The day before Americans took off to celebrate the July 4th weekend, the governor’s office owned that Gov. Cuomo supported hydrofracking in New York State — under certain conditions. Hydrofracking or, simply, fracking is short for hydraulic fracturing, a drilling technique that allows natural gas companies to get at long-sequestered sources of gas. The horizontal hydrofracking technique that the gas industry wants to use in New York involves drilling deep into the ground and turning the drill sideways into shale rock formations. By creating cracks in the shale, this technique releases gas, and drilling companies pump tanks of chemical-laden water into the holes in order to keep the cracks open and allow gas to bubble up to the surface.
In Pennsylvania, Colorado and other states where fracking has been used, communities near drilling sites have found their water contaminated with methane and other noxious gases. The Environmental Protection Agency is conducting a study on the connection between fracking and such environmental degradation. Gas companies claim there is none.
New York has waited longer than most states to permit gas companies to start mining its gas resources. Gov. Cuomo says he believes fracking can be done safely and that New York’s approach will be a balanced one. The Department of Environmental Conservation will release to the public this week a 900-page draft document detailing the potential environmental impacts of fracking. The agency’s decision to allow fracking in some areas of the states “was based on rigorous testing, research, facts and science, not politics or ideology on the issue,” Gov. Cuomo said last week. The members of the High-Volume Hydraulic Fracturing Advisory Panel, appointed by DEC Commissioner Joe Martens could also be said to be a balanced group: It includes business leaders, former politicians, industry representatives and environmentalists.
At first glance, it seems that the panel is weighted towards environmentalists: seven of the panel’s 13 members are affiliated with environmental groups that include the National Resources Defense Council, the Waterkeeper Alliance, the Environmental Defense Fund, and President Clinton’s White House Council on Environmental Quality. On closer inspection, however, the panel is weighted not so much towards environmental advocates as towards people committed, like Cuomo, to a balanced approach to fracking.
On fracking, environmentalists divide into two camps. Larger groups that work on a national or international level (Greenpeace, NRDC, Sierra Club) support increased natural gas production although, like Cuomo, they want a close watch kept on gas companies and strong regulations governing the process. These groups see natural gas as a low-carbon alternative to coal. It is often referred to as a “bridge fuel” that will help slow climate change. Smaller groups voicing environmental concerns about hydrofracking, like the Coalition to Protect New York, tend to oppose it completely. They are not ready to sacrifice their communities’ air and water quality or to change inalterably the landscapes they live in for an energy solution that even its supporters admit is only incrementally better than coal.
The environmentalists on the DEC advisory board come from the first camp. NRDC, for instance, has been a strong national ally to local anti-fracking groups, but its institutional outlook on fracking is that “Natural gas has an important role to play in America’s energy future.” Like Cuomo, NRDC is looking for balance on natural gas policy. The New York League of Conservation Voters also believes “that natural gas will play a critical role in the eventual transition to a clean energy future.” Environmental Advocates of New York is the only group native to New York that has been enlisted in the advisory board and the only group that echoes the fervor with which local opponents to fracking have been fighting against the practice.
Fracking opponents now have three angles from which they are fighting back against gas companies. As the state government moves to open up land to fracking, it will open up a 60 day comment period: In the last round of study, the comment period attracted more than 10,000 contributions. Local groups have also despaired of finding a sympathetic ear in Albany or in Washington and have been working to institute fracking bans town by town, city by city, county by county. And Attorney General Eric Schneiderman is also taking seriously the possibility that, unlike national environmental groups, natural gas companies are not interested in balance. He’s pursuing a case against the federal government that digs into the potential health and safety impacts of natural gas. Gov. Cuomo has said he would not support fracking unless he believed it could be done safely. He’s apparently convinced; Schneiderman, it seems, still has questions about whether a balanced approach is possible.
In the past six months, Gov. Andrew Cuomo has led the state through passing a budget on time, “redesigning” Medicaid, accepting ethics reform, renewing rent regulations, agreeing to a property tax cap and mandate relief, and doubling the number of people in this country who live in a place where same-sex couples can wed. It seems that every political entity in New York State has bowed to the governor’s wishes at some point: Even Mayor Bloomberg, who normally gets what he wants, couldn’t convince Albany that the “last in, first out” teacher hiring policy needed to go.
