March 7, 2025
A NYS Council member agency leader shared the attached Memo the agency received from SAMHSA yesterday. I just spoke to Chuck Ingolia at the National Council about it. He told me all SAMHSA grantees and contractors received it.
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Democrats say threat of Medicaid cuts not a factor in NY’s budget
Albany Times Union, 3/7/25
ALBANY — The specter of federal cuts to Medicaid is looming over New York’s fiscal future. But state officials are loath to start preparing for a potential funding drop before concrete details are unveiled.
Democratic lawmakers who control New York state government have been dismissive of the need to preemptively plan for possible cuts to the massive Medicaid program that powers health care coverage for the nation’s economically challenged, even as the beleaguered party has used the threat of those cuts as political fodder to stoke anger against Republican members of Congress.
The GOP-controlled House of Representatives voted in February for a sweeping budget blueprint that they argued would tamp down runaway government spending by cutting $1.5 trillion over the next decade — a level of savings that, according to budget experts, would be difficult to achieve without hitting federal health care funding.
“I think every Republican member of Congress who claims to represent New York state should come to St. Mary’s,” Gov. Kathy Hochul said last week during a visit to a pediatric hospital in Queens. “Look in the eyes of these kids, listen to their voices, talk to the parents and then still see if you can go back to Washington and cut this program. I bet you cannot — because otherwise, you’d be the most heartless, callous people who ever walked this Earth.”
At the state Capitol, where negotiations on New York’s $252 billion fiscal plan are set to begin in earnest next week, lawmakers have signaled that they will not at this time be accounting for any potential future federal spending reductions. Assembly Speaker Carl E. Heastie, a Bronx Democrat, told reporters earlier this week that his colleagues will proceed as planned with the state’s annual budget process without considering federal cuts.
The state Department of Health, which oversees New York’s Medicaid program, similarly has not conducted its own analysis of proposed cuts, a spokeswoman for the agency said. The Health Department has not received and does not anticipate any direct information from the federal Centers for Medicaid and Medicare Services regarding how potential cuts would impact enrollment, though the state will conduct a “more concrete evaluation” once federal lawmakers begin to hammer out the finer points of their budget plan.
The threat of cuts targeting Medicaid specifically has not yet been backed by specific policy proposals, which are anticipated in the coming weeks.
But they’re not just idle rhetoric, according to an analysis released Wednesday from the Congressional Budget Office, a federal nonpartisan agency. That review found that achieving the financial targets approved last month by congressional Republicans would be impossible without at least some cuts to Medicaid, Medicare or the Children’s Health Insurance Program.
That’s based on the $880 billion savings target given specifically to the House Energy and Commerce Committee, which oversees Medicaid and Medicare spending.
Political observers note that it remains in Democrats’ best interest to operate as if the financial status quo will hold — at least until more concrete policy proposals are unveiled by Republicans, many of whom are reluctant to slash health care funding for fear of an outcry from constituents who rely on those programs.
“I think if we had to build a budget that is going to anticipate the Republicans … we would never get a budget,” Heastie said during a news conference earlier this week. “These questions should be (directed) to the six Republican members of Congress (who) would have to effectuate any votes, and then they should explain why the Legislature would then have to come back and do cuts. So I’m not conceding anything about us having to backfill a budget that Republicans in Washington are going to slam on us.”
New York’s Medicaid spending consistently ranks among the highest in the country; the state has around 7 million residents — 2.5 million of whom are children — enrolled in the joint state-federal health insurance program.
But Medicaid has also long been riddled with accusations of runaway growth at least partially driven by fraud and abuse. Hochul and her budget officials have in recent years telegraphed their desire to trim several components of New York’s Medicaid program to cut down on fraudulent activity, including a recent, controversial push to overhaul the Consumer Directed Personal Assistance Program, which allows New Yorkers with complex medical needs to hire and pay for their own home care aides.
In lieu of their own analysis, the state Department of Health pointed to a report from a Washington, D.C.-based think tank, the Center for American Progress, which bills itself as a progressive “independent, nonpartisan policy institute.” It has projected 1.8 million New Yorkers could lose health care once the proposed federal budget blueprint is implemented.
“Even without specific legislative text, the scale and scope of the proposed cuts House Republicans passed would drastically impact Medicaid programs nationwide,” Health Department spokeswoman Cadence Acquaviva said. The agency’s mission “is to promote the health and well-being of all New Yorkers. With that objective in mind, we will continue to closely monitor any proposed cuts to Medicaid at the federal level that would devastate lifesaving care for the most vulnerable New Yorkers.”
