Medicaid, the largest single cost in Erie County’s operating budget, is no longer just an urban expense, according to a report released Thursday by the Medicaid inspector general for the county.
The report shows that a majority of the county’s Medicaid recipients reside in the city but that increasing numbers of people who rely on the program can be found in virtually all of Buffalo’s first-ring suburbs, including Cheektowaga, Amherst, Hamburg and West Seneca.
“What I want people to understand is that there’s no one place where people live in poverty. Every community in Erie County has at least one person on Medicaid,” County Executive Mark C. Poloncarz said during a news conference.
The report is the first in a series to analyze Medicaid data from Jan. 1, 2008, to April 30, 2013.
The Office of Medicaid Inspector General was created last year through a joint effort of the county and New York State as a pilot program for auditing Erie County’s annual $1.5 billion in Medicaid activity.
The report also analyzes the number of Medicaid recipients in the county by age and race, as well as the annual growth rate of enrollees, the average cost per enrollee by demographic group, and the 12 ZIP codes with the highest number of recipients.
While the top six ZIP codes are concentrated in Buffalo, the seventh-highest is in Lackawanna, the 10th is in Cheektowaga, and the 12th-highest concentration is in the City of Tonawanda and part of the Town of Tonawanda.
“Look at Amherst,” Poloncarz said, alluding to a map overlay charting every ZIP code in Erie County. “There are three major ZIP codes in Amherst. There’s more than 2,400 people in each of those ZIP codes who are on Medicaid.
“Even in the Town of Concord, Village of Springville, there are between 1,000 to 2,400 people in that rural area who are on Medicaid,” he added. “Poverty exists everywhere in Erie County, and we need to address it everywhere. We cannot ignore the issue.”
Medicaid is a federal- and state-funded health insurance program for low-income people that, in New York State, is administered through the county, which covers about 15 percent of the cost of the program.
Between 2008 and 2013, according to the report, 22 percent of all Erie County residents either have received or are receiving Medicaid assistance, 30 percent of them children.
In 2008, there were 183,249 county residents enrolled in Medicaid. That number is expected to grow to 225,000 by the end of 2013, which reflects an average growth rate of 4 percent a year.
The data also show that 97,016 white residents in Erie County, or 13 percent of that demographic, received Medicaid assistance in 2010. Fifty-two percent of black residents in the county, or a total of 64,067, were enrolled in Medicaid in 2010; and 17,624 Hispanic residents, or 42 percent, were Medicaid recipients.
The report also revealed that while white residents made up 44 percent of the Medicaid population in 2010, they accounted for 60 percent of the total Medicaid dollars spent in Erie County that year.
The average cost for a white Medicaid recipient was $8,527 in 2010, according to the report, while the average cost per enrollee for all other racial groups that year was $4,825, a difference of $3,702.
“This is troubling, and I’ve asked the Medicaid inspector general’s unit to take a greater look at this,” Poloncarz said.
“We’re going drill in further and find out why there’s such discrepancy in spending on whites versus other racial groups. We don’t know if it’s related to long-term care, … mental health … (or) more tests being prescribed for white Medicaid recipients as compared to others, but this is disappointing to see this, because Medicaid is supposed to be a fair system,” he added.
Meanwhile, the total cost for Erie County’s Medicaid program in 2011 was $1.4 billion, of which the county’s share was $206.4 million. In 2012, that cost rose to $1.426 billion, with the county’s portion rising to $211.7 million. In 2013, total Medicaid costs reached $462.8 million through April 30, with the county’s portion estimated to rise to $219.7 million by year’s end.
In addition to painting a sobering portrait of poverty in Erie County, a part of the aim of the analysis is to also target fraud, waste and abuse, as well as developing more efficient delivery of services, Poloncarz said.
The county executive emphasized that most people who receive Medicaid benefits are among the working poor.
“You can have a family of four and make $23,550 or less and still be eligible for Medicaid, so Medicaid is not just for individuals who are without jobs,” Poloncarz said. “Many of the people on Medicaid are working full-time jobs, but they do not receive health care coverage at their jobs, and they’re not making enough money to pay for health care on their own.”