Proposed changes in the state's Medicaid formula set off a cascade of questions in the State Capitol, where lawmakers have just 10 days to come up with an on-time state budget. Zack Fink filed the following report.

If the Affordable Care Act is repealed and what's known as the Faso-Collins amendment stays intact, New York State could be dealt a new, unanticipated cost: a $2.3 billion gap in Medicaid funding.

"I have a certain amount of skepticism," said state Senate Majority Leader John Flanagan. "I don't want to see New York adversely affected. And I would go back to some basic questions, if this happens. Are counties going to reduce their sales tax or their property tax or are they just going to continue to spend at different rates?"

The reaction from Democrats was predictably more severe, with Assembly Speaker Carl Heastie warning of dire consequences.

"This will really put a strain on the state budget," Heastie said. "There are a lot of things connected to the counties paying their share of Medicaid, and just shifting it to the state is just not as simple as Congressman Collins would like to believe."

Some Republican lawmakers representing upstate communities applaud the move to shift more Medicaid costs to the state.

"We have advocated for the state takeover of the Medicaid costs of the counties. That just drives up the costs to local taxpayers," said Assembly Minority Leader Brian Kolb.

Five years ago, Governor Andrew Cuomo announced with much fanfare that the state would start picking up the counties share of the growth in Medicaid. According to the governor's office, counties currently pay only 13 percent of the Medicaid burden, down from 25 percent.

"It's the same taxpayer at the end of the day," Flanagan said. "We have done a lot in the state of New York to alleviate the burden on county property tax payers shifting a lot of the burden to the state of New York."

All of this is, of course, hypothetical since no bill has passed either house of Congress. But state leaders say they are prepared to come back mid-year and open up the budget for changes, if necessary.