MEDICAID MATH: Thanks to billions of dollars in unanticipated Medicaid expenses logged in the current fiscal year, the state’s massive Medicaid program is slated for what’s effectively a budget decrease in the upcoming year, according to a POLITICO analysis of state budget records. Hochul’s executive budget calls for $96.4 billion for Medicaid in the 2024-2025 fiscal year. That’s more than the $94.4 billion devoted to Medicaid in the enacted budget for the current fiscal year, but a decrease of 3.5 percent from the $99.9 billion that the program is expected to actually spend. The decrease accounts for declining Medicaid enrollment, following the end of Covid-era continuous coverage requirements and over $1 billion in savings initiatives. Hochul did not identify a source for much of the savings, saying only that her administration will work with industry stakeholders to find them. But she did propose nixing a wage parity policy that requires supplemental pay for certain home care workers downstate, saving about $200 million. — Maya Kaufman WATER INFRASTRUCTURE: Hochul is including funding for flood control projects in her executive budget but wants to reduce the annual amount for water infrastructure projects. Hochul proposed only $500 million over two years for clean water infrastructure, setting up a battle with top environmental leaders in the Legislature and advocates. The chairs of the Environmental Conservation Committee want to see the amount kept at $500 million annually, and environmental groups and other advocates are organizing to push for $600 million. The program has been funded at $500 million each year since 2017. It provides grants to local governments for drinking water and wastewater projects. The state expects to receive $2.6 billion in funding from the federal infrastructure law for water infrastructure projects as well. “This is not a moment that we should be taking our foot off the gas. Our goal when we pushed to pass the bond act and when we advocate for environmental funding is to make sure the resources are closer to meeting the need,” said Jessica Ottney-Mahar, The Nature Conservancy’s policy director. “There’s a lot of water infrastructure needs in New York State… so to see a reduction in that program is concerning.” — Marie J. French A LIFE FOR DEATH ISSUE: The push to make New York the latest state to legalize euthanasia is once again coming to a head, with lawmakers vowing 2024 is the year the Empire State will join neighboring New Jersey, Vermont and eight other states in legalizing the practice. Sen. Jessica Scarcella-Spanton and Assemblymember Amanda Septimo gathered at the Capitol on Tuesday morning to promote the Medical Aid in Dying Act — with faith leaders, public health organizers and other advocates standing behind them. “I think death is just an uncomfortable thing for people to talk about,” Scarcella-Spanton said when asked why it has taken almost a decade for the measure to be passed in New York. The bill was initially introduced in New York state in 2015 and Oregon became the first state to legalize the practice in 1997. The renewed enthusiasm comes as a Siena College poll in November found New York voters support medically assisted death by a nearly 2-to-1 margin. “I don't think there's even a lack of support. I just think that there is an unwillingness to kind of put their name on it,” Scarcella-Spanton said. “I don’t think you think about death as something that’s legislated all the time.”
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