2023 Financial Condition Report

For Fiscal Year Ended March 31, 2023

Public Health

2023 Financial Condition Report
For Fiscal Year Ended March 31, 2023

Total Medicaid Spending Reaches Record High of $92 billion, a 10 Percent Increase

  • State Medicaid spending grew by $3.6 billion (13 percent) to $31.3 billion in SFY 2022-23, its highest level ever, due in part to higher enrollment levels impacted by federal restrictions on disenrollment during the COVID 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 an estimated $3.7 billion and local Medicaid spending by $789 million in SFY 2022-23.
  • State share spending is further influenced by the continued deferral of certain Medicaid payments with a State share total of $1.8 billion from SFY 2022-23 to SFY 2023-24.
Bar chart of Medicaid Spending in New York State

Nearly 9.4 Million New Yorkers Benefited from Medicaid, Essential Plan or Child Health Plus 

  • In March 2023, nearly 9.4 million individuals or 47.6 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 214,090 (2.8 percent) to nearly 7.8 million by the end of March 2023, the highest level ever to that point, largely due to federal restrictions on disenrollment during the public health emergency.
  • The State Department of Health (DOH) reports that enrollment exceeded 7.9 million in July 2023, a decrease of about 103,000 enrollees (1.3 percent) which was the first decrease since February 2020. However, the Division of the Budget expects enrollment to decline to 6.9 million by March 2024 and to 6.6 million by March 2025.
  • Children and adults represented 74.7 percent of all average monthly DOH Medicaid enrollees, but only 43 percent of the costs of DOH Medicaid claims for the State in SFY 2022-23. Elderly, blind, and disabled enrollees made up 18.8 percent of eligible recipients, but accounted for 55.1 percent of DOH Medicaid claims costs.
Bar chart of Medicaid Costs and Enrollees

Essential Plan Enrollment Exceeds 1 Million

  • Enrollment in the Essential Plan, which began in SFY 2015-16, exceeded 1 million in SFY 2022- 23, increasing by 19.8 percent to 1,163,584, largely due to coverage extensions without eligibility review during the COVID-19 public health emergency. The Division of the Budget expects enrollment to grow to over 1.2 million by March 2026.
  • In 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 (ACA) 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 (CHP) Program, without access to affordable coverage and with incomes at or below 200 percent of the federal poverty level. The State has submitted a proposal to the federal government to expand the Essential Plan to New Yorkers with incomes between 200 and 250 percent of the federal poverty level. Spending on the Essential Plan increased by $789 million (14.2 percent) to more than $6.3 billion. In SFY 2022-23, federal funds covered 99 percent or nearly $6.3 billion in Essential Plan costs, with State funds covering the remaining 1 percent.
Bar chart of Enrollment in Medicaid, Essential Plan and Child Health Plus