The Greater New York Hospital Association and health care union 1199SEIU are putting their full lobbying might behind a push to get Gov. Andrew Cuomo to restore Medicaid funding to his budget proposal.

The trade group and union's Healthcare Education Project is funding a "No Health Care Cuts" campaign that will include radio and digital ads as well as labor rallies around the state. Union members protested outside Montefiore Medical Center in the Bronx on Monday and will rally at New York-Presbyterian/Columbia University Irving Medical Center today.

The governor had promised a 2% Medicaid payment bump to hospitals and a 1.5% increase for nursing homes, which went into effect Nov. 1, and announced increased financial support in his budget proposal in January. But on Feb. 15, he reduced health spending by $550 million in his revised budget, eliminating that support. In total, the budget reduces funding to hospitals by about $650 million. State Budget Director Robert Mujica told Crain's last month that a decline in expected tax revenue led the state to pull back on spending.

Because Medicaid is jointly financed by the federal and the state governments, the reversal amounts to a loss of about $1.1 billion in funding.

The state will still spend more on Medicaid next fiscal year, starting April 1, than it does now. Under its global cap, Medicaid will spend $19.4 billion on Medicaid next fiscal year, 3% more than in the current year, before contributions from federal and local governments. When including all state Medicaid spending, including funding for mental health outside the cap, state spending will increase 2.1%, to $23.9 billion in fiscal 2020.

"There's still year-to-year growth in the program," said Patrick Orecki, a research associate at the Citizens Budget Commission.

The city stands to save at least $288 million if it adopts employee protections for school bus drivers that lapsed more than a decade ago, a new analysis released Tuesday revealed.

The report, conducted by former White House economist Benjamin Harris, predicts those savings would be realized over a five-year period through reducing costs associated with turnover and labor unrest, saving on unemployment insurance and increased tax revenue based on higher wages.

It contradicts previous studies that predicted the city would lose money by instituting employee protection provisions, which guarantee drivers and bus matrons retain their seniority rights, salary and benefits when the city Education Department signs or revises contracts with private bus companies.

The Citizens Budget Commission brushed aside the report and said it overestimates the benefits of bringing back the protection provisions.

“The report understates the potential contract savings from eliminating [employee protection provisions] and competitively bidding all pupil transportation contracts, while also overstating the benefits of mandating EPPs,” said Ana Champeny, the group’s director of city studies.

tate legislators could be forced to make some hard choices this budget season if they stick with the cautious revenue projection issued Tuesday evening by state Comptroller Thomas P. DiNapoli.

The comptroller's forecast was unveiled late Tuesday, after Democratic lawmakers and Gov. Andrew M. Cuomo had failed to reach an agreement on how much money the state would have to spend in the coming fiscal year.

The comptroller's revenue estimate — about $190 million higher than the governor's, but several hundred million dollars below the Legislature's — reflects the comptroller's assessment that New York will soon face an economic downturn.

While the governor has contended that his budget projections represent a prudent path forward, it's still "optimistic" because of his future reliance on economic expansion, according to David Friedfel, director of state studies at the Citizens Budget Commission.

He said the governor's budget proposal includes "significant risk" because it anticipates revenue that wasn't realized in January to fill the state coffers in the coming fiscal year. If the governor's estimation is wrong, the state's revenue shortfall could be worse than anticipated.

Federal Reserve Board Chair Jerome Powell again professed patience on monetary policy Thursday night.

"The Federal Open Market Committee will be patient as we determine what future adjustments to the target range for the federal funds rate may be appropriate to support our dual-mandate objectives," Powell said in the keynote address at the Citizens Budget Commission 87th Annual Awards Dinner. “This common-sense risk-management approach has served the committee well in the past.”

The Fed chief accepted the group’s Medal for High Civic Service.

Noting the economy was approaching 10 straight years of growth, Powell repeated that it’s in “a good place,” despite slowing growth in China and Europe and the possible disruption caused by Brexit.

The majority of his speech focused on productivity and the labor force, where the prime age participation rate has been falling. Part of this can be attributed to younger people eschewing work for added education.

Noting that these are issues outside the Fed’s purview, so he would not suggest solutions, Powell said fixing these issues “could bring great benefits both to those workers and to our economy.”

7 On Your Side Investigates is looking into how much money it would actually take to fix all the problems facing public housing complexes in the city and turn NYCHA around.

Eyewitness News has reported story after story about NYCHA's crumbling conditions, but the plot is always the same - something needs to be repaired, usually because of a leak.

And then the long wait for repairs begins.

"NYCHA's units are 60 to 70 years old, they are at the point they need repairs," said Sean Campion.

Campian, of the watchdog group Citizens Budget Commission, says as NYCHA's housing stock aged, the federal government reduced funding. He says the agency actually gets less money now from the feds than it did 17 years ago.

"Underfunding is the biggest problem, it's hard to do repairs when you have $32 billion in capital needs when you don't have resources available to pay for the repairs," Campion said.

City Council Speaker Corey Johnson warned Thursday that any cuts the mayor plans to make to city agencies should not impact social services, even as the city faces lower-than-expected revenues and a recession that some economists have warned is inevitable.

For the first time in his tenure, Mayor Bill de Blasio is mandating agency spending cuts throughout city government to the tune of at least $750 million. As the Council prepares to hold hearings next week on the mayor's $92.2 billion preliminary budget, Johnson said he would look to protect funding for social services, youth programs and health related programs.

