The Medicaid Institute™ at United Hospital Fund

An initiative of United Hospital Fund

Covering More Low-Income New Yorkers

New Yorkers are eligible for Medicaid if their incomes are below the program’s limits and they meet requirements related to assets, residency, and immigration status. Medicaid’s income limits range from 133 percent of the federal poverty level for childless adults to 223 percent of poverty for pregnant women and infants. (The federal poverty level for 2014 is $11,670 for an individual and $19,790 for a family of three.) Children in families whose income exceeds Medicaid limits are eligible for subsidized coverage under New York’s Child Health Insurance Program (CHIP) at family incomes up to 400 percent of the poverty level.

About 5.2 million New Yorkers were enrolled in Medicaid as of December 2013, including:

  • 2.0 million children who are not disabled (not including 0.3 million enrolled in CHIP)
  • 1.9 million adults who are neither elderly nor disabled
  • 1.3 million individuals who are elderly, disabled, or both

Of New York's 2.2 million uninsured residents, an estimated 750,000 are eligible for Medicaid or CHIP. Some have never enrolled, and others have lost coverage despite remaining eligible. Complex application, enrollment, and renewal procedures—which do not use modern information technology effectively—are major reasons Medicaid fails to reach a significant number of eligible New Yorkers. Because the program typically enrolls the sickest and most costly subsets of those eligible for it, coverage for Medicaid-eligible New Yorkers who are currently not insured would likely result in larger increases in enrollment numbers than in spending.

Related Publications

Redesigning Children’s Behavioral Health Services in New York’s Medicaid Program      

Published: 2015

This report gives an overview of the complex structure of New York Medicaid’s current services for children needing behavioral health services, reviews the State’s planned approach to reforming this system, and explores several important policy considerations for stakeholders as the reforms move forward.

New York’s Medicaid in Transition      

Published: 2014

This comprehensive overview of New York’s Medicaid program provides essential grounding in the dramatically changing program, focusing on the changes related to the federal Affordable Care Act and the State’s Medicaid Redesign Team; it also presents recent data on spending and enrollment and examines complex reforms underway or planned for the near future.

Integrating and Improving Care for Dual Medicare-Medicaid Enrollees: New York’s Proposed Fully Integrated Duals Advantage (FIDA) Program      

Published: 2012

This report from the Medicaid Institute at United Hospital Fund focuses on a proposed New York State program to better manage care of  beneficiaries who are enrolled in both Medicare and Medicaid, commonly referred to as “duals.”

Health Insurance Coverage in New York, 2009      

Published: 2011

This edition of the annual chartbook quantifies differences in insurance coverage and uninsurance around New York State and within New York City. Data are broken down into 14 separate regions across the state, including the five boroughs of New York City. Within the city itself, estimates are provided for 55 separate neighborhoods.

Medicaid in New York: The Road Ahead      

Published: 2011

This presentation by Michael Birnbaum discusses current enrollment and spending associated with New York's Medicaid program and lays out the challenges ahead.

"Revisioning" Medicaid as Part of New York's Coverage Continuum      

Published: 2011

Federal health care reform and new state Medicaid administration legislation can help New York achieve a radically streamlined, consumer-friendly eligibility and enrollment process for Medicaid and subsidized coverage options in the Exchange.  This report details the challenges of achieving that goal.

Medicaid in New York: Current Roles, Recent Experience, and Implications of Federal Reform      

Published: 2010

This Medicaid Institute publication lays out the challenges and opportunities facing New York’s Medicaid program, against a backdrop of a historic federal health care reform law and an unprecedented state budget deficit.

Enrolling Childless Adults in Medicaid      

Published: 2010

A Medicaid Institute report outlining health care reform's opportunities and incentives for states to extend Medicaid eligibility to more childless adults. New York's experience with this population is relevant to other states that will extend eligibility to it for the first time. The Affordable Care Act's significant financial incentives and new opportunities to streamline enrollment may also help New York meet its own enrollment challenges.

Health Insurance Coverage in New York, 2008      

Published: 2010

Updated and expanded with 2007-2008 data from the Current Population Survey, the Fund’s annual chartbook provides an invaluable snapshot of the uninsured in New York, detailing income, employment status, age, and other demographic information. It also tracks coverage distribution among workers and low-income New Yorkers, estimates the number of uninsured New Yorkers who are eligible for public health insurance, and describes trends in coverage over time.

Medicaid Institute™ at United Hospital Fund
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