Gov. Andrew Cuomo blamed the federal government for denying a Medicaid waiver for a program that was hatched from the 2011 Medicaid redesign and could cost the state more than $600 million. 

Cuomo at a news conference framed the issue as not necessarily dire for the state, but a sign of how the federal government continues to take a punitive posture toward a blue state. 

"We're not going to take this sitting down," Cuomo said. "At one point there has be a line in the sand. I don't believe this is personal. I believe this is all political. They see New York as a Democratic state. They don't believe they are politically viable here, so why would you do anything for New York?"

Cuomo is connecting some dots here: The Trump administration this month cancelled the ability of New Yorkers to re-register or apply for access to trusted traveler programs due to a state law that blocks federal immigration officials from receiving the state's motor vehicle database. 

But the program in question -- known as the Delivery System Reform Incentive Payment -- is not solely a New York-centric one, nor is it ending for just Democratic states. Texas, a state President Donald Trump carried in 2016, is having its money phased out as well. 

In a more narrow context, though, all this Medicaid certainly can feel like they are on a knife's edge, given the $2.5 billion hole that must be plugged in the budget due March 31. A new redesign panel for the program is being tasked with developing savings and ways to slow the growth of spending by early next month. 

"By significantly reducing preventable hospital admissions and readmissions, DSRIP dramatically improved care delivery and achieved major savings for the Federal government," said the Greater New York Hospital Association in a statement. "But rather than build on those gains, CMS has chosen to punish New York. This makes no sense."