Barries to Medicaid

March 1, 2001

Challenges and Opportunities for New York State

In 1965, Congress enacted Title XIX of the Social Security Act, which created Medicaid,  a joint federal and state health insurance program for low-income single-parent families with children,low-income persons over the age of 65, and the disabled.  In addition to those persons coveredunder the federal program, New York State subsequently extended the coverage to include low-income childless adults.

A study of federal law and numerous directives from the Health Care Financing Administration(HCFA), the federal agency with oversight of the Medicaid program, reveals that federal intentwas to design a straightforward program with a simple application process.  Federal law requiresfew of the administrative complexities characteristic in New York State’s application andenrollment process.  In addition, over the years, HCFA has set forth directives to state Medicaidagencies, encouraging greater simplification of the Medicaid application process.

This report identifies areas where New York State and local practices exceed or counter federalregulations and, in doing so, create barriers to accessing Medicaid.  This causes Medicaid-eligible New Yorkers to not apply, to give up during the application process, or to be foundineligible due to inadequate documentation.