Recent Work
How the CDPAP Transition Could Leave Thousands of Home Care Workers Uninsured
The statewide transition to PPL on April 1 risks being a catastrophe for home care workers – lowering wages while eliminating health insurance coverage for tens or even hundreds of thousands of workers. Neither PPL nor the state has offered any explanation of why this is happening or what PPL intends to do about it; many workers are currently seeking information about whether they will still have health insurance on April 1.
Medicaid Enrollment: Getting the Facts Straight
Stories of a New York Medicaid enrollment crisis are difficult to square with other data. Census data shows that 47.0 percent of New Yorkers were covered by employer-sponsored insurance in 2023; that’s slightly below the national average of 48.6 percent, but certainly not a crisis
Strange Accounting: Understanding the Growth in New York’s Medicaid Spending
The Executive Budget projects total state-share Medicaid growth of 17.1 percent, or $6.4 billion – an extraordinary rate of growth. Department of Health Medicaid spending alone is projected to rise by $4.3 billion or 13.7 percent. Yet enrollment has declined sharply over the past 18 months and is projected to remain virtually flat this year. What explains this dramatic divergence between spending and enrollment?
What to Expect in the Budget: Healthcare
Healthcare didn’t take center stage in Governor Hochul’s State of the State address this week, but that doesn’t mean it won’t be central to New York politics this session. After all, rising healthcare costs are a key component of the affordability crisis squeezing New Yorkers, with premiums for individual and small-group health insurance set to increase by 12.7 percent this year.
How Fast is New York’s Home Care Program Growing?
Much recent reporting has focused on the growth of CDPAP in isolation, but this perspective exaggerates home care growth by ignoring the role of agency-model home care, which accounts for 44 percent of all Medicaid-funded home care in New York.
Making Sense of New York’s Medicaid Long-Term Care Spending
New York spends more on Medicaid long-term care than most states, but this higher spending is driven primarily by higher enrollment, particularly among seniors, rather than by higher per-enrollee spending. This high enrollment reflects policymakers’ decision to make long-term care, particularly home care, relatively accessible for working- and middle-class seniors.
The Healthcare Stand-off
The one-house budgets reflect a sharp disagreement between the Governor and the legislature on Medicaid spending. The executive budget proposes sharp cuts to several areas of Medicaid spending — most notably home care worker wages — and provides only limited support for financially distressed hospitals.
The Medicaid MCO Tax Strategy
The legislative one-house budgets come out firmly for higher Medicaid spending, restoring most of the governor’s cuts and offering significant rate increases. But how will they pay for it? The Senate and Assembly budget memos propose to raise $4 billion a year through an obscure mechanism: A tax on Medicaid managed care plans, the private insurance companies which administer most of the state’s Medicaid program.