Statement Health Care

Statement on the "Collins Amendment"

March 22, 2017

Today, the Citizens Budget Commission issued this statement on the “Collins Amendment:”

The recent addition of the “Collins Amendment” to the House of Representatives’ American Health Care Act provides a strong incentive for New York’s Governor and Legislature to eliminate the mandated local share of Medicaid costs, a policy change long advocated by the Citizens Budget Commission. More than 20 years ago the Commission called for a realignment of responsibilities for Medicaid in a comprehensive report on the State and City budgets, and in 2011 our report A Poor Way to Pay for Medicaid documented the two basic reasons for the funding shift: (1) financing burdens should be aligned with administrative control over the program to encourage cost containment, and (2) current arrangements place a disproportionately large and inequitable burden on taxpayers in localities with more poor residents and greater social welfare costs.

The State’s leaders should take preemptive action to obviate the relevance of the Collins Amendment. This legislative session should see the design and enactment of a multiyear program to shift the full cost of Medicaid to the state thereby eliminating the unfair burden imposed on taxpayers in New York City and many counties.


For more information, visit or see:

Citizens Budget Commission, “Local Medicaid Spending Map” (May 26, 2016),

Citizens Budget Commission, “A Step Backward on Medicaid Funding” (March 24, 2016),

Citizens Budget Commission, “A Poor Way to Pay for Medicaid” (December 11, 2011),