Counties Unite to Preserve Affordable Care Act eFMAP Funding

March 21, 2023
The Hon. Charles E. Schumer
Majority Leader
U.S. Senate
The Capitol Building
Washington, DC 20515

Dear Majority Leader Schumer:

On behalf of the 62 counties of the State of New York, thank you for your long-standing support and leadership on behalf of counties and local governments in New York State.

Today we are asking for your help once more.

Governor Kathy Hochul has proposed a State Budget that includes an administrative change that allows the State to permanently intercept all Affordable Care Act (ACA) enhanced Federal Medicaid Assistance Percentage (eFMAP) savings that are currently shared with the counties. We appreciate that you led the effort to secure eFMAP savings for New York State for its Medicaid program, and for our counties because we pay a large share of the program costs. As of today, the state continues to share these federal savings proportionate to the share counties and New York City pay into the program, but the Governor’s budget would end that practice, requiring the 57 counties and New York City to spend $625 million more annually in local tax revenues to backfill the lost federal savings during a period of time where the state is projecting a $36 billion surplus.

We strongly believe that it is Congress’ intent these funds be shared with the counties and New York City on a continuous basis because we pay such a large share of the costs of the state and federal Medicaid program. New York State is unique in its requirement that its counties and New York City pay such a large share of Medicaid costs. In fact, the counties of New York pay more to support general Medicaid program costs than all of the remaining counties in the country combined. We are a primary payor of Medicaid, spending $7.6 billion annually in local tax dollars to support the program, 18 percent of the nonfederal share. There is no doubt on this point. Counties have long used these federal savings to support local services and to reduce pressure on property taxes in our communities. We seek your assistance in clarifying congressional intent for sharing these funds with counties, either through a Resolution or statutory change clarifying beyond any doubt that these ACA eFMAP savings are to be shared with counties proportional to our contribution to the nonfederal Medicaid match.

Senator Schumer, you were there for us during the Great Recession, through the Affordable Care Act, and through COVID and our latest economic recovery. You visit each of our counties every year. You are a champion for innovation and economic development projects that make our communities stronger. These efforts have also made you a champion for local taxpayers to ensure New York remains an affordable place to live and that quality services continue for those most in need. We appreciate your assistance and thank you for your continued leadership in the Senate.

Your partners in government,

Sincerely,

 

Michael E. Zurlo, President (NYS Association of Counties)

Hon. John Becker, President (NYS County Board Chairs Association)

Hon. Andrew C. Joyce, Chair (Albany County Legislature)

Hon. W. Brooke Harris, Chair (Allegany County Legislature)

Hon. Daniel J. Reynolds, Chair (Broome County Legislature)

Hon. Howard V. VanRensselaer (Cattaraugus County Legislature)

Hon. David S. Gould, Chair (Cayuga County Legislature)

Hon. Pierre E. Chagnon, Chair (Chautauqua County Legislature)

Hon. Mark Margeson, Chair (Chemung County Legislature)

Hon. Goerge J. Seneck, Chair (Chenango County Legislature)

Hon. Mark R. Henry, Chair (Clinton County Legislature)

Hon. Matt Murell, Chair (Columbia County Supervisors)

Hon. Kevin J. Fitch, Chair (Cortland County Legislature)

Hon. Tina B. Mole, Chair (Delaware County Supervisors)

Hon. A. Gregg Pulver, Chair (Dutchess County Legislature)

Hon. April N.M. Baskin, Chair (Erie County Legislature)

Hon. Shaun Gillilland, Chair (Essex County Supervisors)

Hon. Edward J. Lockwood, Chair (Franklin County Legislature)

Hon. Scott M. Horton, Chair (Fulton County Supervisors)

Hon. Rochelle M. Stein, Chair (Genesee County Legislature)

Hon. Patrick S. Linger, Chair (Greene County Legislature)

Hon. Brian Wells, Chair (Hamilton County Supervisors)

Hon. Vincent J. Bono, Chair (Herkimer County Legislature)

Hon. William W. Johnson, Chair (Jefferson County Legislature)

Hon. Larry Dolhof, Chair (Lewis County Legislature)

Hon. David L. LeFeber, Chair (Livingston County Supervisors)

Hon. Sabrina LaMar, Chair (Monroe County Legislature)

Hon. Robert A. Purtell, Chair (Montgomery County Legislature)

Hon. Richard J. Nicolello, Presiding Officer (Nassau County Legislature)

Hon. Rebecca J. Wydysh, Chair (Niagara County Legislature)

Hon. Gerald J. Fiorini, Chair (Oneida County Legislature)

Hon. James J. Rowley, Chair (Onondaga County Legislature)

Hon. Todd D. Cambell, Chair (Ontario County Supervisors)

Hon. Katherine E. Bonelli, Chair (Orange County Legislature)

Hon. Lynne M. Johnson, Chair (Orleans County Legislature)

Hon. James Weatherup, Chair (Oswego County Legislature)

Hon. David T. Bliss, Chair (Otsego County Representatives)

Hon. Paul E. Jonke, Chair (Putnam County Legislature)

Hon. Kelly Hoffman, Chair (Rensselaer County Legislature)

Hon. Jay Hood, Jr., Chair (Rockland County Legislature)

Hon. Theodore T. Kusnierz, Jr., Chair (Saratoga County Supervisors)

Hon. Anthony Jasenski, Chair (Schenectady County Legislature)

Hon. William Federice, Chair (Schoharie County Supervisors)

Hon. Carl H. Blowers, Chair (Schuyler County Legislature)

Hon. Michael Enslow, Chair (Seneca County Supervisors)

Hon. David W. Forsythe, Chair (St. Lawrence County Legislature)

Hon. Scott J. VanEtten, Chair (Steuben County Legislature)

Hon. Kevin J. McCaffrey, Presiding Officer (Suffolk County Legislature)

Hon. Robert A. Doherty, Chair (Sullivan County Legislature)

Hon. Martha C. Sauerbrey, Chair (Tioga County Legislature)

Hon. Shawna Black, Chair (Tompkins County Legislature)

Hon. Tracey Bartels, Chair (Ulster County Legislature)

Hon. Kevin B. Geraghty, Chair (Warren County Supervisors)

Hon. Robert A. Henke, Chair (Washington County Supervisors)

Hon. Philip Eygnor, Chair (Wayne County Supervisors)

Hon. Catherine A. Borgia, Chair (Westchester County Legislature)

Hon. Rebecca Ryan, Chair (Wyoming County Supervisors)

Hon. Leslie Church, Chair (Yates County Legislature)