>>"In New York, a draft proposal of Governor-elect George Pataki's
>>administration calls for a cut of over $1 billion in Medicaid, while Mayor
>>Rudolph Giuliani proposed a 25 percent reduction in Medicaid and other
>>help for the poor.
>
>How does a mayor propose a 25% cut in Medicaid?
Fiscal responsibility for Medicaid members can be passed on to local/county governments. This is usually by eligibility groups (i.e., people with disabilities are the fiscal responsibility of county governments in Ohio and Iowa). This is largely just an accounting/management formality as "statewidedness" is (was?) a basic tenet of Medicaid eligibility and benefits.
With the increasing advent of waivers (sect. 1115) of statewidedness in order to allow managed care, it's possible for different local jurisdictions to have different benefits and undoubtedly different eligibility. I am not an expert on New York but I vaguely recall that NYC hired a private firm to do managed Medicaid outreach and enrollment. It struck me as another dubious case of privatization (managed Medicaid is already a form of administrative privatization) but I do not what happened and what control the mayor of NYC has there.
Note that the quote above could be referring to completely different matters.
Peace,
Jim
" . . . they never told him the cost of bringing home his weekly pay
and when the courts decide how much they owe him
how will he spend his money
as he lies in bed and coughs his life away?"
from "He Fades Away" by Alistair Hulett