Albany budget bill advances with Medicaid, mental-health and Nassau University Medical Center provisions; 101-49 vote

The New York State Assembly advanced Assembly bill A.3007-c, the Health and Mental Hygiene portion of the 2025–26 state budget, after extended floor debate on Medicaid financing, mental-health reforms and a contested takeover-style restructuring of the Nassau University Medical Center (NUMC) board. The bill passed by a roll-call vote of 101 in favor and 49 opposed.

The bill packages several health-related measures into the enacted budget, including language extending the Medicaid global cap mechanics while authorizing use of managed-care organization (MCO) tax revenue to cover provider disbursements; new statutory authority for penalties against managed-care plans; changes to involuntary commitment under Kendra's Law; funding and administrative changes for the Medical Indemnity Fund (MIF); and a provision that reconstitutes NUMC's governing board and gives review authority over large contracts to the Nassau County Interim Finance Authority (NIFA).

Assemblymember Will Pretlow, the bill's sponsor on the floor, told colleagues the final financial plan was still being completed but said the bill “does not make any changes to the CDPAP nor transition to a single fiscal intermediary” and that some allocations would be published in the forthcoming scorecard. On the MCO tax, Pretlow said the bill relies in part on MCO tax revenue “to ensure that it stays in the cap.”

Why it matters: the bill affects Medicaid — one of the state’s largest budget items — safety-net hospitals, long-term-care providers and mental-health operations across New York. Several provisions create managerial or oversight changes (NUMC board restructuring, NIFA approvals), while others change statutory standards for civil commitment and add review mechanisms intended to inform policy after incidents involving use of force.

Medicaid financing and MCO tax

Members pressed the sponsor and chair on how the enacted budget will remain within the Medicaid global cap and on the risk that the federal government might not renew waivers that support collection of the MCO tax. During questioning, lawmakers cited published executive financial plans that projected cap breaches without additional measures. Pretlow and other supporters told the Assembly the enacted plan intends to use MCO tax receipts to hold…