Medicaid applications surge
July 6, 2003

ELIZABETH COOPER
Observer-Dispatch

Jeanette Saponaro was one of a steady stream of people entering and leaving the county medical services office Tuesday morning.

She was checking to see if her husband, who is diabetic, might be eligible for one of the many new Medicaid programs being offered by the state.

"He could have insurance through his job, but it costs money," she said, her small daughter in tow. "He doesn't want to do that with me being sick and out of work. We're in a real bad situation."

Saponaro is not alone in her hope that the Medicaid system will give her family the help they need.

A deluge of 1,200 new applications for Medicaid or one of its programs have been filed each month this year.

Though only between 400 and 500 of those applications are granted each month, the influx is still substantial.

According to Department of Social Services statistics, the number of Medicaid recipients in the county held steady in the 29,000 to 30,000 range from 1999 to 2001. But in February 2002, the number was up to 31,394, and by February 2003 there were 35,800 people receiving the benefit.

Herkimer County Commissioner of Social Services Ervin Fuller said his county has seen a 19 percent increase in its Medicaid caseload in first six months of 2003 over the same period last year.

Statewide, 300,000 new Medicaid beneficiaries have signed on over the past 18 months, state health department spokesman Robert Kenny said.

However, Kenny characterized that increase as within normal fluctuation levels.

"If it continues, that would be something we'd have to take a look at," he said.

Oneida County Social Services Commissioner Theodore Mohr attributes the rise to the panoply of new Medicaid programs the state has created, and not to the troubled economy.

And Director of Medical Services Ellen Luley agrees.

"Many of the people we see coming in and out don't report a change in income or jobs," she said. "It's just that now they're aware there's a program (they might be eligible for) and they want to try and apply."

In the last few years, the Child Health Plus and Family Health Plus programs were implemented and the income levels for eligibility for certain Medicaid programs were raised, allowing more people to obtain the benefit.

The increase in beneficiaries is causing a rise in costs.

In 2002, Medicaid payments cost Oneida County $41.6 million, but this year, the costs are projected to leap to $48.9 million, county Budget Director Tom Keeler said.

The county's 2003 budget is about $277 million, and the increase in Medicaid spending is taking a heavy toll. In the 2003 budget, most department heads were required to cut costs by as much as 10 percent and a property tax increase of 16 percent was approved, Keeler said. The 2004 budget could be even tougher.

Of total Medicaid costs, the federal government pays 50 percent, the state pays 25 percent and the county pays 25 percent.

Mohr and Fuller say they believe the state should cap the county share of Medicaid costs at a specified dollar amount, so counties don't have to keep paying more and more as the state creates new programs.

"The rising cost of Medicaid is a disease, like cancer, that will soon be the destruction of local economies in New York state," said Mohr.

Many of the people at the medical services office Tuesday said they don't relish the idea of being on Medicaid, but they have no choice.

"I'm a very proud person," said a woman who would only give her first name, Nancy. "I think I cried for two days."

Nancy is self employed and pregnant, and said it would have cost hundreds of dollars to purchase private health insurance, far too much for her to pay. She will find out in two weeks if she is eligible for any of the programs.

A young woman in a bright orange T-shirt, who declined to give her name, said she makes about $13,000 a year in her job as a teaching assistant at an early childhood education center.

"I used to pay $50 a month (for health insurance)," the 23-year-old mother said. "They told me if I went on Medicaid with Child Health Plus, it would be free."

Luley said her staff has seen a lot of people such as the young mother who are dropping employer-based insurance in favor of Medicaid.

Though she sees the rising cost of Medicaid as a problem for the county, Luley said her staff is still focused on providing local people with the health services they need.

"If they get the medical care and keep healthy, they continue to be productive, which contributes to the well-being of the entire county," she said.