This analysis does not reflect the reality of how state budgeting works, at least not in NY.

It presumes that states are spending the bare minimum necessary on Medicaid, and that any cut in federal aid would "force" them to either raise taxes or cut spending elsewhere In truth, a growing share of NY's Medicaid spending is not about providing care to anyone, but rather pumping money to hospitals, labor unions and other parts of the health-care industry, which are by far the most influential lobbying force in Albany

More errors and sloppiness from the Hochul-commissioned study of NY's pandemic response:

P. 58: "A brief list of the most relevant standards for this discussion [of nursing home policy] is appended."

No list was appended.

empirecenter.org/publications/h… On that same page, the heading "Metrics for assessment" appeared twice, for no apparent reason.

Setting aside the merits of these actions, why is Hochul bypassing constitutional procedures for spending the public's money? You know, like in Schoolhouse Rock?

governor.ny.gov/news/governor-… Article VII, Section 7: "No money shall ever be paid out of the state treasury or any of its funds, or any of the funds under its management, except in pursuance of an
appropriation by law." nysenate.gov/sites/default/…

This story, which will surely spark a bunch of debate, leaves big questions unaddressed.

1. Is either of them infertile in the medical sense?

Presumably not, or IVF wouldn't help. So they're asking the health plan to cover a non-medical issue.

nytimes.com/2022/04/12/nyr… 2. Where is the egg coming from?

Presumably an unrelated donor. So they're asking for coverage of a procedure involving someone who is not on their policy.

Two years into the pandemic, there is still no evident correlation between staffing levels and COVID mortality rates in NY nursing homes.

A link identified by the AG's office in January 2021 disappeared when more complete data became available. empirecenter.org/publications/p… Homes with the worst CMS staff rating of one star also saw the lowest death rate, while three-star homes have the highest.

Richer staffing may improve care in other ways, but it has not seemed to affect COVID risk.

This @nytopinion essay repeats a lot of misinformation about the home health workforce in New York. Here are five examples. 🧵nytimes.com/2022/03/30/opi… "Many of us want to age at home. But that option is fading fast."

Home care is more common than ever in New York and growing at an explosive rate. empirecenter.org/publications/t…

Some quibbles with this timeline.

First, it seems to be based on what was known at the time rather than the historic record.

For example, nursing home mortality data obtained by the @empirecenter shows 11 COVID deaths before March 10 (one confirmed, 10 presumed). The first known COVID death in a New York nursing home (and possible in the whole state) was a resident of the Island Nursing and Rehab Center in Holstville, L.I., on March 2, 2020.

From the DOH response:

"The scope of health data that was released to the public by the prior Administration was determined by that Executive Chamber, not Department personnel, and any Department-issued data was accurately described."

Not so fast. osc.state.ny.us/files/state-ag… Among the officials who inaccurately described COVID data and spread other misinformation was former former Commissioner Howard Zucker.
empirecenter.org/publications/l…

No, Californians would not save $117 billion a year by switching to single payer. No one other than the writer of this article has even made that claim.

It's a fine example of innumerate and/or bad faith arguments in favor of single payer. thenation.com/article/politi… Here's how the writer apparently came up with that utterly implausible number -- by comparing dollar numbers from completely different contexts.

The 1st is an estimate of baseline costs from Health California for All. The second is unlinked quotes from unnamed Republicans.

The push in Albany for the Fair Pay for Home Care Act, which would cost Medicaid an estimated $4B, inspired me to look at employment data. Here is some of what I found ... 🧵empirecenter.org/publications/t… Proponents say NY is facing an "extreme shortage" of home care workers.

According to BLS, however, NY's per capita employment of home health and personal care aides is 140% higher than average and 30% higher than any other state. empirecenter.org/publications/t…

A joint letter from seven groups, including @empirecenter, urges lawmakers to reject the unilateral spending authority Hochul is seeking in her budget.

Among the items called out: $1B that Hochul wants to park in the "Health Care Transformation Fund." cbcny.org/advocacy/watch… Cuomo and the Legislature created the HCTF in 2018 as a vehicle to receive $2B in proceeds the Fidelis sale.