Over the summer, members of Cuomo’s cabinet will fan out to communities across the state to tout their boss’s accomplishments. But State Room is one step ahead of them! Here’s our list of Cuomo’s top four accomplishments in his first six months.
Convincing New Yorkers He’ll Do What He Promises
Every major initiative that Andrew Cuomo has started on, he’s finished. For months, he focused on the budget, and against all historical odds, it passed on time. The Post’s Fred Dicker criticized him for letting an early opportunity to pass ethics reform — the fall of State Senator Carl Kruger — float on by. But Cuomo passed ethics reforms in his own sweet time.
Cuomo has proven skilled at getting people on board and giving them reasons to work with him. But he’s also made promises that have a decent chance of passing the Republican Senate, the sticking point for any progressive policy he might offer. But instead of fighting with Skelos and his caucus, Cuomo has focused on legislation like the property tax cap that Republicans wanted anyway and that he can argue are good for citizens in a down economy. He also has a knack for avoiding public discussion and debate of knotty problems (*cough* Medicaid *cough*…also mandate relief) by kicking them over to special commissions.
Showed He’s Not Afraid to Barbecue the Democratic Party’s Sacred Cows
Andrew Cuomo has not been a friend to unions. The teachers’ unions got very little, if anything, they wanted out of the budget process. Public employees unions are facing lay-offs and benefit cuts. He’s embraced ideas normally associated with Republicans: the property tax cap, pension reform, streamlining government and mandate relief are all policies that argue that government should be doing less (or at least spending less money).
But in a national field of governors that includes Scott Walker and Chris Christie, who aren’t just Republican governors but blood-red conservatives, even a Democrat who’s been called a Rockefeller Republican can still be talked about as a leading contender in the 2016 Democratic presidential primary.
Showed He’s not Afraid to Champion Progressive Social Policy
Same-sex marriage didn’t have to pass. It did.
Escaped the Shadows of Spitzer and Cuomo, Sr.
Andrew Cuomo has accomplished at least as much in his first six months as Spitzer did the entire time he was in office. And people still like him! Chatter comparing the current Governor Cuomo to the first one has died down, and our current governor has formed his own identity as a pragmatic get-’er-done leader. The comparison won’t end for good until Andrew Cuomo’s had a chance to get on a campaign plane to New Hampshire (and actually does it), but as far as Albany’s concerned, he’s made his own mark.
When Andrew Cuomo advocates for smaller government, he does not mean, as conservatives often do, that the government should do less. He means that the government should be smaller — fewer agencies, fewer employees, fewer entities whose jurisdictions and purposes overlap. As governor, Cuomo has talked most about streamlining the state government, but he’s also interested in consolidating local government entities, of which, he’s pointed out in the past, New York has more than 10,000. More efficiency on either level gets New York to the same place. Smaller government, state or local, means a smaller tax burden.
In 2007, as attorney general, Cuomo shepherded through Albany a piece of legislation that made it easier for New York villages to vote themselves out of existence. New York, he said at the time, had the highest local tax burden in the country, “because we’re paying for all those local governments.” This year, Cuomo’s first budget as governor included $35 million for Citizen Empowerment Tax Credits and Citizen Reorganization Empowerment Grants, two tools to incentivize local governments to downsize government. The tax credits benefit only communities that consolidate governments, but both policies aim to save taxpayers money.
“The goal here is to decrease property taxes and to make sure that governmental entites are efficient and that people try to work together,” Dede Scozzafava, the deputy secretary of state for state and local government, told State Room.
In New York, every acre is a town or a city, but in some places, where one agglomeration of people contains both a town and city, the dividing line can seem arbitrary. A village doesn’t exist on its own but overlays a town. As a rule, villages came into existence in rural towns where a small knot of more concentrated houses decided to join together to provide municipal services, like water delivery. Today, they might also be suburban areas. Some villages are tiny, with fewer than 400 people; some have populations of more than 15,000.
Local governments do overlap in ways that don’t always make sense. In Ithaca, NY, for instance, where the town and city have studied consolidation, the town hall is located within the city’s limits. But streamlining government and, in particular, consolidating local government entities means navigating intergovernmental territorial disputes and strongly held notions of community identity.