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Fight continues over opioid settlement funds
03/06/2025 05:11 PM EST, Politico
TENSIONS BREWING: Members of the Opioid Settlement Fund Advisory Board want the state to reverse its decision to omit some of their recommendations regarding how the funds should be allocated.
A Hochul official, last month, said the requests could violate state and federal laws.
The state is at odds with board members over their calls to invest settlement funds in overdose prevention centers and the state Office of Drug User Health.
Opioid Settlement Fund Advisory Board members are warning that the Hochul administration’s resistance to some of their recommendations for the use of settlement funds may result in more overdose deaths, and broaden disparities in minority communities, they wrote in a scathing letter.
“This refusal would suggest that the state does not, in fact, share this goal,” the group wrote in its missive to the state Wednesday, referring to its aim of ending New York’s opioid epidemic. “We are concerned that without bold, targeted action, these disparities will persist.”
The letter comes in response to a Hochul official’s denial of several recommendations surrounding the use of settlement funds. Office of Addiction Services and Supports Commissioner Chinazo Cunningham claims some of the recommendations violate state and federal law. The agency did not immediately respond to requests for comment.
The 23-member advisory board issues an annual report on how it wants the state to invest settlement funds, and this year members issue guidance over $46 million of the $398 million acquired by the state to distribute. The board makes recommendations, but Gov. Kathy Hochul and the state Legislature have final say on how the funds are spent.
The board issued recommendations in November for how the state should use 20 percent of the remaining settlement funds. Last month, Cunningham denied three of the requests.
The rebuked requests included: a call for the governor to issue a public health emergency surrounding the state’s opioid epidemic; a request to funnel funds through the state Department of Health to the Office of Drug User Health; and a repeated request to spend money on opening overdose prevention centers.
Members expressed frustration at the state’s handling of their recommendations at a board meeting last week, when they voted to issue a formal rebuttal imploring the Hochul administration to reconsider its stance.
“The state’s refusal to protect New Yorkers with proven public health strategy will not be understood or justified,” the board wrote.
In a meeting last week, Cunningham claimed her agency cannot carry out the denied recommendations due to state and federal laws that she said put restrictions on how the funds are used.
A long-time point of contention between the Hochul administration and advisory board members is the use of settlement funds for overdose prevention centers, which provide medical oversight and sterilized equipment for individuals using drugs. The board has made that request three years in a row, to no avail. Cunningham maintains that using settlement funds on prevention centers would violate federal law, but board members question the state’s interpretation.
“Existing federal laws were written at the height of the war on drugs before overdose prevention centers existed, they should not serve as a barrier to states moving forward,” the letter said. — Katelyn Cordero
FEDERAL UPDATE
(Politico: Capitol Insider, 3/7/25)
Assuming House Republicans can successfully pass the six-month spending patch they plan to put on the floor next week, GOP senators will need help from at least eight Democrats to get a House-passed stopgap bill through the other chamber. And they could need more if other Republicans join Sen. Rand Paul in opposition.
Right now, Republicans have one Democrat committed: Sen. John Fetterman, who told Lisa on Thursday that he’ll “never” be part of shutting the government down. He said it was “bullshit” that Democrats “would even rattle those sabers.”
Sen. Dick Durbin, the chamber’s No. 2 Democrat, told our colleague Jordain Carney on Thursday that he didn’t believe enough of his members were willing to support a full-year stopgap bill to get it through the Senate. But Democrats have clearly been keeping their options open — Senate Democratic leaders have avoided saying the party would blanket oppose a clean funding patch, and they’ve privately urged members to keep their powder dry.
Senators are listening, for now. Across roughly a dozen interviews, Senate Democrats largely declined to say they’d vote against a clean stopgap. Sen. Tim Kaine said he is “anti-shutdown” but declined to endorse Republicans’ plan. And swing-state Sen. Elissa Slotkin told Mia she was “open to all options” but “I gotta understand what protections we have that money we appropriate is going to be used right for the purposes it was appropriated for.”
The bill may not be totally clean. It’s expected to include measures that would avert cuts in pay for doctors treating Medicare patients and extend eased Medicare telehealth rules, our Ben Leonard reports. Those provisions are expected to be narrow. But any additions could make passing a stopgap harder, given that fiscal conservatives don’t want more spending and Democrats would like to propose additions of their own.
Several Democrats — and some Republicans — want to give negotiators more time to hash out a deal on overall spending levels with top appropriators saying an agreement is imminent. But GOP Sen. Susan Collins, the chamber’s top appropriator, indicated Thursday that House Republicans would not support a shorter stopgap.
“I do not think the House is interested in that,” she told reporters, adding, “I don’t know what’s going to happen next week, but I’m determined to prevent a government shutdown.”
There are eight days left until a potential government shutdown.