Max Politics Podcast Summary
Episode: Senator Gustavo Rivera on State Budget Negotiations, Health Policy, & More
Date: March 21, 2026
Host: Ben Max at New York Law School
Guest: NYS Senator Gustavo Rivera (Bronx, Chair, Senate Health Committee)

Episode Overview

In this episode, journalist Ben Max sits down with New York State Senator Gustavo Rivera to unpack the crucial state budget negotiations as the April 1 deadline looms. Their in-depth exchange spans Medicaid and health policy, looming federal challenges, the debate over revenue and tax increases, the governor’s controversial push to amend key climate legislation, support for New York City, mayoral control of schools, auto insurance reform, and more. Senator Rivera candidly describes both the technical and political dynamics shaping New York’s 2026 budget, especially on the health front.

Key Discussion Points & Insights

1. State Budget Status & Political Dynamics

• Budget negotiations are progressing, with the likelihood of a brief delay beyond April 1 due to overlapping holidays.
  • Quote (B. Rivera, 06:46): “I don't envision this being a long one after that... there's nothing crazy at this moment to report. But, you know, weird things have happened.”
• This year’s budget is seen as a “do no harm” plan, with less contentious policy than in years past—no major criminal justice reform fights.
• Major points of disagreement:
  • Tax increases proposed by the Legislature vs. Governor Hochul’s resistance to new revenue measures.
  • The governor’s push to alter the 2019 Climate Leadership and Community Protection Act (CLCPA).

2. Medicaid, Health Funding, and Federal Challenges

• Rivera’s top concern: Insufficient state response to significant federal cuts to health care, especially Medicaid and the Essential Plan.
• Over 1.2 million New Yorkers are at risk of losing coverage over the next two years due to federal eligibility changes (notably HR1).
  • Quote (G. Rivera, 13:24): “Starting in July, probably something like 450,000 New Yorkers will lose essential plan eligibility... by the end of 2027, potentially another 800,000.”
• Proposed state responses:
  • Use state-only dollars to extend coverage for those losing the Essential Plan, even if it means modest premiums.
  • Provide premium assistance for marketplace plans.
  • Directly offer Medicaid to more with state funds if federal match is unavailable.
• Need for new revenue, particularly through tax increases on the wealthy, to address health coverage gaps.
• Caution that administrative hurdles (waiting on federal waivers, slow movement of MCO tax money) and conservative fiscal management in the Governor's office slow solutions.
  • Quote (G. Rivera, 17:39): “The administration has been conservative… in how much [they spend], not in the ideological sense, but cash management.”

3. Medicaid Scrutiny & Accountability

• Federal investigation underway into New York’s Medicaid for “waste, fraud, and abuse.”
• Rivera counters these accusations:
  • New York's Medicaid is more expensive because it covers more people and services—part of the state’s social contract.
  • While acknowledging possible fraud, Rivera sees federal scrutiny as politically motivated targeting of blue states, not genuine oversight.
  • State oversight is ongoing, with Rivera introducing new legislation ("Oversight of Health Programs Act") to boost accountability for private contractors handling public health funds.
  • Quote (G. Rivera, 24:30): “I just introduced a bill... we found that private companies... say, ‘We can’t share that with you, that’s a trade secret.’ That’s not acceptable.”

4. Budget Health Initiatives: Drug Manufacturing & Home Care

• Affordable Drug Manufacturing Act: Modeled after California, letting NY partner with pharma to produce generics (starting with insulin) to save Medicaid dollars and possibly generate revenue.
  • Quote (G. Rivera, 30:28): “Think about us selling New York manufactured insulin to other states or to Canada…”
• Home Care Savings and Reinvestment Act: Would eliminate private “partially capitated” long-term Medicaid plans, returning to state-run fee-for-service to save billions and reduce insurance company influence as a model for broader reform (like the NY Health Act).

5. The Climate Law Showdown (CLCPA)

• Gov. Hochul seeks to delay implementation deadlines of the landmark 2019 climate law; both houses resist “watering down” or delay.
• Rivera: Such a consequential topic deserves deliberation outside budget negotiations, not as a last-minute bargaining chip.
  • Quote (G. Rivera, 34:39): “This is something that should be done outside of the budget... we should not be rushing this kind of discussion.”
• He questions whether the law is responsible for increased utility costs (it isn’t, per Gov. Hochul herself) and calls for post-budget dialogue.
• Warns against the governor’s strategy of leveraging budget deadlines to pass tough policies.

