In this episode of Messages of Necessity, Empire Center Senior Fellow for Health Policy Bill Hammond is joined by Cam Macdonald, the Center’s General Counsel, to dissect Governor Hochul's recently proposed “MCO tax” and the implications it may hold for New York's Medicaid financing. They delve into the tax’s origins, modeled on a similar approach in California, and discuss how this plan could bring in a fraction of the projected $4 billion in extra federal aid that state lawmakers anticipated. With details pulled from the state’s federal waiver application, Bill and Cam explore the estimated $2.8 billion in gross revenues and the net returns of $1.4 to $1.8 billion after state costs, unraveling the financial mechanics and potential legal and policy consequences for insurers, Medicaid recipients, and New York taxpayers.