ALBANY — New York’s county governments are suggesting the state could curb rising Medicaid spending by reviewing a practice that allows an institutionalized spouse to qualify for the government health program if the other spouse refuses to provide financial support.

Only New York and Florida allow the practice known as “spousal refusal” in the awarding of Medicaid benefits, the New York State Association of Counties points out.

Medicaid now serves 6 million New Yorkers, with the program’s soaring expenditures now accounting for a large share of the $6 billion budget deficit the state faces in the fiscal year beginning April 1.

New York State Association of Counties (NYSAC), the umbrella organization for county governments, suggested a review of spousal refusal as one of 29 recommendations to a Medicaid Redesign Team created by Gov. Andrew Cuomo.

The association is also urging lawmakers to derail a Cuomo proposal that could force counties to adhere to a 3% limit on any increase in local Medicaid spending or refund any amount above that to the state.

In a new report Tuesday, NYSAC said the governor’s Medicaid proposals, as written, will result in higher property taxes along with a reduction in such services as Meals on Wheels for seniors, veterans’ programs and road maintenance.

While the budget proposal nudges the counties to tighten Medicaid spending, Stephen Acquario, NYSAC’s director, said county governments have no control over the costs.

The Cuomo administration argues it is simply asking the counties to partner with the state in the effort to rein in Medicaid spending in return for the state picking up local Medicaid costs.

The county governments are also suggesting greater Medicaid efficiency could be achieved through reconsideration of the allowed assets of applicants for the program and increased efforts to encourage New Yorkers to acquire long-term care insurance.

“There are too many exemptions to assets that allow applicants of significant means to become eligible for Medicaid,” NYSAC said.

Joe Mahoney covers the New York Statehouse for CNHI’s newspapers and websites. Reach him at .

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