Medicaid is a huge expense in NYS, impacting both the state budget and, especially, the county budgets. Even as long ago as 6-7 years ago, county execs from all over the state went to the Pataki administration begging for relief as Medicaid expenditures were then sucking up 100% of property tax revenues in virtually every upstate county and some wealthy downstate ones as well. Unfortunately, the response to that wasn't any kind of "reform" but a very modest shifting of costs to the state and cutting reimbursement rates.

I've included a link to a PDF that describes the Medicaid system here: Medicaid. Since Medicaid is a federal program, minimum standards for eligibility and services are required by the US government. That means that NYS cannot apply state residency restrictions, so that isn't really a viable "reform" proposal.

What I'd like to do is make this thread a "brainstorming" one in which posters come up with good ideas for reforming Medicaid. Once we created a good list, I volunteer to put them into a "letter" that MB members could copy and paste into email or snail mail docs to send to the governor-elect, state legislators, and to friends in different parts of the state so that they can forward the docs as well.

It's easy to say, "cut Medicaid!" but that's an amorphous idea that usually only results in reducing the rates the state allows to hospitals and doctors for services. That doesn't fix the problem but only creates financial problems for hospitals, especially those in small cities and towns (ie, outside of NYC, Buffalo, Albany, Syracuse, Rochester, Utica, Yonkers). It also restricts access to medical services as there are fewer physicians/physician groups that accept Medicaid patients. I think coming up with a list of concrete proposals is a much better way to go about reining in this program -- and doing it without simply dumping on poor people.