The Health Department has been either unable or unwilling to document the eligibility status of almost one million Medicaid recipients, raising further concern about the possibility of large-scale over-enrollment.

New York’s Medicaid program, a safety-net health plan, has more than 17 eligibility categories with different income and asset limits based on age, disability, pregnancy and other factors.

In May 2024, the Empire Center filed a Freedom of Information Law request with the Health Department, seeking a count of recipients in each category over the past 10 years. These data were expected to shed light on why New York’s Medicaid enrollment has grown to be millions larger than its population living in poverty, as the center documented in a recent report.

After 10 months’ delay and a lawsuit by the Empire Center, the department in January provided records that turned out to be incomplete, covering only about 88 percent of enrollees.

In March 2024, for example, the department’s website showed Medicaid enrollment to be 7.3 million. The records released to the Empire Center gave the eligibility categories for 6.4 million recipients in that month, which was 970,000 short of the total.

When asked to explain this disparity, department officials said on Feb. 5 that they had provided data only for categories contained in a chart attached to the center’s FOIL request, which was taken from the Health Department’s website.

In response to your request, we provided you with the corresponding enrollment for the 17 categories in the chart you included.  To clarify, the chart is not meant to be an inclusive list of Medicaid categories but rather is a “desk guide” for local Departments of Social Services of common income thresholds for common populations. … Based on your request, we are unable to speculate exactly what categories you are interested in.  We suggest filing a separate FOIL request with the specific categories you are interested in.

However, the center’s request made clear that it was seeking all categories, not just those listed in the chart: ​​

The attached Health Department document identifies 17 eligibility categories. This request seeks an accounting of each of those categories along with any others reflected in the state’s database of enrollees (emphasis added).

The department’s limited interpretation of the request had never previously come up during the nine months that the query was pending. The center submitted its FOIL request in May 2024. In September, the department said it could provide the data if the center was willing to pay $794, which was meant to cover 20 hours of work by a data analyst. The center immediately paid that fee.

The department initially said the work would take three weeks. However, the center still had not received any records 10 weeks later, prompting it to file suit with legal representation from the Government Justice Center. The department committed to finally fulfill the request in exchange for having the suit withdrawn, but then on Jan. 13 provided incomplete records.

The center is considering its legal options to obtain the missing data.