Legislative Bulletin: State Budget Progress Report

April 25, 2025

State Budget Progress Report: Past Due

This week, the Legislature passed two more budget extenders which together carry the State’s budget work through Tues., April 29^th and maintain state funding at FY 2024-25 levels. The extender passed on Thursday of this week was the eighth of its kind.

The Legislature was in Albany on Tuesday and Thursday of this week to pass each extender, and while there are still no budget bills in print, Senate Majority Leader Andrea Stewart-Cousins and Assembly Speaker Carl Heastie hinted this week that they would be in Albany through the weekend in an effort to make more progress toward a final state spending plan.  Policy issues remain the chief roadblock on the path to the final budget, but leadership seemed hopeful that an agreement could be reached sometime next week.

Interestingly, the scheduled state legislative recess has now lapsed, so legislators will be returning to Albany in full force on Monday to continue both the state budget work and resume legislative efforts.  

LeadingAge New York is continuing to urge lawmakers to keep long-term care (LTC) and aging services at the forefront of state budget discussions. But we need our members’ help to keep our budget requests top-of-mind!

ACTION NEEDED: Members are strongly encouraged to call State legislators in their Albany offices on Monday!

• Members can find state legislators’ contact information here.
• Use these state budget issue briefs, including our latest pieces on nursing home capital cuts, closures, and a new flyer pointing out additional costs associated with state staffing penalties and proposed increases to MTA payroll taxes (more on this below).

Budget issue briefs should be used to inform your phone calls and conversations with legislative offices. Please feel free to reach out to Sarah Daly at sdaly@leadingageny.org if you would like to discuss messaging and focus of your conversations with state legislators. 

LeadingAge NY will continue to closely monitor state budget developments and advocate on our members’ behalf every step of the way. But we need your advocacy to ensure our priorities are addressed in the final budget! Thank you for your continued advocacy!

 

ACTION ALERT: Ask Legislators to Exempt LTC from Increase in MTA Payroll Tax

Earlier this month, LeadingAge NY became aware of a revitalized proposal to increase the MTA payroll mobility tax. While we have not seen any recent proposal in writing, we understand that the increase to the tax under consideration could apply to downstate nonprofit LTC providers such as nursing homes, home care agencies, and other settings critical to the wellbeing of older adults. Unfortunately, if this tax is imposed on our members, it could dilute the impact of proposed Medicaid investments being considered in the state budget process.

LeadingAge New York is asking legislators for an exemption & we need member advocacy! Please call your State Senator and Assembly Member TODAY with the below talking points!

1. Find your State Senator and State Assembly Member information here.

• Call the Albany and/or district offices, and ask to speak with or leave a message for the Assembly Member/Senator.

2. MTA Tax Exemption Talking Points:

• I am calling on behalf of my organization [NAME], regarding the MTA payroll tax increase that is under consideration in the State Budget process.
• As a non-profit long-term care provider serving your district and surrounding communities, I urge you to exempt nonprofit nursing homes and long-term care providers from any increase to the MTA payroll tax in this year’s budget.
• Medicaid is the predominant payer for most nursing home, home care and long term care options. Medicaid alone funds approx. 75% of nursing home resident care in New York.
• Medicaid dollars are intended to provide care for vulnerable New Yorkers, and unless nonprofit nursing homes and long-term care providers are exempt, these funds will be diverted to fund the MTA.
• The Legislature should carefully consider the taxes imposed on long-term care providers, and how this proposal would require homes to divert their limited resources away from resident services and staff.
• Nursing homes and other LTC providers are already experiencing significant financial strain.
• Approx. 60% of downstate nursing home providers posted negative operating margins in 2022 (most recent data available). This tax would further exacerbate the high rate of financial distress.
• I have heard that the MTA payroll tax increase under consideration would apply to at least 50 downstate, nonprofit nursing homes and approx. 10 other nonprofit long-term care providers such as home care agencies, adult care facilities and other settings critical to the wellbeing of older adults. 
• An increase in the MTA payroll tax will add to our workforce costs, while reducing our ability to offer more competitive wages and benefits that support our workforce and our residents.
• The tax increase could also negate the Legislature’s efforts to provide necessary Medicaid funding increases that we and older adults depend on.
• I urge you to exempt nonprofit nursing homes and LTC providers from an increase to this MTA payroll tax.

In addition, our latest nursing home advocacy flyer points out that proposed Medicaid reimbursement increases will not have the desired impact, if providers are simultaneously forced to absorb unforeseen taxes, capital cuts, and new penalties based on labor market conditions beyond their control.  Members are encouraged to share the flyer with legislative offices as you speak with them about this MTA payroll tax increase proposal.

Please be sure to make your phone calls today and Monday, as state budget work is expected to pick up the pace over the coming days.

 

ACTION ALERT: Unfunded Nursing Home Bill Advancing in State Senate!

While LeadingAge New York works tirelessly to advocate for necessary state budget measures, we are also monitoring and advocating on all state legislative activity. Unfortunately, a bill which LeadingAge NY strongly opposes is now advancing through the Senate and has already passed in the Assembly. Bill A.1365-A (Paulin)/S.15-A (Skoufis) has been added to the Senate Health Agenda for next week, and would require nursing homes to develop and submit to the Department of Health (DOH) a designated location for the storage of deceased persons who pass away while living in a nursing home. While the bill has been amended, we believe the amendments do not go far enough to lessen the burden on nonprofit nursing home providers.