“It’s an extremely emotional issue,” said Jason Molino, the city manager of the City of Batavia, which has been working since 2007 towards a vote on consolidating with the Town of Batavia. “When you do public hearings, people come out who are very much for it or very much against it.”
Dissolving even a tiny village can take years, and there is not a clear procedure for merging larger entities like towns and cities. Local governments find that citizens have little trouble accepting partnerships on some government functions, like wastewater treatment, but may object to combining forces on others, like community policing. And despite the emotions that these discussions raise, taxpayers generally don’t receive windfall savings.
“When you look at the overlapping levels of government, the reflex is to say, ‘Oh we’re wasting so much money!’” said Kent Gardner, the president and chief economist at the Center for Governmental Research, a New York consulting firm that’s worked with more than 40 municipalities on reorganization and consolidation. “Our experience suggests that the cost savings are often quite modest.”
While property taxes may be high, the cost of local government makes up only a piece of the tax burden. School district taxes take up a huge percentage, for instance. “Maybe you’re down to 25 percent of your tax bill going to the general purpose government below the county level,” Gardner said. “Suppose you can save 25 percent. If you can save 25 percent of 25 percent, you’re down in the 6 percent level of savings on your total property taxes.” In Johnson City, one village that voted against dissolution, village and town services amounted to about a third of the local property tax burden. Taxpayers would have saved 29.2 percent of that portion. For individual taxpayers, that would have meant yearly savings in the range of $231.19 on a house with a $50,000 market value to $927.60 for a house with a $200,000 market value — not an insignificant sum, but not enough to revolutionize a household’s yearly budget.
In recent years, the state has spent more than $2 million in funding grants for more than 30 studies of different villages, towns, and cities looking to reorganize. All but a handful of the grants have gone to study village dissolutions or town-village consolidations, essentially the same projects. So far, four of the villages studied have voted to dissolve. (In the past four years, another four which aren’t on the State Department list of reorganization grantees have voted to dissolve.)
“You can’t judge the not successful votes as failures,” said Scozzafava. She pointed out that going through the process of studying consolidation often leads to ideas for collaborations, cost-savings, and efficiencies, even if the relevant government entities remain in tact.
The Center for Governmental Research consultants have found that to be true, too. “In our experience, although they rarely pull the trigger on the big change, they almost always behave differently after the study than before,” Gardner said.
But those improvements aren’t necessarily measured in property tax savings, in part because local governments that operate on top of or right next to each other have often figured out how to work together and save money. In Ithaca, a consolidation study committee found that it was possible that town and city officials had already realized through informal agreements the majority of the savings consolidation could offer.
In Batavia, where the city and town have been working since 2007 towards a vote on consolidation, the two governments work together on programs like wastewater treatment and code enforcement.
“We actually maintain their one or two traffic lights,” said Molino, the Batavia city manager. Consolidation, Molino said, would take cooperation to the next level. CGR found that the town and the city would save just under a million if they combined, but the real advantage could be less fiscally tangible. “You’re starting to see economic development, but it’s right on the city-town line,” Molino said. Consolidation could give the area an advantage when making economic development decisions, he said.
But any village, town, or city that’s interested in the benefits of cooperation, fiscal or not, has to be able to look beyond the territory and the loss of identity to what a better system might look like. Reorganization is a headache not worth chasing without the right attitude, Molino tells other government officials.
“If you can’t accept the fact that your name or your color can’t be on the truck that’s going to service you from now on, don’t waste your time on it,” he said.
On Friday, Gov. Andrew Cuomo, Majority Leader Dean Skelos, and Speaker Sheldon Silver announced a deal on ethics reforms, yet another of Cuomo’s legislative priorities. The third stab at ethics reform during the tenure of as many governors, this one has more to like in it than its immediate predecessors.
The deal that Albany’s leaders outlined requires substantially more disclosure from both elected officials and the business interests that petition them. Although officials had to disclosure the level of income they receive from jobs outside their public office, that information was not made public. Now it will be, and the ranges that officials use to detail their income from each source will be smaller.
Officials will also disclose the names of their clients or customers. This type of disclosure allows the public to hold officials accountable about decisions that affect the interests of the people who pay their bills. It’s an important, but less common disclosure requirement: The last time the Center for Public Integrity counted, 21 other states made similar provisions. (Nine go further, requiring the level of income garnered from each client be disclosed.)
