New York State budget expands Medicaid eligibility for older adults

[MM Curator Summary]: A new change in the NY budget process will allow older members to make more money and have more in assets and still have Medicaid coverage. It will also give non-citizens over 65 Medicaid coverage, but those members will have to be paid for using zero federal dollars.


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New York State Department of Financial Services


Bronx nursing home resident James Galbert receives his first dose of the COVID-19 vaccine in December 2020.

Reaction to the 2023 New York State budget continues, and older adult advocates are pleased that the $220 billion plan passed by lawmakers earlier this month expands Medicaid eligibility.

Starting in 2023, older, disabled and blind New Yorkers can make up to 138% of the federal poverty level and still qualify for taxpayer-funded health care coverage. That would increase the maximum monthly income for those groups from $934 a month to $1,563 a month.

“So what this is going to do is massively expand the reach of the Medicaid program for folks, specifically in the age, blind and disabled categories of eligibility,” said attorney Kelly Barrett Sarama with the Center for Elder Law and Justice, a Buffalo nonprofit legal agency.

In addition, the maximum assets those groups can have and still qualify for Medicaid will nearly double, from $16,800 to $28,134. For couples, the allowable maximum assets will increase from $24,600 to $37,908.

Under the current limits, Sarama said many people have to spend down much of their assets in order to qualify for Medicaid. Plus, she said, many younger Medicaid recipients, who are not subject to an asset test, lose their coverage once they move into the older, disabled or blind categories.

“What this increase will do is help protect folks who do have a bit of a retirement savings and who have a little bit of resources in their account from completely being forced to deplete their income and assets in order to qualify for Medicaid,” she said.

The budget also makes Medicaid available to undocumnted immigrants 65 and older, as well as extends postpartum coverage for Medicaid-eligible mothers from 60 days after they give birth to one year after they give birth.

One in three New Yorkers, 7.4 million people, are currently on Medicaid, including over 280,000 in Erie County. That number has increased by about 1 million since the COVID-19 pandemic began, as the economic recession made more people eligible and federal laws barred states from terminating coverage for most enrollees during the public health emergency.

Gov. Kathy Hochul’s office did not immediately respond to an inquiry about how many more New Yorkers are expected to be on Medicaid once eligibility expands next year. In December, the state Division of Budget had projected Medicaid enrollment to return to pre-pandemic levels of just over 6 million by 2024.

New York already has the second-largest Medicaid budget of any state in the nation, with total spending at $72.8 billion in 2020. Only Californida, with a $97.8 billion Medicaid budget, spent more.

The funding is crucial, Sarama said, as it’s the primary payer of long-term care in the state. Medicaid accounts for nearly 80% of New York nursing homes’ revenue and determines the wages of the state’s home care workers.

“As you age, you’re more likely to end up needing some care in your home in order to sustain your lifestyle and to remain living in your home, and so this increase will help more folks access the Medicaid program, access long-term care in New York State,” Sarama said.




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