NYS Office of the Comptroller DiNapoli: As Share of NYers Without Health Insurance Reached New Low, Disparities Persisted Among Black, Asian, and Latino Populations

 

As State Recertifies Medicaid Enrollees, Reporting is Necessary to Understand Impact on Health Coverage and State Finances

From 2010 through 2021, the percentage of New Yorkers without health insurance declined every year to 5.2% in 2021, well below the national average of 8.6% and less than half of what it was in the state in 2010 (11.9%), according to an analysis by New York State Comptroller Thomas P. DiNapoli. Rates of uninsured New Yorkers are lower than the national average due to the state’s higher enrollment in public health insurance programs, which provided coverage to 4 in 10 New Yorkers in 2021. New York was tied with Connecticut for the 10^th lowest rate of uninsured in 2021 (the last year for which U.S. Census Bureau data are available).

Coverage disparities persist among the state’s Black, Asian and Latino populations and higher uninsured rates were also prevalent among low- and moderate-income groups. In 2021, just 3% of white New Yorkers did not have insurance, compared to 10% of Hispanic and 6% of Black and Asian New Yorkers. The highest uninsurance rates were in households with incomes between $25,000 and $49,000.

“Public policies over the last decade have had a significant impact in reducing the number of uninsured New Yorkers,” DiNapoli said. “As the state begins reprocessing eligibility determinations for public health insurance, continued transparency and reporting will be essential for understanding the implications for coverage rates among New Yorkers of all races and ethnicities and on the state’s budget.”

While most people with insurance both nationally (67%) and in New York (65.9%) have private health insurance, expansion of public health programs under state and federal policies has played an important role in reducing the number of uninsured. Rates of New Yorkers enrolled in Medicaid increased from 20.2% in 2010 to 27.7% in 2021 and surpassed national Medicaid enrollment rates every year.

Record Medicaid enrollment in 2021 reflects an increase in enrollment prompted by the pandemic and maintained under federal law. According to the Department of Health, there were 8 million enrolled in Medicaid in June 2023. As reported by DiNapoli’s office, the Division of Budget projects Medicaid enrollment to decrease to 6.9 million recipients by April 2024 as the state proceeds with recertification of those enrolled in its public health programs to determine their eligibility for continued enrollment. If enrollment exceeds projections, the Financial Plan may incur significant additional unbudgeted costs. 

DiNapoli emphasized the importance of transparency and reporting as the state undertakes its recertification efforts, and called for continued outreach to inform New Yorkers with public health insurance about impending program changes. In addition, he urged continued consideration of solutions to expand the number of New Yorkers with health insurance, such as the state’s request for a waiver from the federal government to expand access to the Essential Plan to those up to 250 percent of the Federal Poverty level, providing access to nearly 100,000 more New Yorkers.

Analysis

Health Insurance Coverage in New York State