So, if I live in one of these counties, I am required to pay the extra fee?
Yes, the MCTD fee.
I may be moving out of New York in the next few years. Can I get a refund of my licensing fees if I've exchanged my New York driver license for an out of state one?
Yes, you can get a refund. You will need to attach a photocopy of your out of state driver license to form MV-215 and mail it to the address on that form. It may take up to 12 weeks to receive the refund.