Gov. Andrew Cuomo's budget proposal would pin over $1.1 billion in Medicaid growth costs on New York City, the de Blasio administration said Wednesday.

"The consequences are devastating," First Deputy Mayor Dean Fuleihan said.


The city and the state governments are in a war of numbers over how much Medicaid costs will grow next year and who should be responsible for paying for it.

The Cuomo administration is using a new funding formula because of a $6 billion state budget deficit, with Medicaid costs responsible for $4 billion-worth of that shortfall.

One in three people in New York state is on Medicaid, the federal and state program providing health care to low-income individuals. Lately, the costs of the program have skyrocketed — a growth rate of 7 percent just in New York City in the last couple of years.

Cuomo wants to put a stop to it and is pushing municipalities to help him do the job.

The state wants local governments to pay for any growth beyond 3 percent.

And New York City would have to pay for all of the growth if its property taxes grow beyond 2 percent.

The de Blasio administration believes this formula means the city will have to pay a higher projection than originally thought. Officials with the administration say it could have a big impact on the city budget and the services the city provides.

The Cuomo administration says that's not true and puts the number at $221 million.

Cuomo is also reconvening a "Medicaid Redesign Team" to help the state find savings. It's still unknown when this team will have its first meeting.

The state budget is supposed to be ready by April 1, the start of the new fiscal year.

The city and state are diverging on their estimates because they are using different formulas to calculate the Medicaid growth costs. The state argues the city's Medicaid cost growths in the past seven to eight years should actually be at 3 percent or lower, not 7 percent.

The budget deficit is in part because of Medicaid overspending, a jump in enrollment, the rising cost of long-term care, the minimum wage hike, and cuts from the federal government.

Any cuts that stem from increased costs for the city could apply to a majority of Medicaid spending, such as payments to hospitals, nursing homes, and home care providers.

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