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:
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.
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.
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.”
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.
This presentation by Michael Birnbaum discusses current enrollment and spending associated with New York's Medicaid program and lays out the challenges ahead.
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.
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.
Published: 2010A 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.
Published: 2010Updated 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.
This Medicaid Institute™ report examines ways to increase enrollment and retention of eligible children and adults in Medicaid and CHIP, lower administrative program costs, and improve convenience for applicants.
This Medicaid Institute™ report explores a series of federal administrative and legislative changes that states can seek to improve their current public health insurance programs and increase participation.
This report examines the stability of Medicaid coverage and Medicaid managed care enrollment of adults and children in New York City over a four-year period.
This report analyzes the potential to enact continuous Medicaid coverage for children in New York State.