Millions of New Yorkers Ineligible for Medicaid and Essential Plan, Report Shows
This story originally was published by Real Clear Wire
By Jeremy Portnoy
Real Clear Wire
Topline: According to a new report from the nonprofit Empire Center for Public Policy, an estimated 3 million New Yorkers on Medicaid or the state-run Essential Plan do not meet the income eligibility requirements for these programs.
Key facts: New York is projected to spend $113 billion on the two programs in 2025, with one-third of enrollees found to be ineligible.
Data from the U.S. Census Bureau indicates that only 5.5 million New Yorkers qualified for coverage based on income levels last year, yet 8.5 million people were enrolled in the state’s health insurance programs.
The Empire Center highlights that the Essential Plan, established under the Affordable Care Act in 2015, allows families living at 250% above the poverty level to enroll, making it the most generous plan in the U.S.
On average, each nondisabled adult costs the programs $6,600 to cover, leading to an estimated annual taxpayer expense of $20 billion to cover the 3 million ineligible individuals. This cost is shared between the state and federal government.
About 44% of New Yorkers utilize either Medicaid or the Essential Plan, with 60% of enrollees located in New York City. The Empire Center notes that no other state has more than 37% enrollment in similar programs.
Over the past decade, 3.7 million new individuals enrolled in these programs, yet the number of uninsured individuals in New York only decreased by 1.2 million, suggesting that many new sign-ups were previously insured elsewhere.
New York allocates 28% of its budget towards health insurance annually.
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Critical quote: “A generation ago, both major political parties would have viewed growing Medicaid rolls as a problem to be solved – a sign of rising poverty and social dysfunction and an unwelcome burden on taxpayers. Now, the state’s leaders treat record-high enrollment as an accomplishment to be celebrated, a benchmark of progress toward universal coverage,” the Empire Center wrote.
Summary: Medicaid is intended to assist Americans who cannot afford private insurance, not nearly half of a state’s population. The screening process for applicants in New York requires reevaluation and revision.
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This article was originally published by RCI and made available via RealClearWire.
