By 2030, 25% of New York state’s population will be 60 or older.

At the same time, Gov. Kathy Hochul is looking to cut long-term care services, home care and other services that older New Yorkers rely on. The reason? The Medicaid budget is bursting at the seams. It’s grown 40% over the past three years.

During her budget address, the governor told lawmakers that state Medicaid spending is exceeding projections by $1.5 billion at a time when the state is already facing a budget gap.

While the governor is looking to cut spending, some lawmakers, including Senate Health Committee chair Senator Gustavo Rivera, are creating alternative options.

“It is not the time to talk about cuts,” Rivera told Capital Tonight. “It’s the time to talk about stabilizing this system, and there are options available to us that we can pursue.”

One of the options is a bill Rivera introduced a few weeks ago that advocates call the “Home Care Savings & Reinvestment Act.” 

The bill would stop the state from paying insurance companies billions of dollars for Managed Long Term Care plans (MLTCs), and return that money for home care management directly to the state.

Rivera calls MLTCs “a failed experiment.”

Advocates for MLTCs view their work much differently.

According to a guest column written for City Limits by Diana Gelfand, chief clinical officer at Elderplan/HomeFirst, MLTCs are valuable assets and include “care managers, assessment nurses and home care workers… who find innovative solutions to complex problems.”

Rivera sees MLTCs as “middlemen.”

“So getting rid of MLTCs and transitioning the system back into being managed at the state level, as opposed to having these insurance companies in the middle of whole thing, would save us (to) the tune of between $1 billion and $2 billion dollars a year,” Rivera estimated.

The bill’s Assembly sponsor is Assembly Health Committee Chair Amy Paulin.