Enrollment in NYC Disaster Medicaid Program ‘Surges’
Enrollment in New York City's Disaster Relief Medicaid program has "surg[ed]" with "no advertising and little official promotion," offering "important lessons" on enrollment expansion, according to advocates for the uninsured, the Washington Post reports. Over the past six weeks, more than 75,000 New Yorkers, many of whom previously qualified for Medicaid but did not apply because of a lengthy application process, have enrolled in the new program. The surge is the "biggest one-time enrollment increase in Medicaid history," according to Medicaid experts. The Sept. 11 attacks on the World Trade Center damaged the city's computer system that processes Medicaid applications, forcing officials to "drastically streamlin[e]" the normally "arduous application process." At the same, the Sept. 11 attacks "clearly expanded the pool of New Yorkers eligible for Medicaid" as the city lost more than 100,000 jobs and the economic downturn in the city "accelerated." Under the temporary program, applicants can sign up for four months of Medicaid coverage "on the spot" if they sign a single-page statement swearing that they meet income requirements, which range from $716 a month for childless adults to $2,626 for a family with four children. Normally, the enrollment process requires an eight-page application and can take six weeks to process. Applications for Disaster Relief Medicaid will be accepted until Jan. 31 and coverage expires four months after enrollment. Those who are eligible for standard Medicaid must complete the regular application after the four months. While Disaster Relief Medicaid was designed to provide temporary coverage for those impacted by the Sept. 11 attack on the World Trade Center, many applying for coverage have been "poor for years," but thought they were ineligible or did not have the required documentation. The Post reports that those enrolling heard about the program through the city's "multilingual word-of-mouth network" and decided to apply because they needed treatment and would be covered "immediately." Many applicants said they chose to be uninsured in the past because applying for Medicaid seemed like "too much of a hassle" or they were hoping their economic situation would improve.
Kristine Smith, a spokesperson for the state Health Department, said that the state is "evaluating the results" of the temporary program, but that it is unlikely that there are "lessons" for Medicaid in general. "This was an extraordinary response to extraordinary circumstances," she said. However, Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, said, "The message from New York is that if you build it right, they will come." Federal officials have "urged" states to simplify Medicaid enrollment, the Post reports, and the program in New York has created an "opening" for advocates who "long have called for less-stringent applications" and longer periods to provide supporting documentation. According to the United Hospital Fund, a not-for-profit research organization, about one million families in New York City are eligible for Medicaid but "remain outside the system." A coalition of advocacy groups is now working with families who enroll in Disaster Relief Medicaid to prepare applications for standard Medicaid before the temporary program expires (Russakoff, Washington Post, 11/26).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.