base the state share on SNAP overpayment error rates.

The Agriculture Department reported a nationwide overpayment rate of 10 percent in fiscal year 2023. Van Orden’s proposal would require Wisconsin to pay 4.7 percent of its SNAP costs. Alaska would see the highest rate of nearly 60 percent, according to the Agriculture Department’s 2023 figures.

“We’re not going to pay for Alaska. Not going to happen,” he said.

Still, House Agriculture Chairman Glenn “GT” Thompson, R-Pa., said after the meeting Tuesday that his panel is on track to mark up its portion next week.

“We haven’t really landed on a final proposal. I’d say we’re really close,” Thompson said.

Those two committees, plus Ways and Means, which is working on the tax package, would be the last to put their pieces of the reconciliation package together. Then the Budget Committee would vote on it before it goes to the floor.

Johnson is still eyeing the week of May 19 for a floor vote, though others are skeptical.

“We’ll have the one, big, beautiful bill ready to go,” he told reporters earlier on Tuesday. “We can pass that by Memorial Day.”

David Lerman contributed to this report.

——————————–

Push grows in New York for bills to counter Trump’s agenda post-budget

BY Kate Lisa New York State

PUBLISHED 8:29 PM ET May 07, 2025

New York lawmakers have their sights set on legislation before session ends to counter President Donald Trump’s agenda after the pending budget over $254 billion will not address potentially sweeping federal cuts.

Hochul and legislative leaders have plans to call the Legislature back to Albany later this year if billions of dollars in proposed cuts come into fruition. But lawmakers are focused on several bills, including new immigration, labor and election policies, they said could undercut the effects that Trump’s administration’s policies could have on the state.

“The reality is, we are all under attack,” Assemblywoman Karines Reyes said at an immigration rally in the Capitol last week. “We have seen [U.S. Immigration & Customs Enforcement] kidnap not just people who are undocumented, but citizens. People who have legal, regulated status in this country who are also at risk of being picked up by this rogue agency.”

Reyes, a Bronx Democrat, sponsors legislation known as the New York For All Act, which would bar state police from working with ICE or federal border patrol agents.

Trump’s Department of Justice filed a lawsuit last month challenging New York City’s similar sanctuary city policy.

“I want to remind folks that immigration violations are a civil penalty,” Assemblywoman Jessica González-Rojas told Spectrum News 1. “It is not a criminal activity. These are not criminals. These are people trying to flee violence and make a life here in New York.”

State lawmakers also have their eye on voting rights as Republicans in Washington propose cuts to cybersecurity protections and push voter ID laws, which critics argue disenfranchise voters.

Democrats in Albany want to streamline applying for an absentee ballot, modernize the board of elections and to pass the Democracy in Detention Act to help people vote who are held in pretrial detention facilities, but have not been convicted.

“This is not about creating new rights or new voters, it is about making sure people can lawfully exercise the rights that they already have,” said Assembly Election Committee chair Latrice Walker, who sponsors the measure.

Walker said about 12,000 New Yorkers are detained awaiting trial, but have not been convicted, and can cast a ballot.

“They should be able to exercise the franchise as well and they should be granted that opportunity,” she said. “It should be easy and accessible and available to them.”

And dozens of workers from labor unions across the state rallied Wednesday to demand passage of the EmPIRE Act, which would give workers to tools to defend themselves against wage theft and generate over $100 million per year to help the state Department of Labor.

Lawmakers say it’s needed before Trump and Elon Musk dismantle federal labor protections.

“So many of our labor rights that we have fought for for so long are being gutted and undermined,” said Assemblywoman Claire Valdez, a Queens Democrat. “This will allow the Department of Labor and for workers to fight back and make sure that we stay protected in our workplaces.”

And while U.S. Health and Human Services Secretary Robert F. Kennedy Jr. has pushed state efforts to ban artificial dyes and other additives in processed food — state lawmakers are advocating for three bills to take the matter into their own hands before session ends in June:

• Food Safety and Chemical Disclosure Act will prohibit synthetic dyes in school foods, ban three dangerous chemicals in foods sold statewide, and require companies to disclose evidence that their ingredients are actually safe to eat
• Predatory Marketing Prevention Act will restrict misleading targeted food and beverage marketing aimed at children and adolescents
• Sodium Warning Bill will require clear sodium warning icons on chain restaurant menus to ensure transparency and help consumers make informed choices

Assemblywoman Anna Kelles, who co-sponsors the Food Safety and Chemical Disclosure Act, said RFK’s presentations are disingenuous and focus on a list of food dyes that are no longer used in the food supply.

“That’s a lie,” the assemblywoman said Wednesday. “That is trying to buy all of us so that we’re no longer paying attention and we no longer then try to do it at the state levels.”

Gov. Hochul is scheduled to testify before Congress on June 12 about New York’s immigration policies.