Is New York's Medicaid System to be Overhauled?

It's no secret that New York has one of the most expensive (and generous) Medicaid program of any state.  Outgoing Lt. Governor Richard Ravitch just released this report that recommends that the state legislature carefully examine New York's Medicaid system to see if changes should be implemented to reduce the costs of the Medicaid program, without reducing services to those who need them. 

Ravitch's report notes that New York's spend-down and spousal refusal rules are just two planning techniques that are often used by middle class people to preserve assets while still qualifying for Medicaid long-term care coverage.  If New York's legislature in fact wishes to reduce the state's long-term care Medicaid costs, these techniques will likely be among the first to be restricted.  Given the dysfunction that is New York politics, however, it will likely be some time before any of the issues discussed in Ravitch's report will be scrutinized, and even more time before any changes are made to New York's rules.