3 million New Yorkers on Medicaid, public health insurance are costing state a staggering $20B in potentially fraudulent coverage: report
As many as 3 million New Yorkers may be fraudulently reaping taxpayer-funded Medicaid and other public health insurance benefits at a potential cost of $20 billion a year, a staggering new study claims.About 5.5 million Empire State residents have incomes low enough to meet the standard eligibility limits for Medicaid or the Essential Plan, a related public health insurance program.But with expanded eligibility rules under Obamacare and an increased demand for a controversial homecare program, enrollment has swelled to 8.5 million, a potential surplus of 3 million.“It raises the question of whether there is widespread fraud,” said Bill Hammond, the Empire Center’s senior fellow for health policy who drafted the report published Tuesday.The report says about 44% of state residents — including 60% of those in New York City — are covered by Medicaid or the Essential Plan, seven points above any other state.
The programs take up a large share of the state budget.“The overuse of taxpayer-funded insurance harms the state in multiple ways.Most obvious is the added burden on taxpayers.
Even assuming most of the 3 million excess enrollees are non-disabled adults and children, they could be costing Medicaid $20 billion or more per year,” the study said.It added that one-third of those getting taxpayer-funded coverage are earning more than the standard income limits.Some higher earners can skirt Medicaid’s eligibility limits through legal maneuvering, like putting income into a trust fund managed by a person on behalf of the would-be Medicaid enrollee, the report noted.The report also blamed state officials for the ballooning enrollment — saying the creation of the Essential Plan extended coverage up to 250% of the federal poverty level.Sign up for our Metro Daily newsletter! Please provide a valid email address.
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