The Empire State’s radical leftists, led by Gov. Kathy Hochul, are deathly afraid that President Donald Trump’s Department of Government Efficiency (DOGE) will cut federal contributions to the state’s Medicaid Program.
And they should be. New York is the poster child for incompetent administration of the program.
Let’s review:
The governor’s budget proposal for the fiscal year that begins on April 1 projects that Medicaid spending, which includes federal, state and local government contributions, will hit an incredible $124 billion. That’s up 60% since Hochul was sworn into office four years ago.
Over 44% of the state’s 20 million residents — 8.8 million — are enrolled in Medicaid. That’s 7% higher than the nation’s largest and most left-wing state — California. On a national level, it’s 20% higher than the overall average of the 50 states.
New York City’s numbers are even more depressing. Sixty percent of its 8.2 million people are receiving Medicaid assistance. That’s 4.8 million!
The Empire Center for Public Policy has noted that in recent years the driving force of New York’s enrollment growth has been emergency Medicaid for undocumented immigrants. That program has 480,000 enrollees. It has grown by a breathtaking 1,200% since 2014.
“Most importantly,” Bill Hammond of the Empire Center has written, “adding millions of less needy, healthier employees to Medicaid rolls tends to divert resources from what should be the program’s core mission: providing decent care to people who cannot help themselves. People with serious, lifelong mental and physical disabilities are a shrinking faction of Medicaid enrollment.”
Then there is Medicaid corruption. Here are a few examples:
In October 2024, the U.S. Attorney for New York’s Southern District announced the indictment of eight people, including the owners of two senior citizen daycare facilities, for allegedly bilking the state’s Medicare Home Care Program of a whopping $68 million. The accused were charged with money laundering, conspiracy to collect kickbacks, and fraud.
One month later, New York’s Democratic State Comptroller Tom DiNapoli released an audit that concluded: “billions of dollars have been spent on Medicaid home care services for New Yorkers without the required verification that the services took place.” The audit DiNapoli said “found a disturbing lack of oversight and failure to comply with the required service verifications.”
The amounts that were not reported are staggering. Here’s a summary:
- $14.5 billion (yes, billion) in Personal Care claims for 82 million services (44%) that had no matching electronic visit verification record.
- $97.6 million in home health care claims reflecting 400,557 services (89%) that did not have a matching electronic visit verification record.
- $11.6 million in claims for visits that lasted less than 8 minutes — too short to be billable under Medicaid rules.
- $9.7 million for home services provided when the patient was hospitalized, and home visits should have been suspended.
And the Office of the Medicaid Inspector General was asleep at the switch. Its inspectors “did not take steps to ensure providers that were required to use a verification organization for pre-claim reviews actually obtained verification organization for that purpose.”
Then another audit that investigated Medicaid claims processed between October 1, 2023, through March 31, 2024, released on February 6, 2025, by Comptroller DiNapoli, determined that the state’s Department of Health, which administers Medicaid, made at least $16.2 million in improper payments:
- $11.8 million was paid for managed care premiums on behalf of Medicaid recipients who should not have had managed care coverage because they had other concurrent comprehensive third-party health insurance.
- $2 million was paid for fee-for-service inpatient claims that should have been paid by managed care.
- $1.3 million was paid for newborn birth and maternity claims that contained inaccurate information, such as low newborn birth weights that increased reimbursements.
- $964,333 was paid for inpatient, pharmacy, referred ambulatory, and clinic claims that did not comply with Medicaid policies.
- $126,786 was paid for claims where Medicaid was incorrectly designated as the primary payer instead of another insurer.
- $35,401 was paid for managed care premiums on behalf of incarcerated recipients whose managed care coverage should have been suspended.
These findings are outrageous. But they may only be the tip of the fraud iceberg. Remember, what the auditors discovered were from a handful of samplings. This could mean there are millions and possibly billions of squandered tax dollars that have not been uncovered.
Sadly, these reports did not generate any major headlines. As far as I know, heads did not roll in the Department of Health. For Gov. Hochul and the Democratic-controlled state Legislature, it’s business as usual. They will continue to dump more and more money into a dysfunctional status quo.
Hopefully, Elon Musk and his DOGE posse ride to the rescue and clamp down on New York’s scandal-ridden Medicaid program.
George J. Marlin, a former executive director of the Port Authority of New York and New Jersey, is the author of "The American Catholic Voter: Two Hundred Years of Political Impact," and "Christian Persecutions in the Middle East: A 21st Century Tragedy." Read George J. Marlin's Reports — More Here.