Public Policy Institute of New York State, Inc.


Why Does New York Spend So Much on Medicaid? And What Can We Do About It?

From Long Island to the Niagara Frontier, New Yorkers are telling elected officials to do something about the high and ever-rising cost of Medicaid. But powerful interest groups are pressuring Albany to keep the status quo, predicting catastrophic results from any restraint in spending.

The Public Policy Institute provides the facts about New York's Medicaid spending in a new series of briefing papers, Medicaid Watch '05. The papers will be issued throughout March, as the Legislature continues its review and action on Governor Pataki's proposed budget. PDF versions of the briefing papers are available below.

All nine issues in one PDF file

Issue #9: Who is standing in the way of real Medicaid reform in New York State?
Virtually everyone agrees Medicaid costs too much in New York and does not deliver a commensurately high level of care. Why isn't there bold action, in Albany and at the local level, to reform the system?

Issue #8: Other states move boldly to reform Medicaid; why shouldn't New York?

This year's New York State budget takes some steps toward a Medicaid system that provides better care, while acknowledging the need to control costs. Much more remains to be done in both areas.

Issue #7: Do billions in extra Medicaid spending buy better care? Albany doesn't know

New York falls behind many other states in national rankings of health, and must do more to analyze what its $45 billion Medicaid program does to improve quality of care.

Issue #6: What has HCRA done to reform our costly, inefficient hospital system?

In recent years state leaders have made policy affecting billions in health-care spending under the rubric of the Health Care Reform Act adopted in 1996.

Issue #5: Why does New York spend billions more on long-term care?

Medicaid spending on nursing homes and other programs for the elderly is far higher in New York than elsewhere, but the extra billions may not give our aging residents better care.

Issue #4: What's our biggest single disparity with other states? New York's hospitals

If New York is ever going to get serious about controlling Medicaid costs, we need to go where the money is. For starters, that means hospitals.

Issue #3: How does Massachusetts manage to spend so much less than New York does?

Those who defend New York's enormous spending on Medicaid like to say we have to spend so much because we're different from everyone else.

Issue #2: Where do all those billions of taxpayer dollars go? Answer: All of the above.

Medicaid pays for many different programs. In almost every area, New York spends more — far more — than other states.

Issue #1: Virtually everyone agrees Medicaid costs too much. Will Albany finally act?

The program cost every New Yorker an average of $2,112 in fiscal 2003, the latest year for which national data are available. That was 2.3 times the national average.

These reports were researched and written by Robert Ward, the Institute’s director of research. To interview him about Medicaid spending or any of the reports, telephone 518/465-7511, ext. 271.

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