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It’s becoming Medicaid for the Many.
The number of New York state residents who get government-funded Medicaid health insurance is expected to soar to nearly 8 million this year, data released from Gov. Hochul’s $227 billion budget plan shows.
Another 3.7 million of New York’s 19 million residents qualify for Medicare, the government’s health insurance for the elderly. Some elderly residents also qualify for Medicaid, which covers long term care like nursing home costs.
Excluding those only on Medicare, the number of residents enrolled in New York’s public health insurance hits 9 million when factoring in other programs covering those who don’t qualify for Medicaid — including asylum seekers and other illegal migrants, and those whose incomes are slightly above the Medicaid threshold.
Medicaid rolls have skyrocketed over the past decade.
In New York, the Affordable Care Act — better known as ObamaCare — was used to move more people into the Medicaid program and reduce the number of uninsured residents. Enrollees in Medicaid jumped from 5.2 million in 2012 to more than 6 million by 2019.
And during the pandemic, job losses and unemployment triggered even higher Medicaid surges — to 6.8 million in 2020, 7.3 million in 2021 and nearly 7.8 million by December 2022.
The pandemic’s impact and the state’s ever-growing aging population is putting an enormous fiscal strain on Medicaid programs, whose total costs have ballooned to $94.4 billion, Hochul’s budget plan says.
The costs are split between the federal, state and local governments. The cost to New York will hit a record $34.7 billion — nearly double from a decade ago — in the fiscal year beginning in April.
The average yearly cost per member is $9,531 — more than $1,600 over what it was in 2017, state data reveal.
“The budget reflects over $1.6 billion in new costs associated with Medicaid enrollment estimates above prior projections,” Hochul’s budget analysis said.
The federal government pumped billions into states to help cover the jobless who enrolled in Medicaid and other public health insurances — but some of that emergency assistance will dry up, Hochul’s budget briefing book notes.
“Due to the COVID-19 public health emergency, Medicaid enrollment is projected to peak at a historic high of nearly 7.9 million enrollees in June 2023, and then decline over the next 12 months as COVID enrollment unwinds,” Hochul’s budget plan said.
“Eligibility will need to be re-determined for over 9 million people on the State’s various public health insurance programs. The uncertainty around future Medicaid enrollment puts risk on Medicaid spending in future fiscal years.”
New York’s aging population is another challenge.
“The State’s population is aging and driving significant growth in the Medicaid program, as costs for those who need long term care are ten times that of a typical Medicaid enrollee,” Hochul’s spending plan said.
In addition, the influx of poor migrants or asylum seekers landing here “may drive further costs to the State,” the governor’s plan says. Her proposed budget offers to pay New York City one third of an estimated $1 billion tab to address the migrant crisis.
Her spending plan also Increases the Medicaid reimbursement rates by 5% for hospitals, nursing homes and assisted living providers.
One health care expert said the Medicaid enrollment has become bloated because the federal government suspended its typical verification checks during the pandemic.
“There’s a certain amount of waste going on,” said Bill Hammond, senior fellow for health policy with the Empire Center for Public Policy.
Hammond said Hochul is “putting her foot on the gas” instead of trying to put a lid on Medicaid spending.
“Medicaid is supposed to be a safety net program. It shouldn’t have this many people on it. We have too many people in the Medicaid system who should be in a commercial health plan [through their employer],” he said.
Hochul’s budget briefing admits the Medicaid program “continues to grow beyond indexed growth, further challenged by Medicaid enrollment that is no longer assumed to return to pre-pandemic levels.”
But she also defends spending on the program as providing “critical investments to address the needs of vulnerable New Yorkers, stabilize the health care delivery system and improve health outcomes.”
Hochul says the Medicaid program is fine for now, but warns “in the long term…. Medicaid spending will need to be further reformed to align with allowable growth, while still meeting the needs of vulnerable New Yorkers.”