The deal also extends lobbying disclosure to executive branch agencies and redefines lobbying to include work on the introduction of legislations, not just legislation already in play.
But on enforcement, the deal does less than it might. The new deal replaces with the existing Commission on Public Integrity with a Joint Commission on Public Ethics, but leaves in place the Legislative Ethics Commission, which means Albany will still have two ethics bodies that can find ways to quarrel with each other. Friday’s release said that the new commission will have “enforcement powers to investigate violations.” But investigation is not the same as enforcement. The new commission will hand over findings of investigations of legislators to the Legislative Ethics Commission, which has rarely inflicted even a hand-slap on the legislators it oversees. The deal does increase the penalties for misfiling financial disclosure forms and for violating conflict of interest provisions, but by how much is not yet clear.
But this deal does not guarantee that elected officials in Albany will change their behavior. No legislative agreement can accomplish that. If the goal, in the end, is to keep legislators and elected officials in line, it does help to insist on a stronger ethics infrastructure. If the new structure is to be effective, it will need to be well funded. Good investigations cost money. It also matters who’s chosen to head the commission — a watchdog who will resist political pressures or a go-along-get-along appointee? These are the sort of details that make less dramatic headlines. Cuomo will be able to say, when he needs to, that he brought ethics reform to Albany. But will that be enough for him? Or will he continue to work, when there’s less attention to be had, to shift the capital’s cultural away from scandal? If it’s the latter, Albany might have a chance to change.
Up in Albany, the end of the session is looming: Just four weeks remain before legislators leave for their summer break. Gov. Cuomo and legislative leaders have been hashing over the state’s next big step, now that the budget has passed. Three issues in particular have been getting attention: same-sex marriage, a property-tax cap, and redistricting reform. The final shape of each of these initiatives is still in flux, as is legislators’ support. Here’s the state of play on each issue.
After announcing he’d prioritize a bill legalizing same-sex marriage, Gov. Cuomo soon added that he’d push for the bill to come to a vote in the legislature only if it had enough support to pass. New York’s last same-sex marriage bill died in the Senate in 2009, and the Senate could be the killing ground for this one as well. The governor has been putting his time and effort into rallying individual legislators on this one, but its success hinges on the votes of just a few Albany pols.
New Yorkers support gay marriage, but just barely. Polls have support creeping just over 50%. But a recent Siena survey found that those who are against same-sex marriage are more willing to punish their representatives for taking the opposite view: 60% of them would be “less likely to vote for that legislator,” according to the Siena Research Institute. Only 49% of same-sex marriage supporters took the same stance.
Of these three policies, the property-tax cap has the greatest chance of making it into law at this point. The goal of the cap is to tamp down the total tax burden on New Yorkers by limiting the amount local governments can increase property taxes each year.
Gov. Cuomo promised during his campaign to limit local taxes, and he submitted his version of a property-tax cap bill to the Senate back in January. The bill would keep local governments from increasing property taxes by more than 2% each year. After the Senate passed the bill, the idea languished in Albany for months, but in recent weeks, Senate Majority Leader Dean Skelos has said he’d be open to modifying the version his house already passed and Speaker Sheldon Silver has been floating ways to tweak the bill.
Ideas that are floating around include exceptions for pensions, health care, fuel costs, and new constructions. At this point, it’s likely that some sort of property-tax cap will get through; the question is what sort of exceptions might make it into law.
Finding a way to take away legislators’ power over their own electoral fate was always a long shot, and while talk about redistricting (and ethics) reform is still buzzing in the background of New York politics, there’s not a clear path towards a bill that would pass either house. While ex-New York mayor Ed Koch is still saying redistricting reform could pass if Cuomo wills it to, other reform advocates, like Bill Samuels of the New Roosevelt Initiative have been less optimistic.
It’s amazing how much you can accomplish in politics just by doing what you said you were going to do. Paterson, Spitzer, Pataki — all of their poll numbers took a huge hit during budget seasons. Gov. Andrew Cuomo corralled the state legislature into passing the budget on time, and his poll numbers have never been better.