As the Citizens Budget Commission noted this week, the city is now facing even more uncertainty in the form of a looming recession, which could reduce potential revenue by up to $20 billion over three years.

Things at the Metropolitan Transportation Authority have been moving faster than any of its bus or rail lines since Monday afternoon.

The MTA Board on Wednesday voted to keep the base fare for a MetroCard at $2.75 as part of a budget plan that will go into effect beginning next month. Paratransit rides also will remain at $2.75, but MetroCard users will lose the bonus that now kicks in with purchases of $5.50 or more.

The vote came one day after Gov. Cuomo and Mayor de Blasio released a 10-point plan that at least on paper will reorganize the MTA internally from top to bottom in order to reduce costs.

The plan also calls for implementing congestion pricing on vehicles entering Midtown or Downtown Manhattan and using tax money anticipated from legalized marijuana, internet sales taxes and other streams to add vital revenue to the MTA’s coffers.

The Citizens Budget Commission, in a statement n Tuesday, called the Cuomo-de Blasio agreement positive progress, though it expressed concern that legalized marijuana and an internet sales tax are not yet codified into law.

The CBC statement also said labor costs must be addressed in addressing cost containment.

New York City’s luxury real estate market has a crazy list of loopholes for the wealthy: a tax abatement for affordable housing that somehow managed to benefit those living on Billionaires' Row; buyers who are permitted to mask their identities and potentially nefarious deeds behind anonymous LLCs; builders who have supersized skyscrapers through devious and bizarre designs, and as pointed out by a story in the Wall Street Journal on Thursday, owners who manage to pay relatively minuscule amounts of property tax.

According to a policy 2016 brief by the Citizens Budget Commission, co-ops and condos in New York City have an average effective tax rate of 0.86 percent.

“It is a crazy system,” Martha Stark, a former city finance commissioner who is now the policy director of Tax Equity Now, told the WSJ. “The true market value bears no relation to sales price, and nowhere is that truer than among high-value coops and condos.”

A rise in productivity last year gives more room for wages to grow without the risk of higher inflation, Federal Reserve Chairman Jerome Powell said on Thursday, offering another reason why the U.S. central bank can hold off on further rate increases.

“Signs of upward pressure on inflation appear muted despite the strong labor market,” with unemployment at 4 percent and wage increases picking up of late, Powell said in remarks prepared for delivery at the Citizens Budget Commission in New York.

Since its inception in 2015, ThriveNYC — the city's sprawling $850 million initiative to address a variety of mental health issues — has operated without much scrutiny or accountability.

With few public metrics by which to measure its success so far, and the broad strokes used by city officials to describe its operations, the city has offered little insight into how it has assessed Thrive's efficacy since it began.

For Thrive, not only is it difficult to measure impact, but it is also hard to tell how much funding each initiative receives.

Budget watchdogs have lamented Thrive's opacity.

"It's not easy to track, because Thrive is a multi-agency program that has functions in all sorts of different agencies in the city, so you need someone very detailed with aggregated budget data to sum up the total spending," Champeny said.

And because Thrive encompasses a variety of initiatives — some new, some already in existence — across more than a dozen agencies, it is difficult to establish a central, line-item budget delineating how the city is spending taxpayer dollars on the program.

Of those 7,811 referrals for people with serious mental illness — meaning they can be a risk to themselves or others — Thrive does not track whether those individuals received care or continued with it. Instead, the metrics list the number of individuals in state psychiatric centers — 68 — and individuals incarcerated — 170 — from Nov. 24, 2018 to Nov. 30, 2018.

"When you're thinking about performance, there's both outcome and output," said Ana Champeny, director of city studies at the Citizens Budget Commission. "I think that would be the difference: not simply how many people you're screening or you're training, but what impact that actually has on their life."

When Amazon pulled out of New York City earlier this month, many in the business community went into a panic spiral — one even said it was the "worst day for NYC since 9/11." With more than a week to reflect on the stunning decision, many are now taking a less alarmist tone.

Amazon's pullback was met with a mix of joy and fury. Opponents of the deal, most of whom took exception to the tax incentives, saw it as proof that a community could take on a corporate bully and win. Supporters said Amazon’s decision to leave has done irrevocable damage to New York’s ability to lure businesses and cost the city tens of billions in potential tax revenue.

“I think it would have been a real benefit, but fortunately New York City has a very vibrant economy with a growing tech center,” said David Friedfel, the director of state studies at the Citizens Budget Commission, a nonprofit think tank that analyzes New York state and city budgets.

The congestion pricing agreement by New York Gov. Andrew Cuomo and Mayor Bill de Blasio to overhaul the Metropolitan Transportation Authority made clear that the state-run MTA's needs extend far beyond a tolling fix.

Congestion pricing, a popular rallying cry from transit advocates and the linchpin of Tuesday's announcement, could raise $1 billion annually for the MTA, supporting nearly $15 billion of bonds. It may reduce the city's dire congestion problem by minimizing peak-time vehicle use in Manhattan.

"It's part of the solution and it will help, but it's not sufficient compared with the MTA's capital needs," said Howard Cure, director of municipal bond research for Evercore Wealth Management.

Cuomo and de Blasio, in a joint statement, announced a 10-point transformation program for the MTA, with some provisions subject to state lawmaker approval. It marked a rare accord between the often-at-odds politicians.

The proposed overhaul underscores how the MTA must manage costs — and itself — better, according to Andrew Rein, president of the watchdog Citizens Budget Commission. "Critical to those efforts will be the participation of labor and increased productivity by all segments of the workforce," he said.