As the Executive Budget proposal inches closer to a final product, its insufficiencies and impacts become clearer. One area of especially great concern is the governor’s plan to intercept federal funding meant to help offset localities’ Medicaid costs. Under the governor’s plan, more than $624 million in federal money earmarked for localities would instead be diverted into state coffers, and worse still, as much as $2.9 billion over four years would be shifted away from those same local governments.

The proposal would be alarming under normal circumstances—most local governments are ill-equipped to take on such a considerable expense with almost no warning—but considering New York’s tax burden is already among one of the worst in the nation, this measure becomes even more troubling. Localities unable to shoulder this burden, as undoubtedly many will not be able to do so, will be forced to pass along that burden to taxpayers. That simply doesn’t work considering the crisis-level outmigration the state has faced in recent months and years and the toxic business climate suffocating the state.

In a recent interview, Stephen Acquario, Executive Director of the New York State Association of Counties (NYSAC), expressed his concerns about the proposal. Among his chief complaints are the service and program cuts likely to come as a result of the plan, and the lack of warning localities had to prepare for such a dramatic shift. According to NYSAC, counties like Erie, Onondaga and Monroe are looking at increases between $13 million and $27 million. Suffolk and Westchester are even higher than that, as they are facing $28 million and $32 million in additional costs, respectively. These are staggering figures when put into context with other costs local governments already face.

Clearly, health care is an important industry in New York, and managing its costs can be challenging at times. But the best way to do so is with careful spending, reducing waste, cutting down on inefficiencies and mitigating as many of those burdens away from taxpayers as possible. The Executive Budget does just the opposite. If New York is ever going to get take meaningful steps to improve its economy, it will take a far more nuanced strategy than shifting $2.9 billion away from those who can least afford to pay that bill.