The media has turned gung-ho about Cuomo, too. Last week the Daily News swooned over his deal with the police union: “Hail to Cuomo for demonstrating that productive, taxpayer-friendly labor negotiations really are possible in Albany,” the paper wrote. Back in October of 2010, Chris Smith wrote cluck-cluckingly in New York magazine about Cuomo’s play-it-safe campaign: “Cuomo is missing out on the opportunity to address the pervasive anxiety in New York’s electorate and make a principled emotional connection with the politically disaffected.” In March of 2011, he wrote that “The budget story Cuomo tells…is skillfully crafted, entertainingly performed, and irresistibly compelling” and ceded to Cuomo “a brilliantly played first 100 days in office.” And last week, State Room’s editor pointed out that this reporter was falling into the same trap — that maybe before she said Cuomo had made a smart move by hiring Jason Helgerson, it might be prudent to point out that “Cuomo is being called smart/savvy a lot lately.”
There’s an underbelly to all this praise, though, at least as far as the media is concerned. At the beginning of Cuomo’s administration, much was made of his tight-lipped press shop, and it’s still possible, particularly on big stories that don’t jive with the story Cuomo is writing for himself, to find sentences indicating that calls to Albany got little response. Even Matt Bai, writing in The New York Times Magazine about Cuomo’s father, was rebuffed: “In the weeks after I visited Mario,” Bai wrote, “I tried repeatedly to reach the current governor to talk about his father. He declined to return the call.”
But Andrew Cuomo is, after all, a politician. He has to screw up sometime, right? And when he does, the sting of all those unreturned calls and ignored emails could push the press to be less than kind. The fall of popular politicians is just as good a story arc as their rise.
But what if Cuomo endures? There have been wildly popular governors in this country before — just not in recent New York State history. The best way for Cuomo to keep on riding his wave of popularity is to continue making promises he can actually keep. If he’s lucky, the economy’s recovery will start speeding up, and he can take credit for it.
The most important thing, though, is that he knows when to quit. With politicians, popularity never lasts forever. Just ask Mike Bloomberg. His poll numbers were just as good as Cuomo’s, until this last term. In politics, popularity never lasts forever.
Getting the budget passed on time has earned Andrew Cuomo a round of hosannas for his shrewd political maneuvering. But one of the smartest moves that Cuomo has made since becoming governor may have been hiring Jason Helgerson as his Medicaid director — if, for no other reason, than to hand over responsibility for the details of health care reform. Throughout the budget process, Cuomo got away with promising that the Medicaid Redesign Team, headed by Helgerson, was doing the most important work of anyone in the state — figuring out how to cut almost $3 billion from the Medicaid budget. This promise sounded impressive. It gave Cuomo an excuse to avoid talking about the details of the cuts or the technicalities of Medicaid. It also kept him from needing to sully otherwise stirring speeches with words like “utilization.”
Helgerson, on the other hand, talks about “utilization” a lot. He also tends to use words like “eligibility.” He learned, too, in the past few months that “care management” stings less than “managed care.”
Before Cuomo hired him, Helgerson was working on Medicaid in Wisconsin, his home state, and his first few months in New York have been intense. “I’m a survivor of the New York State budget,” he said last week, at an event hosted by the Center for New York City Affairs. He had not been aware, he said, that meetings might be scheduled at 4 a.m., but in the past months, he had attended more than one at that hour. With the budget over, “my life is going to be a little bit more sane,” he said.
Cutting the Medicaid budget, however, marked only the first step in reining in the largest Medicaid system in the country in total dollars, with the second highest per enrollee spending rates. Helgerson now has to keep tabs on costs, as they roll in over the year, and find places to cut if spending threatens to exceed the limits set in March’s budget.
The Medicaid Redesign Team purported to provide (and will continue to offer) a forum in which health care stakeholders could sit around a table together and decide on the best ways to cut Medicaid. But although the team was quick to pass the package of recommendations put before it back in February, not everyone agrees on how to improve the system.
“I guess the number one worry is that we not go back on coverage and not go back on long-term care,” said Robert Doar, New York City’s commissioner for human resources administration, at the CNYCA event. Doar’s department oversees public health programs in the city, and unlike Helgerson, he has been working in New York politics for awhile: he was the deputy commissioner and then the commission of the Office of Temporary and Disability Assistance at the state level. He has had his current job since 2007.
