Due to the ongoing COVID-19 pandemic and its unprecedented negative impact on the global economy, the Enacted Budget maintains vital services and programs, while ensuring sustainability to weather this downtown, authorizes a reduction in spending by $10 billion and empowers the State Budget Director to develop a plan for across the board reductions and implement that plan as necessary over the course of the year. The budget also puts in place mechanisms to control spending through the year if revenues fall even further, and raise spending if either revenues come in higher than expected or the federal government delivers support that offsets the state's revenue losses. All funds spending is estimated to total approximately $177 billion and state operating spending is authorized up to $105.8 billion, however in the absence of additional federal assistance or a faster than anticipated economic recovery, spending will initially total $95.8 billion.
Realigning School Aid
Due to the extraordinary challenges from our COVID-19 health crisis, creating a $10 billion loss in revenue to the State, support for schools will remain nearly flat for a total of $27.9 billion in school aid.
Redesigning Medicaid and Health Care
The FY 2021 Enacted Budget advances reforms to the Medicaid program that will ensure it remains financially viable for the future so it can continue to provide high-quality care to more than six million New Yorkers.
Medicaid spending will increase by 3%, or about $500 million ensuring continuing high-quality care for the 30 percent of New Yorkers who rely on Medicaid for health care. Spending growth is now back in line with targets established by the Governor in 2012 that kept New York State's Medicaid spending growth to less than half the national average, saving taxpayers more than $19 billion.
Many of these reforms were developed and unanimously endorsed by the Medicaid Redesign Team II, a cross section of health care providers, labor, local government and other industry stakeholders. They were tasked with reforming the system, and their recommendations stuck to the Governor's guidelines that they must have zero impact on local government and zero impact on beneficiaries.
The reforms included in the FY 2021 Enacted Budget include a transformation of the hospital reimbursement structure to better support services to the uninsured, increases investments in primary care to avoid more costly hospitalizations, and new requirements that enhance oversight of managed care and transportation.
The reforms also address managed long-term care, by far the fastest growing sector of Medicaid. These include aligning New York State's eligibility requirements with those of other states for new applicants for Consumer Directed Personal Assistance Program and Personal Care Services and enhancing reporting requirements for both programs; capping statewide enrollment in managed long-term care to incentivize plans to assist in ensuring appropriate enrollment; and creating a statewide independent assessor to achieve efficiencies by removing duplicative efforts to determining eligibility and enrollment in the managed long-term care program.