On Apr. 12, New York Governor George Pataki exercised his line-item veto authority 76 times to eliminate major portions of the State Legislature’s health and mental hygiene budget for the State fiscal year that began Apr. 1. The Governor vetoed every Medicaid funding restoration passed by the Legislature and all new health care spending. He also declared the Legislature’s restorations unconstitutional, and stated that his vetoes are “not subject to override by the Legislature,” implying that even if the Legislature overrides his vetoes when it returns to Albany on Apr. 24, he will implement his budget cuts as proposed.
The funding restorations the Governor vetoed include, among others, Medicaid inflation, or “trend” factors for hospitals and nursing homes; the length-of-stay offset for hospital volume adjustments; graduate medical education payments; inpatient detox; specialty outpatient mental health rates; the mental health alternative rate methodology; nursing home 300-bed-and-over and hospital-based rate add-ons; nursing home adult day care payments; and nursing home case mix. The Governor also vetoed new spending, including the Medicaid emergency department rate increase, quality improvement funding for nursing homes, the Legislature’s nursing home rebasing proposal, and home health worker recruitment and retention funding.
In his January budget proposal, the Governor proposed cutting hospitals by $440 million and nursing homes by an equivalent amount. He also proposed approximately $100 million in cuts to low-income New Yorkers through changes to the Medicaid and Family Health Plus programs. The Legislature rejected all of those cuts. The Governor’s vetoes place hospitals, nursing homes, and the patients they serve at risk of actually bearing the full burden of these devastating cuts.
“We have already seen a rash of hospital and nursing home closings and bankruptcies across New York,” said GNYHA President Kenneth Raske. “The Governor’s cuts will mean more hospitals and nursing homes will be shuttered and communities will be denied health care services. This will lead to tragic situations all across the State.”
Major Campaign: The Healthcare Education Project, a joint initiative of GNYHA and 1199 SEIU United Healthcare Workers East, is conducting a massive advocacy campaign urging all members to contact their State legislators to 1) thank them for their support so far; and 2) override the Governor’s vetoes. GNYHA is also urging members to attend its Annual Meeting on Apr. 18 (see page 1), where Mr. Raske will give an update on the State budget situation and the GNYHA/1199 campaign.
Potential Litigation: The Governor has claimed that many of the provisions of the Legislature’s budget are unconstitutional. To support this claim, he points to several recent State Court of Appeals decisions. One of the decisions, Silver v. Pataki, affirmed that the Governor has broad budgetary powers and outlined the ways in which the Legislature may—and may not—alter the Governor’s budget bills. In another decision, New York City Council v. Bloomberg, the Court of Appeals held that the Mayor need not implement laws he deems to be illegal. Taking those decisions together, Gov. Pataki vetoed a variety of provisions of the budget bills on the grounds that they were unconstitutionally drafted, under Silver v. Pataki, and, even if the Legislature overrides his vetoes, he need not implement the provisions he deems to be unconstitutional, under New York City Council v. Bloomberg. This potentially means that the Governor may implement some, if not all, of the Medicaid reimbursement rate cuts contained in his original budget proposal, despite any successful veto overrides.
The Healthcare Education Project has retained counsel to pursue litigation in the event the Governor implements his cuts, despite veto overrides, or refuses to implement new spending, including the Medicaid emergency department rate increase and other spending items. GNYHA strongly believes that the Legislature followed Silver v. Pataki to the letter and that the findings in New York City Council v. Bloomberg, which dealt with State pre-emption of local laws and local contracting issues, not State budget or State constitutional issues, cannot be used by a Governor to unilaterally ignore duly enacted legislation. GNYHA will do everything it can to ensure that GNYHA members are not exposed to the Governor’s budget cuts and have access to critical new funding as intended by the State Legislature.