6. Tax Policy & Revenue Debates

• Rivera (and the Senate) advocate for new revenue, notably increasing taxes on income above $5 million and closing capital gains loopholes, to offset federal cuts and fund critical services.
  • Quote (G. Rivera, 39:53): “Not only is it necessary, but it is politically popular… Why is this such a hard sell?”
• Rebuts claims that higher taxes drive the wealthy or business out of state. Data shows more millionaires now than before the last tax increase.
  • Quote (G. Rivera, 42:03): “Every study on this issue has shown that rich people don’t leave.”
• The governor remains concerned about retaining high-income individuals and corporate headquarters.

7. Supporting New York City

• The Senate’s “one house” budget proposes over $5 billion in new revenue and funding for NYC, including authorizing higher corporate taxes at the city level.
• Debate continues on whether the state will provide direct aid, allow city tax increases, or require the city to identify local savings.
  • Quote (G. Rivera, 45:10): “We are open to the proposals... just above $5 billion... we want to help make the city whole.”

8. Mayoral Control of NYC Schools

• Gov. Hochul and Mayor Mamdani want 4-year extension of mayoral control; Senate left it out of their budget, reflecting mixed feelings within the conference.
• Ongoing discussions about ensuring more parental involvement and possibly codifying this into law.
  • Quote (G. Rivera, 48:41): “There are varied opinions within the conference about whether mayoral control is a good thing or not… not a consensus.”
• Class size mandate issues appear to be resolving, but no consensus yet on mayoral control’s future.

9. Other Major Issues

Auto Insurance Reform

• Hochul’s late push for anti-fraud auto insurance reform draws skepticism; concerns center on potential unintended harm to communities of color and gig workers.
  • Quote (G. Rivera, 54:41): “Insurance companies are not in the business of charging us less... I’m skeptical about the whole thing.”

Free Bus Pilot Programs

• Rivera is optimistic for localized pilot programs returning, but universal free buses are not imminent.
  • Quote (G. Rivera, 55:30): “We’re going to have some pilot programs come back… not the whole thing, but hopefully a chunk of it.”

Memorable Quotes & Moments (with Timestamps)

• [05:52] Rivera on his reputation: “I am known in certain circles as a table flipper... but I’ve certainly softened up in my olden age.”
• [13:24] On Medicaid coverage loss: “We’re talking about 1.2 million people who... are at the risk of losing some level of coverage.”
• [22:01] On Medicaid scrutiny: “Offering these services and providing this level of stability is part of what New York is about... If they don’t have any level of coverage... they’re still going to rely on the health care system that we got. And what we got is the emergency room.”
• [30:28] On generic drug manufacturing: “Think about us selling, selling New York-manufactured insulin to other states or to Canada, etc.”
• [34:39] On climate law changes: “This is something that should be done outside of the budget... not with a gun to our head.”
• [39:53] On raising taxes on the wealthy: “It's politically popular. Like, come on, you're running for reelection. Let's go. Let's be a champion for working class people.”
• [42:03] Dispelling tax exodus myths: “It’s a lie. Every study... has shown that the rich don’t leave. We have more millionaires now than then.”
• [45:10] On state aid to NYC: “We're open to the proposals that the city put forward... just above $5 billion... we want to help make them whole.”
• [48:41] On mayoral control: “There are varied opinions within the conference about whether mayoral control is a good thing or not… not a consensus.”
• [54:41] On auto insurance reform: “Why would insurance companies charge us less? The insurance companies are not in the business of doing that.”

Timestamps for Key Segments

• Budget Process and Timeline: [06:15–08:47]
• Biggest Issues in Negotiation: [09:01–10:30]
• Health Policy & Medicaid Coverage Loss: [12:17–19:28]
• Federal Investigation of Medicaid: [19:28–24:30]
• Accountability, Oversight, and New Legislation: [24:30–27:50]
• Health Manufacturing & Home Care Reforms: [30:28–33:15]
• Climate Law Showdown: [33:15–38:52]
• Tax Increases & Revenue Debates: [39:53–42:23]
• NYC Fiscal Support: [44:06–46:03]
• Mayoral Control of NYC Schools: [46:03–51:44]
• Auto Insurance Reform: [52:14–54:47]
• Free Bus Pilot: [55:16–55:56]

Summary Tone and Takeaways

Senator Rivera marries detailed policy analysis with unabashed progressive politics, employing humor, passion, and transparency about legislative sausage-making. He repeatedly stresses the urgency of protecting vulnerable New Yorkers—especially in health care—by securing new revenue and resisting shortsighted budget shortcuts. He is wary of executive overreach in budget negotiations and skeptical of politically motivated federal interventions or industry solutions that don’t genuinely serve New Yorkers. The conversation, rich in candor and specifics, offers insight for anyone curious about Albany’s most pressing policy and political debates as the 2026 state budget comes down to the wire.