Medicaid use grows in Lower Hudson Valley

October 1, 2010

WHITE PLAINS — The loss of jobs and employee health benefits has pushed more Lower Hudson Valley residents into Medicaid at a higher rate than the country as a whole. The state-federal health insurance program for the poor grew 8.2 percent nationally in 2009 to a record 48.5 million people, or one in six, according to a report released Thursday by the Kaiser Family Foundation. In the same period, December 2008 to December 2009, Medicaid enrollment grew 10 percent in Westchester, 12.5 percent in Rockland and 14 percent in Putnam.

"This is what happens when you have a private health insurance system that is completely unaffordable and the economy deteriorates — people legitimately qualify for these programs," said Georganne Chapin, president of Hudson Health Plan, a nonprofit managed-care organization that offers government health programs.

The report is just another way to measure a still-anemic economy, after other statistics this week show the number of working poor is at the highest levels since the 1960s. In addition to the recession and unemployment, however, a greater effort to insure more residents and changes that make it easier for more people to qualify for government insurance have contributed to the rise in Medicaid enrollment.

Many of the newer enrollees into the Medicaid program tend to be sicker than the general population, in part because they were previously uninsured or "underinsured," meaning they had no or little health coverage. "These are people with tremendous health-care needs," Chapin said.

Jacqueline Jones is among the newcomers to the Medicaid program. Two years ago, Jones, 41, of Mount Vernon had a full-time job at a nursing home as a medical supply coordinator and a part-time job at another nursing home as a nursing assistant. The mother of two had been earning about $45,000 per year with health benefits. A fall on a wet floor that injured a disc in her spine and tore a ligament in her knee led to mounting medical bills, disability and eventually unemployment. She could not afford to pay out-of-pocket for her family's health insurance after she lost her job. "It's rough. For someone used to going to work for 23 years, to not work is really, really tough," Jones said. Jones is worried that after she gets surgery to repair her injuries, she won't be able to find a job and will continue to rely on public assistance.

In the past four years, Medicaid enrollment in the counties of the Lower Hudson Valley has risen drastically: 17 percent in Westchester, 29 percent in Rockland and 37 percent in Putnam. Population growth and more children who are newly eligible are factors.

Meanwhile, the cost to local governments continues to grow as the counties struggle to balance their budgets. Westchester County, for example, will pay about $27 million more next year, said Donna Greene, spokeswoman for County Executive Rob Astorino. The federal government provided more than $100 billion in additional Medicaid funding to help states cover growing numbers of people in need. But that is set to expire in June.

Westchester County recently launched a computer program called REACH, designed to streamline the temporary assistance application process and weed out fraudulent claims in an effort to save $2 million annually, Greene said. "There seems to be no end in sight to the fiscal pressure on the Medicaid program," said Vernon Smith, who co-authored the Kaiser report.

Local Medicaid beneficiaries rise:

March 2000
* Westchester: 74,797
* Rockland: 26,972
* Putnam: 2,692

March 2006
* Westchester: 103,076
* Rockland: 46,257
* Putnam: 4,147

March 2010
* Westchester: 121,109
* Rockland: 59,894
* Putnam: 5,699

Source: state Health Department's Medicaid Eligibility and Expenditure Statistics report.