Lawmakers and advocates fighting hard against Gov. Kathy Hochul's proposed $1.2 billion in Medicaid cuts have started a campaign of additional pressure as New York budget negotiations plod along with less than a week before the annual deadline.

As spending talks continue in Albany, budget officials Monday said nothing is off the negotiating table as legislative leaders have not decided the size of the total 2024-25 Fiscal Year spending plan. 

And lawmakers against the governor's Medicaid cuts have started to shout louder as the Legislature and Executive Chamber disagree on how the program — one of the largest pieces of the budget — should be funded.

"Certainly, issues around Medicaid, Medicaid funding, reimbursement rates and all of that... those are going to be some of the things that will probably not get resolved until the very end," Senate Health Committee chair Gustavo Rivera said of budget talks.

Various lawmakers and budget officials said they expect the multi-billion-dollar spending plan, due April 1, to be wrapped up in the first or second week of April — especially after the Easter holiday.

Rivera sponsors legislation to eliminate Managed Long Term Care plans in the Medicaid program and return to a fee-for-service model, which the state Health Department would manage. It's estimated to save the state $3 billion and reduce the profit insurance companies' profits.

Advocates Monday shouted questions to Hochul about her decisions to further slash Medicaid programs in her 30-day budget amendments that would cut wages for certain home care workers and limit care options for disabled New Yorkers.

"Governor Hochul, while insurance companies continue to profit, I'm forced to sleep in my chair and not have the care I need to eat and go to the bathroom with dignity," said Renee Christian, of Buffalo, who has cerebral palsy and uses a wheelchair. 

Rivera joined labor unions, home care workers, disabled people and others in the Capitol on Monday to rally for his bill, known as the Homecare Savings & Reinvestment Act, to be included in the budget.

"Ultimately, the state money that we have that should go to the care of these folks should go to those things — it should go to the care of these individuals and to pay the workers who take care of these individuals so they can have dignified lives," Rivera said.

Hochul's administration has expressed interest in the Legislature's budget ask to apply for a federal waiver and tax Managed Care Organizations to generate $4 billion the state would use for health care. But as the Legislature pushes for higher Medicaid reimbursement rates, wages for home care workers and reversing the governor's cuts, it remains unclear if legislative leaders will sway the governor to make their desired changes instead.

The governor's proposed Medicaid cuts anger elected representatives on both sides of the political aisle.

U.S. Rep. Marc Molinaro, R-19, sent Hochul a letter Monday demanding she restore the funding she gutted from the Consumer Directed Personal Assistance Program, which allows disabled New Yorkers to have a trusted friend or family member be their caregiver.

"This isn't a place the governor should touch," Molinaro told Spectrum News 1 during a Capitol visit. "It is heartless, it is cruel and it ultimately will result in people with disabilities getting less support and possibly even threatening their very lives."

Federal and state lawmakers argue $1.2 billion in Medicaid cuts will cost the state more money in the long run, and will add pressure on taxpayers and increase property taxes. But Republicans are not sold on state Democrats' proposal to bank on higher federal reimbursements to generate revenue to fund the program. 

"I've never felt that Albany and New York state have a revenue problem — it has a consistent spending problem," Molinaro said.

The federal waiver to allow the state to tax Managed Care Organizations for $4 billion in state revenue would expire after three years, meaning the state would have to reapply under differing political dynamics in Washington, D.C.

The state of California applied for such a waiver in December, and Democratic lawmakers will spend the next several days working to convince the governor to rely on additional federal reimbursements and make the Medicaid program whole.

"For me, it's a no-brainer — that's the way we got to do it," Rivera said. "That's the way we got to go — not in the way of disinvestment and taking away money from them."