New York’s per capita Medicaid costs have remained the highest among the 50 states even as nationwide spending on the program surged during the pandemic.

New York’s version of the safety-net health plan spent a total of $83.4 billion in the federal fiscal year ending in September 2022, according to a recently released financial report by the Centers for Medicare & Medicaid Services.

That equated to $4,240 per resident, which was more than any other state and 70 percent above the U.S. average. New York was outspent only by the District of Columbia, which had per capita Medicaid costs of $5,784.


Medicaid is jointly financed by the federal, state and local governments. New York's non-federal share – a mix of money from the state, New York City and the 57 counties – amounted to almost $1,500 per resident, which was more than any other jurisdiction, including the District of Columbia.

New York's population-adjusted Medicaid costs were already first in the nation heading into the pandemic. Yet between 2019 and 2022, its total spending surged by 37 percent, which was six points faster than average.

The state's Medicaid spending level is partly driven by its generally high health-care costs. Its 2022 costs per enrollee – as opposed to per resident – were the fifth-highest among the states at $11,644.

Another factor is broad enrollment. In 2022, New York's Medicaid program covered more than one-third of its population, or 7.2 million people, an increasing number of whom live above the federal poverty line.

The 24-point gap between New York's enrollment rate (36 percent) and its poverty rate (12 percent) is the widest of any state.


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

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