In New York state, Medicaid — no matter how much local leaders bellyache about it — is partly a county issue.

Last month, Gov. Andrew Cuomo cited the program during his annual budget presentation noting that all counties may have to pay more into this system very soon. This sent up red flags and protests from leaders across the state.

Over the last six years, however, New York state has been quite generous in regard to the Medicaid program.

In order to help local governments abide by a state-imposed 2 percent property tax cap, the governor and the State Legislature agreed to pick up added costs for Medicaid and freeze payments made by New York City and the counties.

This year, while staring at a $6 billion budget deficit, the governor considered going back to the local counties for added support.

Let’s get one thing clear: Medicaid is not just for the needy. It also assists in care for the elderly.

Chautauqua County has quite a few of these people. According to U.S. Census figures, about 24,000 residents — or 18 percent of the population — are 65 or older.

As noted by Charles Ferraro of Westfield, a former county commissioner of Social Services, a large chunk of that Medicaid funding goes to seniors. “Seventy to 80% of that Medicaid goes to pay nursing homes and home health agencies to take care of sick elderly county residents,” he wrote recently in a letter to the OBSERVER.

According to the tax bills this year, the Medicaid burden on Chautauqua County was more than $30 million. That amount has stayed relatively stable — and is less than some years in the 2000s.

So while county costs have increased in recent years, the Medicaid cost has not. This is a significant fact.

We, once again, offer this important history lesson. While Albany had Medicaid costs flat, your Chautauqua County legislators have been spending. For 2020, they even included a property tax hike — something approved by a majority of Republican legislators. Yes, those same officials who are so quick to criticize Cuomo over the potential increase in Medicaid payments.

Legislators also levied the highest tax increase on residents in 2016 when they raised the sales tax by 0.5 percent to lower your property tax. Because our county leans Republican, there were no temper tantrums. But all this action did was shift the tax burden from your house to your purchases.

You, ultimately, paid more in taxes through this shell game, especially when the economy has been in an uptick.

Finally, in regard to Medicaid, consider this statistic. In 2011, Chautauqua County paid $28.6 million in Medicaid costs to the state. In 2020, it is paying a bit more than $30 million — an increase of $2 million over nine years or less than 1 percent per year.

Even when taking inflation into account, Chautauqua County got a pretty good deal from Albany on Medicaid in the last decade.