Metro

City Medicaid near critical condition

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The number of city residents qualifying for Medicaid has hit a record that’s likely to go even higher next year when enrollment will almost certainly reach the milestone 3 million mark — or more than 37 percent of the population, officials said yesterday.

As of July, a record 2,927,952 people here were getting their health insurance covered by the government. Although the numbers fluctuate slightly from month to month, the annual trend is headed in one direction: up.

Five years ago, in July 2006, the city’s Medicaid rolls stood at 2,573,610.

Robert Doar, commissioner of the city’s Human Resources Administration, which oversees Medicaid, said the steady increases are evidence that low-income workers are becoming dependent on the government for medical insurance as more and more employers drop health coverage.

“The use of Medicaid as a work support for low-income workers is very much a part of what’s going on in the city and the rest of the country as well,” Doar said. “We think it’s an important expenditure. It allows people to take employment that doesn’t provide health insurance.”

But only those with very low incomes can make the cut. The maximum allowable net income for a family of four is $17,420 a year.

Medicaid is no longer the crushing financial burden it once was for the city.

Until five years ago, the feds paid 50 percent of the bill, with the state and city splitting the rest down the middle.

Starting in 2006, the state capped most of the city’s Medicaid cost at 2005 levels, plus a yearly inflation adjustment of about 3 percent.

Washington also began picking up a larger part of the tab in late 2008, as part of a federal stimulus package that largely expired in June.

As a result, total Medicaid spending in fiscal 2011 came to $28.3 billion in New York City. Washington paid $13.5 billion, the state $10.2 billion and the city $4.6 billion, or little more than 16 percent.

But as federal subsidies wind down, the city’s bill in the 2012 fiscal year is expected to reach $6 billion.

Chuck Brecher at the Citizens Budget Commission noted that the revised formula makes the growing Medicaid rolls a fiscal problem more for the state than the city.

“It’s the state that’s the one getting the squeeze put on,” he said.

It’s also much easier to qualify for Medicaid than for welfare, in which recipients are required under federal law to work for their benefits.

As the Medicaid rolls jumped 15,266 between June and July to their highest level ever, the welfare rolls fell to 347,586, lowest since August 2010.

Doar is on a state panel examining how to redesign the Medicaid system. He said one issue under discussion is whether the state or city should screen applicants.

“To the extent that we no longer determine eligibility, the argument could be made, why are we paying any portion of the cost,” said Doar.

david.seifman@nypost.com