Alternative Headline: Counties May Shoulder Medicaid Burden
[MM Curator Summary]: Medicaid changes under Trump’s bill could overwhelm local governments with new workloads and financial penalties.
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WATERTOWN, New York (WWNY) – President Trump’s Big Beautiful Bill aims to save money at the federal level. However, there’s reason to believe that as you save in Washington, you will end up paying more at the local level.
When it comes to Medicaid, President Trump’s bill requires able-bodied workers to check in and prove they are eligible for Medicaid.
There are currently 32,000 people in Jefferson County on Medicaid. At last check, around 6,000 are considered “able-bodied workers.”
Under Donald Trump’s recent Big Beautiful Bill, those people would need to essentially prove they are working or looking for work every six months.
“Early indications are that the work requirements and the recertification are going to be somewhat burdensome on counties,” said Jefferson County Administrator Ryan Piche. “If there’s 6,000 people that need to come through DSS now twice a year, and then go through The WorkPlace twice a year and seek employment opportunities and prove they’re seeking employment opportunities, that’s potentially 24,000 touch points the county government has to account for.”
That means a much bigger workload and a need to hire more people.
Cheryl Mayforth, Executive Director of The WorkPlace, says she is already looking to hire at least one person now to do the recertification.
“It could affect up to 950 families or households in Jefferson County alone, so it’s going to be a challenge,” said Mayforth.
For people who have to check in to keep their Medicaid, they’ll have to check a few boxes.
“They’re going to have to work at least 20 hours a week, 80 hours a month, and they’re going to have to report to us job searches, any volunteer work that they’re doing,” said Mayforth.
Mayforth says those on Medicaid will be exempt from re-certifying if they are 65 or older, disabled, or have a child under 14.
The Big Beautiful Bill also makes changes to who qualifies for SNAP, or the Supplemental Nutrition Assistance Program. It’ll use some of the same recertification as Medicaid.
Piche says in New York State, counties are responsible for administering SNAP, and currently, the state does not meet the new standards the federal government is trying to implement.
What does that mean? Piche says, hypothetically speaking, $5 million in penalties on Jefferson County taxpayers.
“The question is, are those penalties going to be paid by the state or are they going to be paid at the local level? If they’re paid at the local level, that means local taxpayers, on your property tax bills, are going to have to cover those penalties,” said Piche.
It’s important to note that there are still a lot of unknowns.
The changes go into effect in 2027, and Piche says the county will be working with other county governments and the state over the next year to learn more about how to best implement the changes.
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