Even With Billions, Health Care Will Still Be a Battleground

ALBANY—With all of this money, where are the remaining political fights?

The big fronts were health care and education. Education does well, and will do well. David Paterson proposed cutting school aid by $698 million, but New York will get about $1.3 billion next year in funds to plug that hole.

"I have absolutely no problem dedicating all that money because I have to by law," Paterson said. "We have no choice and we're glad we have no choice."

Senator Chuck Schumer said that the excess—some $600 million—will be redistributed to school districts based on state aid formulas. That means education lobbyists, including the powerful teachers unions, should have little to complain about.

Health care is a much different story. The federal money comes to the state and localities by increasing the share of federal reimbursement to the Medicaid program. That means the state pays less—$4.3 billion less this year—than it was planning on.

Despite persistent calls that those funds be dedicated to alleviating health care cuts—David Paterson has proposed about $3.5 billion in cuts—the governor remains uncommitted.

"There will be some very tough decisions, some very difficult cuts, and there will be some pain," Paterson said. "I think it's important that we use stimulus resources where they are intended. I don't mean intended based on policy areas, but the intention is to stimulate the economy. Where we have deficit reduction programs already in effect, that is our responsibility to New Yorkers to clean up our own debt."

Republicans want Paterson to use the excess funds to roll back tax increases he proposed. Paterson seems to be standing strong to restructure health care spending, saying the savings now will pay off in later years.

Health care advocates have already leapt for Paterson's jugular, and say any use of the money for anything else would be a "raid."

"Medicaid dollars should be for Medicaid services," said Daniel Sisto, president of the Healthcare Association of New York State, in an email. "The Governor's plan to raid them must be stopped.  These federal health care dollars must be used to restore the draconian and disproportionate health care cuts and taxes the Governor has proposed.  There's more than enough Medicaid stimulus money to do so." Even With Billions, Health Care Will Still Be a Battleground