First and foremost, LeadingAge NY and our members believe that the remains of all individuals deserve the utmost respect and courtesy upon passing. Under normal circumstances, there is no need for designated storage in nursing homes. Unfortunately, however, this legislation was drafted in 2020, and is a product of a time when all typical processes were difficult to observe due to the COVID-19 pandemic. Meanwhile, the bill’s requirements would impose yet another new and costly requirement on nursing homes that are struggling to deliver high-quality care amidst rising costs, inadequate reimbursement, and 15% reductions in capital funding.

The bill places exorbitant expense, burden, and responsibility on nursing homes, in preparation for an unknown future public health emergency which may, or may not, uniquely impact older adults and individuals living in nursing homes. The bill takes an unconventional approach to emergency response, and use of public dollars (Medicaid), which should be more carefully considered.

If your State Senator sits on the Senate Health Committee, we strongly recommend you contact them ASAP to vocalize your opposition to this bill! You can share our LeadingAge NY memo of opposition to this bill, available here.

Please contact Sarah Daly at sdaly@leadingageny.org if you would like to join us in advocating against this unfunded and costly proposed mandate on nursing homes.

 

ACTION ALERT: Tell Congress that Cuts to Medicaid are Unacceptable!

As we have reported in recent weeks, Congress is currently writing its budget reconciliation bill. The House plans to vote on a bill before Memorial Day. The Senate would then take up the House measure after Memorial Day recess. Whether you have contacted your members of Congress already or not, please take action now to remind Congress that cuts to Medicaid are unacceptable!

Many Congressmembers are committed to achieving at least $1.5 trillion in savings over the next 10 years via this reconciliation bill to help pay for tax cuts and other spending increases (also in the bill). Given the significant amount of cost reductions sought, Medicaid is likely to be a mathematically necessary source of cuts. 

Extensive reductions to federal Medicaid funding would put massive financial strain on state budgets, which would force states to make up the losses through a variety of actions including cutting access to services and lowering provider reimbursement rates. Congress is also considering damaging policy changes such as capping the federal contribution to the expansion population, lowering the provider tax “hold harmless” threshold, or enacting work requirements–all of which would restrict access to critical healthcare and, at the same time, squeeze states financially. 

Bottom line: New York’s health care system depends upon federal contributions to the Medicaid program. Medicaid cuts/changes will impact all New Yorkers and will harm older adults and those who serve them.

Please click here to tell Congress: Cuts to Medicaid are Unacceptable! Now is the time to advocate Federally!

 

New Materials: Keep the Pressure on State Legislators with Social Media and Letter Writing!

With New York State budget work ongoing, perhaps threatening to continue into May, we must keep advocating for top budget priorities to be included in the final budget for State Fiscal Year (SFY) 2025-26. It is crucial that we maintain the urgency and frequency of our message to ensure that our priorities do not fall off the negotiating table, and LeadingAge NY has created several new handouts to support our advocacy.  

Please continue to push for the investments and restorations that LTC providers need, and the funding that the people you serve deserve; use the tools below to continue to advocate with your state legislators and the governor now!

Please take a moment to click one or more of the below links to send an email to elected officials today! It only takes a few clicks!  

• Nursing Home Budget Letter – additional letters for board members, staff teams, family members, etc. are here.
• Adult Care Facilities/Assisted Living Budget Letter
• Home & Community-Based Services Budget Letter
• Managed Long-Term Care Budget Letter
•  Adult Day Health Care Budget Letter

Engage others in advocacy! Print and share advocacy flyers to increase our digital advocacy reach. Flyers can be printed and left in lobby areas or shared digitally with families and volunteers:

• NEW Nursing Home Closures Advocacy Flyer! (Share via email for advocacy impact).
• Family Advocacy Flyer
• Constituent/Volunteer Advocacy Flyer
• Workforce Advocacy Flyer

Finally, social media advocacy is a great way to maintain the attention of lawmakers and urge them to prioritize the care and service needs of older adults! LeadingAge NY has a state budget social media toolkit, which provides pre-written social media posts, along with graphics and videos created by members, residents and staff.

The social media toolkit makes social media advocacy easy: simply download the image that you wish to use, copy the caption from the toolkit, and create a new post on your personal or professional social media accounts. Just be sure that your post “tags” the elected officials we are trying to focus our advocacy on. You will know the legislator has been tagged when their name lights up in blue.

Thank you to all our members who continue to advocate amidst everything else you do! Now is the time to keep the pressure on legislators with a unified message!

 

Top State & Federal Budget Advocacy Resources

There is a lot of activity right now at the State and Federal level that will affect the funding available for LTC and aging services providers in New York. To keep things as simple as possible, below is a simple list of the most salient advocacy actions and resources we ask members to implement as we advocate to protect and increase the funding available for our membership. Your advocacy is critical, and we thank you for all your efforts!

1. Social Media Toolkit – Take your advocacy to social media and tag elected officials!
2. State Digital Budget Advocacy Letters – Keep up the pressure on State Legislators and the Governor!
3. State Budget Issue Briefs – All Service Lines – To inform phone calls to State Legislators
4. LeadingAge National Action Center – Advocate Federally to protect tax exempt bonds, Medicaid and other funding!
5. National Issue Briefs: All Service Lines – To inform conversations and advocacy with members of Congress
6. Contribute to LeadingAge NY PAC Today! – Support our relationship building with elected officials

 

Contact: Sarah Daly; 518.867.8845; sdaly@leadingageny.org