Greene County lawmakers, mostly Republican, have been waging a battle with Democratic governors in Albany for decades. Supervisors in Columbia County, mostly Republican, have been mixing it up with Democratic administrations for a long time.

The latest battlefield is EFMAP, or Enhanced Financial Medical Assistance Percentage, funds the federal government provides to states to contribute to the Medicaid program. Since the passage of the Affordable Care Act in 2012, New York state has shared these funds with the counties, saving them millions of dollars in Medicaid costs.

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