It gives the governor authority to spend $ on any health-related purpose without notifying lawmakers until after the fact. empirecenter.org/publications/a…

Switching New York to single-payer insurance under the NY Health Act would require the largest tax hike in state history.

Yet the bill doesn't specify who would pay how much more. That would be decided *after* the costly entitlement is written in law. 🧵empirecenter.org/publications/s… Because the bill is vague about financing, analysts have come to widely varying estimates of the price tag, ranging from $92B to $226B per year.

The most widely cited study, by RAND Corp, came down at $139B, which rose to $157B when long-term care was added as a benefit.

This is an under-appreciated aspect of gerrymandering. It’s not just about one party seeking an unfair advantage. It’s about incumbents protecting their fellow incumbents

https://twitter.com/redistrict/status/1488145016098897920

Don’t take my word for it. Listen to how the late Denny Farrell, longtime Albany power broker, explained the process in 2012:

“You must understand, for the last 40 years, whatever district Charlie Rangel wants, we give it to him.” nydailynews.com/opinion/albany…

Qs about Gov Hochul's health budget 🧵

1: What is she doing to strengthen the state’s pandemic defenses?

Hochul's plan makes no mention of investigating what went wrong, learning from those mistakes or making sure NYers are better protected next time. empirecenter.org/publications/a… 2: How much is she really spending on the health-care workforce?

She touted a "multi-year investment" of $10B, but her plan is vague about the cost and timing of various components and how much would come from federal aid. empirecenter.org/publications/a…

Hochul proposes $1.6 billion in capital funding for health facilities.

Under Cuomo, the state allocated $3.8 billion over five years to various health-care capital initiatives. As of last spring, $2.6 billion remained unspent. It used to be the state's role in capital funding for hospitals, nursing homes, etc., was low-interest financing through the Dormitory Authority and other public bond issuers.

Straight-up grants is a relatively new practice that mushroomed under Cuomo. empirecenter.org/publications/a…

A pair of slides from my presentation this a.m. that NYers might find interesting.

The first shows the first wave as originally experienced: It started in early March, got worse in late March and reached a peak in early April, 2 1/2 weeks after the shutdown. The second shows a reconstruction of what really happened -- a wave that hit a month earlier and got eight times bigger than we knew. It started in early February, was already spreading fast by March and peaked right around the time of the shutdown.

The quantity of bad info from this 3/2/20 briefing...

AMC: "We should relax, because that's what's dictated by the reality of the situation."

BdB: "This is not something you get from casual contact. This is something you get from prolonged exposure."

politi.co/2TibIZL "The two men ... sought to reassure New Yorkers that city and state health officials were working together to stem the spread of the virus" [no, they weren't] "one they both emphasized was not life-threatening for otherwise healthy adults and children" [yes it was].

This is surreal.

NY's Essential Plan has amassed a $4.8B surplus because a ill-conceived ACA formula generates more federal aid than the program can spend.

Now the American Rescue Plan is sending an extra $750M we don't need and can't use! ($)

subscriber.politicopro.com/article/2021/1… Here's background on the Essential Plan's Bizzarro World finances. As of June 30, 2021, the plan's trust fund had swollen to $4.8 billion. empirecenter.org/publications/e…

The similarities between the Trump/CDC relationship and the Cuomo/DOH relationship are hard to ignore. washingtonpost.com/health/2021/11… Since the beginning of the pandemic, I don't recall officials at NYS DOH holding a single briefing independent of the governor -- with one arguable exception: Zucker's webinar on the nursing home report, which the governor's office rewrote.

These numbers from Hochul's slide show don't mean much without more context. What are the equivalent percentages for unvaccinated people? This seems to say 1% of fully vaccinated people tested positive *this week.*

Of 14M fully vaxxed NYers, 1% would be 140,000.

However, the total number reported as testing positive over the past seven days was 25,000.

.@cxmacdonald spots a flaw in the Abramowitz brief defending Cuomo's nursing home policies -- a flaw that also blows up one of Cuomo's key talking points about the 3/25 order requiring homes to admit COVID-positive patients. [thread] The Abramowitz brief, as posted today by the @NYDailyNews, cites a long-standing regulation providing that a nursing home "shall ... accept and retain only those nursing home residents for whom it can provide adequate care." ... nydailynews.com/opinion/ny-edi…