Mayors from a half dozen upstate cities on Wednesday signed onto a letter released by a powerful health care workers union urging Gov. Kathy Hochul to increase Medicaid support for hospitals and nursing homes as part of the state budget. 

The letter was facilitated by 1199SEIU, a key health care worker labor organization that has called for higher Medicaid reimbursement rates in the yet-to-be-finalized state budget, now more than three weeks late. 

Signing onto the letter: Buffalo Mayor Byron Brown, Rochester Mayor Malik Evans, Syracuse Mayor Ben Walsh, Plattsburgh Mayor Christopher Rosenquest, Utica Mayor Robert Palmieri and Gouverneur Mayor Ronald McDougall. 

"On a near daily basis, we hear from healthcare providers about the financial struggles they face and their fear they may not be able to meet their mission to care for our state's most vulnerable," the letter states. 

The letter backs a call to raise Medicaid reimbursement rates by 10% for hospitals and 20% for nursing homes in New York. 

Health care networks and facilities over the last several months have pointed to increasingly strained financial conditions in parts of the state in the aftermath of the COVID-19 pandemic, ranging from staffing needs to capital expenses like upgrading buildings. 

"They are emerging much weaker from the pandemic, facing dramatic increases in costs with stagnate or reduced income from Medicaid," the mayors wrote. "Federal funding which eased the burden of the last several years is now gone." 

Medicaid is the costliest item in the state budget each year. Budget and health care watchdogs have warned against a spike in Medicaid spending in the state budget. 

"The state’s long-term goal should be to reduce dependence on taxpayer-financed health plans – by fostering the affordability and accessibility of commercial insurance," the Empire Center's Bill Hammond told a budget hearing this year. "Lawmakers should also be clear that the recent growth of Medicaid costs was not entirely or even primarily a result of the pandemic response."

Hochul has supported higher rates of Medicaid support for health care organizations as part of her initial $227 billion budget proposal earlier this year. And last year, Hochul won the passage of a program meant to boost health care worker staffing by 20% over the next five years.