At the beginning of his remarks, Doar welcomed Helgerson to the state and promised, “New York is not as tough a place as they say. We want you to succeed.” Doar and Helgerson were two of five panelists that evening, and Doar was the audience favorite, the one to elicit happy laughter and murmurs of agreements. And although he was careful to say that the city wanted to work with the state to make Medicaid succeed, Doar quietly tried to insert questions and uncertainties into the picture that Helgerson had laid out of the Medicaid Redesign Team’s report and the advances the budget had made.
Helgerson had said, for instance, that the redesign team recommendations and the budget were moving the state towards more care management. He chose that term over “managed care” to indicate that he meant that the government was trying to ensure more rational, more streamlined, and therefore better health care, not as in “managed care,” trying to take away patients’ power to make their own health care choices.
While Helgerson took pains to distinguish those two ideas, Doar tried to conflate them.
“Managed care or care management — that sounds good,” he said. “I want to make sure it is good.”
“Managed care plans can cost more than personal cost plans,” he said.
Although Doar had welcomed Helgerson, he was also defending his territory. New York City, through state and federal health care reforms, is already losing control over one of the key aspects of Medicaid–enrollment decisions. And the city is also defending in court its decisions to enroll some Medicaid patients in home care programs.
“We are a leader in the much maligned community-based long-term care,” Doar noted, and when asked about the lawsuit, he argued that, while the city’s Medicaid program might not be perfect, the U.S. Attorney’s office was using an unnecessarily strong tool to crack down on it.
But New York City is not the biggest issue that Helgerson faces going forward. One issue that the budget this year did not address was “spousal refusal,” which allows a sick person’s partner to remove his or her income from calculations of the funds available to pay for health care. It’s an option that’s available in very few states and used most readily in New York and Florida. It also allows more middle class couples, who do have substantial resources available, to preserve their funds and tap into a program designed to help the least wealthy.
“I had one woman tell me that spousal refusal was middle class people’s portion of Medicaid,” said Helgerson, who still seemed a bit floored by the audacity of that statement.
The good news for Andrew Cuomo is that, with the budget done, he doesn’t have to talk about fixing health care anymore. That’s Helgerson’s job, and he still has a lot to do.
NY Uprising, the good government group founded by former mayor Ed Koch, keeps an official list of “enemies of reform.” Throughout 2010, Assembly Speaker Sheldon Silver was on it, for his refusal to promise change on issues like ethics reform. But now, based on his support for an independent redistricting committee, Silver may be coming off the enemies list.
“I’m going to take him down,” Koch told State Room on Tuesday. “He’s introduced the governor’s legislation!”
Of the reform issues that the former mayor has been pushing since the outset of the 2010 election season, the first one to face political reckoning is redistricting reform. In mid-February, Gov. Andrew Cuomo unveiled his plan for an independent redistricting commission, which would take the responsibility for drawing district lines out of the hands of self-interested legislators. Silver sponsored the Assembly’s version of the bill, and last week, he began more openly canvassing for co-sponsors. Koch will be in Albany tomorrow, working to push the bill into law.
“I believe we’re on the cusp of victory,” he said. “As a result of our efforts last year, including getting candidate — now governor — Andrew Cuomo on board, we have a huge chance of prevailing.”
While Cuomo has embraced this sort of good government pushes, throughout the campaign season, Silver resolutely stayed mum, earning him his “enemy status.” (Nothing personal, of course, says Koch. “Shelly and I go back 40 years,” Koch said. “We’re very good friends. I want to be able to say: Shelly Silver is my leader.”)
Senate Majority Leader Dean Skelos did sign the NY Uprising pledge promising to support their reforms. But in recent weeks, he hasn’t exactly jumped to support the governor’s plan, which would give rise to a commission that would not include legislators, their aides, lobbyists, or other too-interested parties.
“There’s a whole list of prohibitions,” said Koch, who’s scheduled to meet with Skelos and Silver, among others, tomorrow. “Those are what’s intended to keep the ultimate committee one we can all be proud of.”
