In 2020, the biggest headache facing Albany will be Medicaid, the state-run health plan that covers more than 6 million lower-income and disabled New Yorkers. As revealed last month, Medicaid is running 16 percent over budget—opening a $4 billion deficit in the state's current financial plan and contributing disproportionately to a $6.1 billion gap for the fiscal year that begins April 1.
This latest crisis is entirely self-inflicted by Governor Andrew Cuomo and the state legislature. Cuomo blames surging health-care costs—and they are indeed rising at unsustainable rates—but he should take a closer look at his own policy choices. His failure to acknowledge or address costs is what gave birth to the deficit. This pattern culminated with his administration's unannounced decision to delay $1.7 billion in payments from late March to early April 2019—shifting expenses to the next fiscal year and throwing the state's budget out of balance before it even passed.