New York’s per-capita Medicaid spending soared to more than double the nationwide rate in 2018, widening its gap with the other 49 states.

New York’s version of Medicaid, a health plan for the low-income and disabled, cost $3,869 per resident during the federal fiscal year ending in September 2018. That was 107 percent higher than the nationwide cost of $1,866 per resident.

New York’s rate was also 29 percent higher than the second-highest state, which was Alaska.

New York was topped only by the District of Columbia, a city with a large low-income population, which spent more at $4,218 per person.

Source: Centers for Medicare & Medicaid Services

This analysis is based on the most recently available Medicaid Financial Management Report from the federal Centers for Medicare & Medicaid Services.

The disparities between New York and the rest of the country had widened significantly in just two years. In 2016, New York’s per-capita spending of $3,236 was 79 percent higher than the national rate and 14 percent higher than the No. 2 state, which at the time was Vermont.

Albany’s spending surge came at a time of flat or declining overall enrollment, both in New York and nationwide.

During that period, however, New York was experiencing a sharp increase in demand for home-based care, especially the non-medical services known as “personal assistance.” 

As of 2016 – the last year for which nationwide data is readily available – New York accounted for 40 percent of nationwide Medicaid spending on personal assistance, up from 23 percent when Governor Cuomo took office in 2011. The program has continued to grow rapidly in the years since – and became a central target for the cost cutting changes recommended by the governor’s Medicaid Redesign Team earlier this year.

The coronavirus pandemic is likely to increase pressure on Medicaid’s finances. Between February and May, enrollment in the program jumped 4.3 percent to an all-time high of more than 6.3 million.

About the Author

Bill Hammond

As the Empire Center’s senior fellow for health policy, Bill Hammond tracks fast-moving developments in New York’s massive health care industry, with a focus on how decisions made in Albany and Washington affect the well-being of patients, providers, taxpayers and the state’s economy.

Read more by Bill Hammond

You may also like

One Brooklyn Health’s Money Troubles Raise a Billion-Dollar Question

A brewing fiscal crisis at One Brooklyn Health, which has received more than $1 billion in turnaround funding from the state, raises the question of whether that money has been well spent. Read More

Federal Staffing Rule Would Compound Hiring Pressure for New York Nursing Homes

Nursing homes that are struggling – and mostly failing – to comply with the state's two-year-old minimum staffing law would face even stiffer hiring challenges under newly proposed federal standards. Read More

What DFS Doesn’t Want To Tell You About Soaring Health Premiums

When the Department of Financial Services made its annual announcement about health insurance price increases last week, it neglected to mention one thing: how much the prices were increasing. Read More

Migrants, Medicaid, and More: NY’s Widening Budget Gap

The multi-billion-dollar gap Governor Hochul and the Legislature must confront in next year’s state budget appears to be growing larger.  Read More

Beware of Medicaid’s Spending Swings

The state's Medicaid spending is becoming increasingly volatile from month to mo Read More

New York’s Health Insurance Affordability Gap Grows Wider

New Yorkers paid some of the highest health premiums in the country in 2022, with one benchmark of affordability reaching its worst level yet, according to recently released federal survey of private-sector benefit plans. Read More

The Health Department’s Medicaid ‘Unwinding’ Report Leaves a Key Question Unanswered

As Medicaid downsizes in the aftermath of the coronavirus pandemic, reporting by New York and other states is missing data on an important group – outgoing enrollees who successfully made the switch to job-based insurance Read More

The Uncertain Math of ‘Coverage for All’

State lawmakers are divided over proposal known as "Coverage for All," which would allow low-income undocumented immigrants to obtain free health insurance through the state-run Essential Plan. Read More

Empire Center Logo Enjoying our work? Sign up for email alerts on our latest news and research.
Together, we can make New York a better place to live and work!