New York: Medicaid expansion enrollment up 25% since COVID struck; total Medicaid up 19%

New York

I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from Medicaid.gov's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In some states I've been able to get more recent enrollment data from state websites and other sources.

Today I'm presenting New York.

For enrollment data from January 2021 on, I'm relying on adjusted estimates based on raw data from the New York Health Dept.

Most New Yorkers enrolled in Medicaid via ACA expansion were actually eligible prior to the law being passed under pre-ACA funding & waiver arrangements. However, those programs & funding sources have long since been discontinued, so this distinction doesn't mean much if the ACA were to be struck down; all Medicaid enrollees funded under the ACA terms (90% federal) would likely be out of luck.

Overall Medicaid enrollment in NY (including ACA expansion) remained remarkably consistent from 2014 - early 2020, except for two extremely odd periods in early 2015, when expansion enrollment supposedly jumped by half a million people out of the blue in March before dropping back down by a similar amount in June...and especially in April 2017, when non-ACA enrollment supposedly plummeted by a whopping 1.5 million people in April, only to jump back up again by around the same amount in October, just six months later. I'm also not sure what was going on in the first few months of 2014, when CMS data claims that only 1.25 million NY residents were enrolled in non-ACA Medicaid when it was clearly upwards of 4.7 million or so.

Clearly all three of these involved either a data-entry error, some sort of internal recategorization (note how overall Medicaid enrollment stayed consistent through the second incident) or both. I'll post a follow-up if I find out what the heck happened in either instance.

Since COVID hit New York hard in early 2020, however, non-ACA Medicaid enrollment has increased by 16.4% and the expansion population has grown by 24.8%, for an overall increase of 19% in the COVID era.

New York has 20,201,249 residents according to the 2020 U.S. Census. As of May 2021:

  • around 7.21 million were enrolled in Medicaid overall, or nearly 36% of the population
  • around 4.89 million were enrolled in non-ACA Medicaid
  • around 2.32 million were enrolled in ACA Medicaid expansion
  • in addition, around 893,000 New Yorkers are enrolled in the "Essential Plan," NY's ACA-created Basic Health Plan program.
  • Add in the ~120,000 subsidized ACA exchange enrollees and that's around 3.33 million New Yorkers who would lose healthcare coverage if the Supreme Court strikes down the Affordable Care Act, or 16.5% of the state population.