Gov. Andrew M. Cuomo, New York City Mayor Bill de Blasio and legislators from the state demanded that the federal government approve New York’s $10 billion Medicaid waiver. The waiver request, which was originally submitted in 2012, would allow the state to reinvest significant Medicaid savings toward transforming New York’s health care delivery system, with a focus on primary and preventative care while also minimizing unnecessary hospital admission.

After Cuomo raised the issue of the long overdue waiver in his executive budget address last week, the state received a letter from the U.S. Department of Health and Human Services that failed to give approval to New York’s application. Under Cuomo, New York’s health care system has gone from a symbol of waste to a model of reform. With a focus on innovation and efficiency, the governor’s Medicaid Redesign Team identified savings of $34 billion in New York’s Medicaid system while also managing to add 500,000 people to the program. With the federal government’s approval, New York would be able to spend its portion of these savings toward improvements in the state’s health care delivery system.