Medicaid Reform

Beginning with the Southern Tier Organization to Reform Medicaid (STORM) spearheaded over a decade ago by Chemung County Executive Tom Santulli – who’s been such a widely respected and effective leader in this arena of reform for so long – our region has been on the leading edge of the fight to reform New York State’s system of Medicaid.

It’s a system that now costs state and local taxpayers more than one billion dollars a week but remains plagued by unacceptable abuse, fraud and waste.

I agree, wholeheartedly, that we need to take care of people in our community and region that need the care Medicaid was intended to provide. But by some accounts, one out of four New Yorkers now receives some type of Medicaid benefit — a rate of growth which is, very simply, unsustainable now but that’s expected to just keep growing.

Medicaid needs to be reformed to provide essential care – but to provide it cost effectively and without being the abused, mismanaged and overwhelmingly expensive system of health care that it’s become in New York State at the expense of taxpayers.


Throughout his tenure in the Legislature, Senator O’Mara has been a strong advocate for and sponsored legislation to reform the state’s Medicaid system.

The cost of Medicaid is the single largest unfunded state mandate on counties. It’s an unfair and unreasonable cost that overwhelms their finances and places some counties on the brink of bankruptcy. The local share of Medicaid accounts for far too large a share of our counties’ total real property tax levy. This local share — again, an unfunded State mandate (the most burdensome one of all) — has driven up real property taxes, the worst job-killing tax there is, in virtually every county in the State.

That’s why reform of Medicaid has long been and remains so important to me.

Many state fiscal experts are pointing to New York’s effort to redesign its system of Medicaid as the cornerstone of recent state budgets. I won’t argue. Again, it’s the state’s most expensive program and it’s the largest unfunded mandate burdening our local governments. If we’re going to get serious about state spending control, we have to get serious about Medicaid reform. It’s that simple. We’ve taken some important and meaningful steps since 2011 – including a state takeover of the growth in local Medicaid costs – but it’s time to go even further, which is why I have:

  • co-sponsored legislation, together with local Assemblymen Phil Palmesano and Chris Friend, to begin a full state takeover of local Medicaid costs. The idea behind this move is that if it’s the state’s responsibility, then the state will become more aggressive at fighting fraud and waste, and even more intent on redesigning and reducing the cost of the system;

  • sponsored legislation to encourage the more widespread use of modern, fraud detection technology like the software developed and continually fine-tuned by the Horseheads-based Salient Corporation. This Salient technology lays out a blueprint for effectively detecting and preventing fraud, inefficiency, mismanagement, overutilization and waste. My legislation would help more localities get started with its use by reimbursing them for the software’s initial cost – the underlying idea being that this small state investment could lead to significant cost savings;

  • encouraged the reinstatement of the eligibility requirements for face-to-face interviews, finger-imaging and asset tests for Medicaid applicants that were once conducted by counties but that were eliminated as part the 2009-10 state budget;

  • and sponsored legislation to restore the incentive for localities to pursue Medicaid fraud investigations.

One of my priority goals in the Senate is to continue to lead the fight to reform Medicaid in order to save property taxpayers and our counties and communities our hard-earned and limited tax dollars. I will continue to fight for the reforms highlighted above, and others, to ensure a better system for those and only those the program was intended to serve, and before the burden of the system simply sinks local governments and property taxpayers.