At one point in New York State’s history, the state was apportioned into districts according to something resembling common sense. The map below, from the archives of the New York Public Library, represents the state’s senatorial districts in the mid-1800s:
At the time, there were only eight districts, but each one consisted of particular counties. The first district, for instance, contained the most heavily populated areas: New York, Kings, and Richmond (that is, Staten Island). The second district contained the area around that — the two Long Island counties of Queens and Suffolk, and counties directly north of the city, like Westchester, Rockland, and Orange.
Over time, however, those lines have been distorted according to the political whims of those in power at the time. This map traces the borders of state senate districts, as they were drawn in 2002, after the last census:
Instead of each district containing multiple counties, each county might contain multiple districts.
There’s no guarantee, of course, that the independent commission will change this situation and create rational districts out of the multi-limbed beasts that currently dot the state. As Koch says, the success of his push for reform will only be clear once an independent commission does its work.
“You’ll see the lines,” he said. “Are the districts compact? Or do you see salamanders running around?”
Wherever he goes to talk up his plan to tame the state’s budget, Gov. Andrew Cuomo has been telling New Yorkers how essential the work of his Medicaid Redesign Team is.
That’s what the governor’s budget director, Robert Megna, assured the task force’s members, anyway, two and a half hours into their second meeting, which was held Wednesday in New York City.
“I was just with the governor this morning on Long Island,” said Megna, “and I can tell you, traveling around the state with him, in every presentation he does, he talks about how important the work of the task force is and how vital it’s going to be in getting the budget done this year.”
The work of the task force is not glamorous, even for government work. Although the meeting was scheduled to last for four hours, ending at 2:30 p.m., there would be no lunch, as co-chair Dennis Rivera announced at the start of the meeting. The room was small, hot, and paneled in a neutral taupe. There was so little space between the horseshoe of tables at which the task force members sat and the wall that when State Sen. Tom Duane arrived late, he chose to drag his assigned table into the middle of the room and then drag it back into place, rather than squish behind his colleagues in order to take his seat.
The task force has 27 members, drawn from state and local agencies, the state Senate and Assembly, and organizations representing patients, nurses, doctors, hospitals, and unionized health care workers. Megna is an ex-officio member, as well. The task force has an executive director, Jason Helgerson, who is also the state’s Medicaid Director, and a staff, some members of which were on hand to run through detailed slide shows for the panel. Others, according to Helgerson, were back in Albany, frantically crunching numbers to come up with cost-saving figures for the hundreds of proposals the task force has already gathered.
These are the people onto whom Gov. Cuomo has shifted responsibility for coming up with the $2.85 billion cuts to Medicaid that he says are necessary to make the state’s budget make sense going forward. They are mostly men, and almost all white. They do not have very much time to finish the task they have been assigned.
The team first met about a month ago, and since then has been holding public hearings (five in total) across the state to solicit ideas for curbing Medicaid costs. It has also set up a Web site, another forum in which constituents can submit suggestions for change. Helgerson and the staff have also been meeting in 30-minute increments with interested stakeholder groups. (There are many interested stakeholder groups.) Less than three weeks from now, the team is scheduled to take its final vote on its recommendations to the governor about this year’s budget.
So far, the task force has collected more than 600 ideas from hearings and an additional 2,000 through the Web site, according to Helgerson. Many people have the same ideas, of course; when winnowed down to unique ideas, the suggestions numbered 274, as of the meeting. Helgerson suggested that they stop accepting ideas by this coming Friday, February 11th. He said he had been encouraging stakeholder groups who had not gotten a meeting yet to submit their ideas via the Web. He also encouraged the team members to submit any ideas they themselves had to the committee by Friday, a deadline they were not entirely pleased with.
As far as actual cuts, approximately two out of every five ideas submitted focused on “recalibrating” benefits and reimbursement rates, Helgerson reported. “Recalibrate” really means cut: the task force was given a list of the ideas, as collated by the staff, and the descriptions of the proposals in this category were studded with words like “reduce,” “limit,” and “eliminate.” Other types of proposals dealt with regulatory and malpractice reform, empowering patients, enrolling more Medicaid members in managed care, and cracking down on fraud and abuse.
Next week, the team will have an opportunity to evaluate in more detail a select group of the proposals: Helgerson initially suggested the number would be about 30, but task force members — in particular, Assemblyman Richard Gottfried, who chairs the Assembly Committee on Health — were concerned that they were only being asked to weigh in on a limited number of proposals, likely the ones that would save the most money the most quickly.
