"This New York amendment is bad medicine for our state's health-care system", Massie said.

NY spends more for Medicaid recipients than other states and should have no trouble finding savings in the program, Collins said. "Any tax increase flies in the face of New York's success in reducing spending and taxes to record lows". Rep. Daniel Donovan, who represents Staten Island and Long Island, indicated in an editorial he still will not vote for the bill. Its passage is uncertain.

Andrew Cuomo isn't mincing words when describing how Congressional Republicans have handled the health care overhaul. "We are deeply concerned that the proposed AHCA legislation will devastate our frailest: the elderly, the disabled, mentally ill, developmentally disabled and children in foster care".

Some Republicans, though, are supportive of the Medicaid amendment.

Under that provision, if the state doesn't pick up the counties' tab, it would lose federal funding for Medicaid worth the same amount.

"These cost shifts would mean that previously covered populations would be turned away from vital services", the letter said, referring to provisions in the AHCA.

Under the GOP proposal, "county governments will now have some breathing room to assist our local schools and community colleges, improve local roads and support safety and security initiatives desperately needed by first responders", Tenney said.

In a conference call with journalists Wednesday, he said this was an old Republican tactic of "passing the buck without passing the bucks".

"Our Medicaid mandate relief amendment would save homeowners and businesses hundreds of dollars on their annual property tax bill", said Faso, who has proposed the cost-shifting amendment with Rep. Chris Collins, R-Erie County.

Stead said he doesn't believe property taxes are a good way to fund a program such as Medicaid. Increasing costs for Medicaid have prevented counties from appropriately prioritizing their budgets; counties must pay their share of Medicaid and adhere to the tax cap mandated by the state.

Republicans countered the change would free counties from a state-mandated burden they have borne for five decades, to the detriment of local taxpayers, particularly upstate.

Stefanik's only announced challenger for re-election in 2018, Democrat and former Bernie Sanders delegate Patrick Nelson of Saratoga County, said he was "a little disappointed" Stefanik never vocalized her support or disapproval of the AHCA.

"To think that a state that has money for a Buffalo billion and Brooklyn billion and a Bronx billion and money for signs on the highways that violate federal law and money for corporate welfare and money to advertise NY is open for business when it isn't - to think it doesn't have money to trim is ludicrous", Faso said.

"And we will continue to (communicate with federal legislators) as future changes to the American health care system are considered", Getman said. Rep. John Faso, a Capital Region Republican, said Cuomo should "man up" and have the state take responsibility for Medicaid as it should have years ago.

Stead said other counties could see even larger cuts based on their current Medicaid portion. He said that the state has taken some steps to address cost issues, such as capping costs of Medicaid, but the Medicaid costs still have a huge impact on upstate counties. Neither will Central New York Rep. John Katko. "The state has until 2020 to plan for takeover of Medicaid costs from counties and there is ample room in the state budget to cut spending by 1.5 percent to pay its fair share of Medicaid". Nathan Littauer Hospital and Nursing Home and its Primary/Specialty Care Centers, alone, could lose reimbursements totaling up to $5 million per year.