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2022 Financial Condition Report For Fiscal Year Ended March 31, 2022
Total Medicaid Spending Reaches Record High of Nearly $84 billion, an 11 Percent Increase
State Medicaid spending grew by $5.2 billion (22.9 percent) to $27.7 billion in SFY 2021-22, its highest level ever, due in part to higher enrollment levels impacted by federal restrictions on disenrollment during the COVID-19 public health emergency. Federal restrictions during the pandemic have also prevented the State from implementing a portion of Medicaid savings actions enacted in 2020.
Enhanced federal Medicaid funding during the pandemic helped lower overall State Medicaid spending by nearly $3 billion and local Medicaid spending by $645 million in SFY 2021-22.
State share spending is further influenced by the continued deferral of certain Medicaid payments with a State share total of $1.7 billion from SFY 2021-22 to SFY 2022-23.
Nearly 9 Million New Yorkers Benefited from Medicaid, Essential Plan or Child Health Plus
In March 2022, nearly 9 million individuals or 45 percent of New Yorkers were enrolled in Medicaid, the Essential Plan or Child Health Plus (which provides coverage for children under the age of 19 with incomes above Medicaid eligibility levels, subject to other income limits).
Medicaid Enrollment Reaches Record Heights
Individuals covered by the State Medicaid program rose by 500,831 (7.1 percent) to nearly 7.6 million by the end of March 2022, the highest level ever, largely due to federal restrictions on disenrollment during the public health emergency.
The Division of the Budget expects enrollment levels to peak at over 7.9 million in SFY 2022-23 and return to near pre-pandemic levels of approximately 6.1 million enrollees in SFY 2023-24.
Children and adults represented 74.9 percent of all average monthly Department of Health (DOH) Medicaid enrollees, but only 43.1 percent of the costs of DOH Medicaid claims for the State in SFY 2021-22. Elderly, blind, and disabled enrollees made up 19.3 percent of eligible recipients, but accounted for 55.2 percent of DOH Medicaid claims costs.
Essential Plan Enrollment Nears 1 Million
Enrollment in the Essential Plan, which began in SFY 2015-16, neared 1 million in SFY 2021-22, increasing by 8.9 percent to 970,939, largely due to coverage extensions without eligibility review during the COVID-19 public health emergency. In June 2021, the State also eliminated monthly premiums and added free dental and vision benefits for Essential Plan enrollees. The Division of the Budget expects enrollment to exceed 1 million in SFY 2022-23 and grow to over 1.2 million by March 2025.
In April 2015, New York State joined Minnesota to become the only states in the nation to establish a Basic Health Program, a new low-cost health insurance option authorized by the Affordable Care Act and largely funded by the federal government. In New York, the program is known as the Essential Plan. It is available to individuals who are under 65, not eligible for Medicaid or the Child Health Plus Program, without access to affordable coverage and with incomes at or below 200 percent of the federal poverty level. The State expects to expand Essential Plan eligibility to 250 percent of poverty in SFY 2022-23.
Spending on the Essential Plan increased by $948 million (20.6 percent) to more than $5.5 billion. In SFY 2021-22, federal funds covered 98.9 percent or nearly $5.5 billion in Essential Plan costs, with State funds covering the remaining 1.1 percent.
