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Between Medicaid and the state’s Essential Plan, 8.5 million New Yorkers enjoy taxpayer-supported health coverage “for the poor” — but more than a third, 3 million, earn too much too qualify, reports the Empire Center.
That’s roughly $20 billion a year in excess and potentially fraudulent spending, fostered by the progressive political class’ belief that the more people signed up, the better.
The center’s Bill Hammond identified the mismatch by simply comparing the known enrollment numbers with the Census report on New York income levels.
Created in the 1960s to serve the truly poor, the state-federal Medicaid program has gradually expanded to cover those with somewhat higher incomes; with its Essential Plan, New York aims to enroll anyone up to 250% of the poverty line.
But the state’s been beyond careless in policing enrollment.
As of this September, 44% of the Empire State’s population is covered — 20 points above the national average and seven points above the closest state.
That includes 60% of New York City residents.
The mismatch has been building over the years, Hammond finds: Over-enrollment reached 1.6 million in 2019, then zoomed to 3.6 million, thanks to Democrats’ ban on checking eligibility during the pandemic.
Yet the state’s failure to check since that rule expired still has the excess at about 3.4 million.
The impact isn’t just having taxpayers cover bills they shouldn’t: Because these programs reimburse providers at well below market rates, hospitals and so on make up the gap by charging even more to those with private insurance.
That is, this boosts bills for everyone else.
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And Hammond notes that enrollment in state-sponsored coverage is up 3.7 million over the last decade, even as New York’s total uninsured has dropped just 1.2 million — meaning the growth is mainly about replacing private health plans.
State leaders have been papering over the problem for years; back in 2019, then-Gov. Andrew Cuomo just rolled over massive red ink in the state’s then-$24 billion Medicaid budget to the next year’s budget.
Other Cuomo-era policies expanded coverage beyond less-needy individuals and families while at the same time approving stiff rate increases for hospitals and care homes.
Deep-pocketed special interests like the health-care union SEIU 1199 and the Hospital Association of New York love it, and reward lawmakers who keep up the madness — while Democratic Socialist types see this as progress.
But the insanity is a major reason the state budget has ballooned to nearly $230 billion, with no end in sight.
Or maybe there’s one on the horizon: New York voters took a bigger step to right this last election than the electorate of any other state, not because they love Donald Trump, but in revolt at the toxic policies of our local political class.