Enrollment in New York State’s Medicaid program just topped 5 million, another milsteone for the massively expensive program, the Wall Street Journal reports today (subscription required). As the article notes: “The surge presents a fiscal challenge for the Cuomo administration and its effort to rein in the $52.6 billion Medicaid budget, the state’s single biggest spending area when federal and county funding is included.”

The Journal helpfully points out that this increase can’t simply be blamed on the recession. In large part, it’s the result of a deliberate policy aimed at making more New Yorkers dependent on government-subsidized health insurance:

New York is one of five states to provide Medicaid to childless adults. In recent years, the state eliminated resources tests, allowing most applicants to attest their family assets. It also stopped requiring face-to-face interviews, switching to mail-in applications.

Last year, the state health department posted online tips explaining how people with too much income for Medicaid can still get into the system.

The Cuomo administration’s Medicaid team is seeking to remove the requirement that applicants submit original documents to enroll. It’s also proposed using technology to recruit more patients and add an “Are you interested?” in Medicaid line on tax return forms.

The official policy of encouraging more people to sign up for Medicaid dates back more than a decade, and was expanded under Republicans. Family Health Plus was pioneered under Gov. George Pataki in 1999.  A year later, Mayor Rudolph Giuliani launched New York City’s HealthStat program, described by approving health care organizations as “a major citywide initiative to enroll uninsured New Yorkers in public health insurance programs.”