ALBANY - More than one-third of New Yorkers are now on Medicaid or other publicly funded health-care plans, a spike of 57 percent over the past decade, a new report found.

The findings from state Comptroller Thomas DiNapoli in a report Wednesday highlighted New Yorkers' growing dependency on health-insurance programs run by the state and federal government amid uncertainty over the programs' future in Washington.

In all, more than 7 million of the state's nearly 20 million residents are enrolled in health-insurance programs that are publicly subsidized, DiNapoli said.

“There are disturbing calls in Washington to repeal the Affordable Care Act (ACA) and make radical changes to Medicaid,” DiNapoli said in a statement.

“We cannot go backwards on health care and force people to choose between buying groceries or seeing a doctor."

Fighting cuts

New York leaders, including Gov. Andrew Cuomo, have vowed to fight federal cuts to Medicaid and other program tied to the federal Affordable Care Act, which was a signature program of President Barack Obama that Congress passed in 2010.

President Donald Trump and the Republican-led Congress have sought to strip away provisions of so-called Obamacare, including ending an individual mandate that all Americans have health care or face tax penalties.

DiNapol and Cuomo, both Democrats, are seeking re-election this year.

New York has more than 4 million people on its health-care exchange, called NY State of Health, set up after the Affordable Care Act.

The majority of the exchange customers are enrolled in Medicaid because they were income-eligible to participate in the health insurance program for the poor and disabled.

Last month, New York regulators approved insurance-rate increases of about 9 percent, even though a dozen insurers sought increases of as much as 24 percent — blaming the higher expenses, in part, on the loss of the individual mandate.

Largest in nation

New York, when federal aid is included, spends $75 billion a year on its health-insurance programs, by far the most of any state in the country. It's the largest part of the state budget, when federal aid is included.

New York's programs are mainly Medicaid, Child Health Plus and the Essential Plan, which is available for people who can't get Medicaid but are still income eligible for assistance.

Medicaid alone covers an average of 6.2 million people a month, up 46 percent over the past decade, DiNapoli said.

While the Medicaid growth had historically been in New York City, DiNapoli said, there was even larger increases over the last 10 years in the city's suburbs — including the Hudson Valley.

In six counties — Dutchess, Nassau, Putnam, Rockland, Schenectady and Suffolk — the number of Medicaid enrollees more than doubled over the decade.

And 11 other counties saw enrollment growth of more than 75 percent, DiNapoli said: Columbia, Ontario, Orange, Saratoga, Seneca, Sullivan, Ulster, Warren, Wayne, Westchester and Wyoming.

Funding at risk

Federal funding paid for 54 percent of state Medicaid costs last year. The state picks up most of the rest, while counties pay a capped portion.

The Essential Plan has become a popular option for some income-eligible New Yorkers, and New York and Minnesota are the only two states that offer it.

It is available to New Yorkers under age 65 who meet certain income requirements and are not eligible other state-run programs.

Enrollment in the Essential Plan rose to nearly 729,000 individuals last year, DiNapoli said.

Overall, the programs have lowered the number of uninsured New Yorkers, and changes by the federal government could lead to more residents going without insurance, DiNapoli warned.

Cuts could also strain the state's finances, he said.

The National Center for Health Statistics said the percentage of New Yorkers without health insurance fell from 11 percent in 2008 to 5 percent in 2017, DiNapoli said.

Despite the cost of New York's programs, the state's uninsured rate was lower than the national rate by almost 50 percent last year, DiNapoli said.

"We need more people to have access to quality health care, not fewer," DiNapoli said.

"These cuts would also impact the state budget and require difficult decisions to cover shortfalls.”

JSPECTOR@Gannett.com

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