ALBANY, N.Y. — New York state could face some tough financial decisions if Republicans in Washington follow through on proposals to cut funding for state health care programs.

That’s the conclusion of a report issued Thursday by New York state Comptroller Thomas DiNapoli (dee-NAP’-oh-lee).

DiNapoli, a Democrat, says possible federal funding cuts are “key risks” facing the state’s new $153 billion budget.

He says every New Yorker should be concerned that the cuts could force state leaders to make “tough fiscal choices.”

DiNapoli also criticized what he called a lack of transparency and accountability in the budget. He noted that lawmakers and Democratic Gov. Andrew Cuomo included billions of dollars in lump-sum spending, giving state agencies, and not elected lawmakers, wide discretion in deciding how it’s spent.

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