Medicaid expenses in Empire State continue to rise
Approximately 8.5 million New Yorkers benefit from taxpayer-supported health coverage through Medicaid and the Essential Plan, but a surprising 3 million do not qualify due to earning too much, as reported by the Empire Center. This leads to around $20 billion in excessive and potentially fraudulent spending each year.
The progressive political class believes that enrolling more people is better, leading to a significant number of individuals signed up for these programs despite their income levels exceeding the eligibility criteria.
By comparing enrollment numbers with income levels reported by the Census, Bill Hammond from the Empire Center identified the mismatch in the system.
Initially designed to aid the truly poor, Medicaid has expanded over the years to cover individuals with slightly higher incomes. The state’s Essential Plan aims to enroll anyone up to 250% of the poverty line. However, enrollment monitoring has been lacking.
Currently, 44% of New York’s population is covered by these programs, which is significantly higher than the national average.
The excessive enrollment issue has been growing, particularly with the ban on eligibility checks during the pandemic leading to a surge in enrollments. Despite the rule expiring, the state has still not addressed the 3.4 million excess enrollments.
The repercussions of this mismatch extend beyond taxpayers covering unnecessary expenses; providers are forced to make up for low reimbursement rates by charging higher fees to individuals with private insurance, ultimately increasing costs for everyone.
State-sponsored coverage enrollment has risen by 3.7 million in the last decade, mainly replacing private health plans. This growth has contributed to the state’s ballooning budget, currently standing at nearly $230 billion.
Although special interests and certain political groups support these policies, New York voters showed discontent in the last election, signaling a potential shift in addressing these healthcare issues.
