More applying for Medicaid; states struggle with costs

More people signed up for Medicaid last year than at any time since the program's inception in the late 1960s, as the recession wiped out jobs and workplace health coverage, according to a report released Thursday by a nonprofit organization that focuses on health care issues.

The report by the The Henry J. Kaiser Family Foundation found that enrollment in the safety-net medical insurance program jumped to nearly 48.5 million as of December 2009. With the economy barely improving, states are forecasting a 6 percent increase in the rolls next year, meaning another strain on their cash-depleted budgets.

Nearly 6 million people nationwide have signed up for Medicaid since the start of the recession in December 2007, according to Kaiser.

Starting in the fall of 2008, the federal government provided more than $100 billion in additional Medicaid funding to help states cover growing numbers of people who are unable to afford medical care. The last of that money will run out in June of next year, and states will face a jump of 25 percent or more in their share of costs.

"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.

From December 2008 to December 2009, Medicaid enrollment nationally rose by nearly 3.7 million people, the biggest 12-month increase since the early days of the program's implementation, the report found.

In New York State, Medicaid enrollments during that same time period jumped 383,221 - to 3,837,487 from 3,454,266.

"If the economy improves and people find jobs, then things will get better," said Peter Constantakes, a spokesman for the state Health Department. "We are trying to control costs, but Medicaid is basically income-driven, and more people are enrolling."

Constantakes noted that the department is slated to come up with a plan by Nov. 1 for the state to take over administration of the program from the counties and New York City. "We expect to be able to save money once that is in place," he said, adding that it is a process that will take some time.

However, the New York State Association of Counties said through spokesman Mark LaVigne that "Medicaid administration only accounts for 2 percent of the total $52-billion budget the state spends on Medicaid each year, and property taxpayers fund $7 billion of the state's total cost of the program, and none of that covers Medicaid administration."

LaVigne also said the association believes the state should take over full fiscal responsibility of the program.

In Nassau County, the increase in Medicaid enrollments from December 2008 to December 2009 was 79,261 to 88,799, and in Suffolk, from 98,601 to 125,110.

Suffolk County Executive Steve Levy noted that there now is a cap in place on county costs for Medicaid. But "even with the cap in place, we are still forced to come up with millions of dollars extra to slay the Medicaid beast," he said.

Nassau County Executive Edward Mangano, through spokesman Michael Martino, said, "The number of families and seniors struggling to make ends meet is growing each and every day. My 2011 county budget holds the line on property taxes while maintaining critical services to help our residents stay afloat during these poor economic times."

With Sid Cassese