Making Public Programs Work
An estimated 35.5 percent of New York's uninsured are eligible for public coverage (2009 data). Some have never enrolled; others have lost coverage although they remain eligible. The Fund is working to reduce the number of eligible but uninsured through a range of analytic efforts.
Recent work has focused on Medicaid reforms adopted by New York State in 2010 and 2011 and far-reaching provsions of the federal Affordable Care Act related to Medicaid eligibility determinations and enrollment procedures. The report Coordinating Medicaid and the Exchange reviews the challenges facing New York in integrating public program enrollment through the State's health insurance exchange, implementing consumer-friendly federal standards for detemining income eligibility and citizenship, and building the complex information technology system needed to meet these goals for public program enrollees, as well as for small businesses and individuals eligible for subsidizied or unsubsidized coverage through the exchange. Another report, "Revisioning" Medicaid as Part of New York's Coverage Continuum, highlights similar important issues for policymakers, focusing on a state law requiring New York to take over Medicaid administration from local social service districts and the challenges of meeting the needs of the various categories of Medicaid-eligible populations. Both these reports build on the Fund's longtime work dedicated to the simplification of Medicaid enrollment and recertification processes and are informing decisions related to the implemetation of federal health reform.
Complex application, enrollment, and renewal procedures that do not make effective use of modern information technology have been a major factor in the failure of New York's public programs to reach a significant number of eligible New Yorkers. The Fund's analytic work focuses on this eligible-but-uninsured population to better understand their unique characteristics and to consider approaches to improving New York's public program participation and retention rates.
A United Hospital Fund issue brief on the topic, New York's Eligible but Uninsured, found that New Yorkers who are uninsured despite being eligible for public health insurance coverage are more likely to be noncitizens, in working families, and in better health than their counterparts who are enrolled in coverage. Eligible but uninsured adults are also more likely to be childless.