The arrangement through which Monroe County pays its Medicaid costs is complicated and President-elect Barack Obama's economic stimulus package might make it even uglier.

Obama's plan will probably include a boost in state Medicaid funding. And the way that would happen is through the percentage of funds the feds kick in for Medicaid - FMAP if you want to get wonky. If Obama and Congress increase the funding New York gets for Medicaid, the state presumably would reduce the percentage counties have to pay.

New York splits Medicaid costs 50-50 with the feds. And then the state splits its share with the counties. All except Monroe, that is. Monroe County officials opted into the Medicaid intercept, an arrangement where the state takes 40 percent of the county's sales tax receipts and the county doesn't have to pay for Medicaid.

Because of this exclusive arrangement, there's a distinct possibility that Monroe County might not see a reduction in its Medicaid costs, said Democratic County Legislator Vinnie Esposito during a press conference earlier today.

"We're working to try to figure out how that's going to affect us," Esposito said.

He's been in touch with the offices of Democratic House members Dan Maffei and Louise Slaughter.

Some will view Esposito's concern as partisan politicking. Maybe so, but it's a question that deserves an answer. If New York gets more federal Medicaid funding, will Monroe County see any benefit?