Ed Matthews, who heads the New York City chapter of United Cerebral Palsy, echoed Gottfried’s concerns and said he had hoped that the task force would be working from a “basic agreement about what’s important…that we could agree on some way to look at these things so some team members are not saying this is number one because it saves the most money.”
That, in the end, is the crux of the problem that the Medicaid Redesign Team faces. The governor asked them, in two short months, to come up not just with places to cut Medicaid, but places to cut Medicaid based on inefficiencies in the system. He asked them to make suggestions that would simultaneously save money and improve Medicaid. But, of course, the inefficiencies that drive the state’s Medicaid costs up are not confined to this one program. As Dr. Jeffrey Sachs, who co-chairs the JFK Jr. Institute for Work Education, said after just a few minutes of discussion, “We’re not talking about Medicaid; we’re talking about the health care system.”
But, at least in public, the redesign team is not doing all that much talking at all. Most of Wednesday’s meeting was taken up by updates from Helgerson and power point presentations by the team’s staff about the “Key/Complex Issues” they faced: problems like managing long-term care, limiting physicians’ ability to prescribe name-brand drugs, and incorporating “pay for performance” measures into the system. The task force discussed these complex issues for about an hour in total, and one member commented that the discussion felt “disjointed.” Members echoed and supported each others’ statements, but they rarely spoke to one another or debated any of the issues raised.
One assumes that won’t be true in two weeks, when, on Feb. 24, the redesign team is will meet in Albany to consider for the first time the staff list of recommendations, in preparation for their final vote, on March 1, on the report they will present to the governor. The Feb. 24 meeting is scheduled to last all day, and Helgerson assured the task force that they would have the use of that meeting room all of the 25th, as well, if they needed to extend their time together. Since the team is, after all, doing vital and important work at the behest of the governor, it seems that during this next round of meetings they might at least be given time to break for lunch.
When he presented his budget last week, the governor promised that it would “enflame the Albany establishment,” that the capital’s lobbying corps would running around “like their hair is on fire.”
Certainly, anyone with any interest in the budget will have plenty to do for the next couple of months. The first of 13 legislative hearings on Andrew Cuomo’s budget began this morning in Albany. These hearings stretch on for the next four weeks: this first one is on local government; there are two on education (higher education and elementary and secondary education each get their own); the last one is on “Health/Medicaid.”
And some advocates are busy. For an organization like NYSUT, the state teacher’s union, the deep cuts mean that their team of lobbyists is working not only on explaining to legislators how the new budget will affect their district but on ginning up public support for their cause. Last week, for instance, Melinda Person, an in-house lobbyist for the union, was working at a sprint, explaining the implications of the governor’s proposed tax cap to legislators in the Capitol, meeting about coalition strategies, scripting public information campaigns, and helping plan rallies across the state.
Besides education, the governor’s other budget bete noir is health care, which really means Medicaid. Changing health care spending in the state is integral to Cuomo’s budget strategy. Federal stimulus dollars have been hiding the hole in the state’s Medicaid budget; this year, covering those costs falls to the state.
Although health care cuts are the key stone of the budget plan, it’s still not clear what exactly will be cut. The governor’s strategy — form a task force, let them make the hard decisions — has the added bonus of limiting the amount of time opponents have to push as hard as they can against his plan.
For instance, George Gresham, president of SEIU 1199, which represents the state’s health care workers and fought hard against former Governor Paterson’s proposed budget cuts, is on the governor’s Medicaid Redesign Team. The union released a statement that was critical of the level of cuts the governor proposed, but an 1199 spokesperson told me that it would be “premature” to talk about any other work the organization was doing on the budget right now. They’re working with the task force on costs.
So far there hasn’t been much information from the team about what recommendations they’re considering. The group is holding public hearings across the state and will hold a meeting this Wednesday in New York City.
But those are just the biggest chunks. There are plenty of tiny nips and tucks across the budget that will have their opponents. The state is scaling back its contribution to New York City’s shelters for the homeless. It’s cutting the bump that foster care programs would get to account for cost of living increases. It’s changing the way it reimburses local governments for juvenile detention costs. There’s plenty of places for push-back. And even if the budget passes on schedule, there’s plenty of time for it to grow.