2011 was the year the state Legislature was finally able to come together, put politics aside, and pass some of the most taxpayer- and business-friendly legislation in decades. Despite these accomplishments - from the property tax cap, a reduction in state spending, repeal of the MTA payroll tax, and a reformed tax code – however, there remains one piece of the people’s business left undone: Medicaid.

With an annual tab of nearly $54 billion, nearly a third of the total state budget, Medicaid continues to be one of the top cost-drivers in New York State. There are currently 4.9 million enrollees in our state, with every indication that this number will only continue to rise. Twenty-five percent of our state population is eligible to receive 33 percent of our state’s spending in 2012. That statistic alone is a bruising example of how poorly the Medicaid system is administered. What’s worse, New York currently spends $1 billion per week on Medicaid, with costs skyrocketing annually.

Since the passage of Medicaid in 1965, New York’s local municipalities have been required to share in both the cost and administrative operation of the program. The ever-increasing costs to the program have been due to Albany edicts – unfunded mandates handed down to localities who are forced to pay but have no say.

Despite this shift in responsibility, counties continue to be required to contribute a significant share of the total Medicaid cost. Currently, these counties combine to pay approximately $8 billion per year, and, under existing law, these costs will continue to increase by three percent each year. With the recently enacted two percent property tax cap, counties simply cannot continue to meet this state mandate without cutting essential local services such as senior care, veterans’ services, law enforcement, parks, and infrastructure needs.

If Albany wants to get serious about real cost control measures, legislative leaders and Governor Cuomo will join me in passing legislation I have sponsored to reduce the burdens of Medicaid on local governments: Assembly bill 5305 would allow for an immediate moratorium on unfunded mandates; Assembly bill 5687 would call for legislative approval for regulatory mandates; and Assembly bill 1104 would allow counties to use discretion for optional Medicaid services. These are practical solutions to a decades-old problem.

The recent proposals by the Medicaid Redesign Team certainly offer suggestions worthy of consideration by Governor Cuomo. While these proposals are very local and specific, they can serve as the basis for additional broad-based Medicaid reform. It is critical for both Governor Cuomo and the state Legislature to consider these proposals as a way to reduce the highest spending item in our state budget.

Albany’s runaway Medicaid spending continues to strangle taxpayers and undercuts the overall quality of health care in the Empire State. If Albany were able to find a way to reduce its Medicaid spending per capita, currently the nation’s highest at $2,283 and more than twice the national average of $1,026, our local governments would not have to compromise many of the programs and services currently in jeopardy.

I am eager to hear feedback from my constituents on an issue like Medicaid that jeopardizes our state budget each year. Through my Facebook page, “Assemblyman Dave McDonough,” constituents can send me a note, post a comment on my wall and answer surveys posted to my main page. I want to be able to take your concerns right to Albany, and I urge my constituents to take advantage of this opportunity to connect with me online.

This year will be a challenging and difficult one for families across our state. Amidst political gridlock in Washington, D.C., Governor Cuomo worked in a bipartisan manner to accomplish great things with me and my colleagues in the Legislature in 2011. We led by example and designed a path for brighter days ahead. My hope is that Governor Cuomo will see another opportunity here to lead by example, and tackle a decades-old problem that continues to waste more taxpayer money each year.