Medicaid move: Anatomy of a surprise vote

It was shaping up to be another boring Medicaid Redesign Team meeting. Facts about “patient-centered homes.” Figures on savings from cutting dental programs for poor people. At least one audience member was caught napping after the lunch break.

Then, Michael Dowling (in photo, left), the team’s chairman and the chief executive of North Shore Long Island Jewish Health System, got everyone’s attention when he suddenly called for the 27-member panel to take a vote.

No matter that the team had a meeting scheduled for Friday, had just received 79 intricately detailed proposals, and was supposed to digest them and vote next week.

“I don’t think we need to belabor the issue,” Dowling said.

Drama ensued.

Assemb. Richard Gottfried (D-Manhattan), the chairman of the Health Committee, objected. “Highly inappropriate,” he said.

Panel member Lara Kassel of the Center for Disability Rights said she was “shocked.”

And then the team voted voted anyway, unanimously, to adopt the 79 proposals, with Kassel, Gottfried, Sen. Kemp Hannon (R-Garden City) and Assemb. Joe Giglio (R-Cattaraugus County) abstaining.

Panel members said they were in the dark about the vote’s timing. But Capitol insiders said one person definitely was in the know: Gov. Andrew M. Cuomo, who had set aside time to meet the panel after the vote and then hold a news conference.

Asked about the vote’s timing by Newsday, Dowling smiled and said: “Hey life is full of surprises.”

Afterward, advocates for the poor said the redesign team’s promise of opening up the dialogue about budget cuts rang hollow.

“You had a process that supposed to be open and transparent and it was pretty much everything but that,” said Gwen O’Shea, president and chief executive of the Health and Welfare Council of Long Island.

Nisha Agarwal of New York Lawyers for the Public Interest said she was concerned after attending one of the panel’s five public hearings.

“The public hearings were thrown together,” she said. “Then to find out today they voted on proposals that no one had any time to review … I’m completely exasperated by the whole thing.”