The Medicaid costs for Erie County residents enrolled in the government health care program are expected to soon crack $2 billion even though the number of local Medicaid recipients has leveled off after years of growth.
White Medicaid recipients are the ones costing the program more, according to a Medicaid data report being released today.
Overall, the average Medicaid cost per recipient is $6,680. But the average cost for a white recipient last year was $7,976, compared with $6,100 for blacks and $5,593 for Hispanics, according to the report from the Erie County Medicaid Inspector General's Office.
"It is a big difference, and it's something that we have not discovered a root cause for," said County Executive Mark Poloncarz.
Nearly 31 percent of county residents – 282,844 people – receive Medicaid benefits, according to the report. That percentage is stable from 2015 to 2016, though the actual number of Medicaid recipients dropped by about 3,000 last year.
Medicaid is a government-sponsored health care program for poor and low-income residents. A family of four earning $32,718 would qualify for Medicaid.
Whites comprise the largest single group of Medicaid recipients by race at nearly half, a fact Poloncarz and Erie County Medicaid Inspector General Michael Szukala said is not broadly understood by the public.
"There seems to be an impression for people that minorities make up the bulk of the people on public assistance," Szukala said. "And I can tell you on Medicaid, that's not true."
Blacks comprise 29 percent of recipients, followed by 9 percent for Hispanics. Though more whites receive Medicaid benefits than other races combined, black and Hispanic recipients comprise a greater proportion of Medicaid recipients compared with their proportion of the county population, in keeping with broader poverty demographics.
Poloncarz said he was troubled to see that whites make far more use of Medicaid benefits than all other racial groups. He speculated whites may have greater access to transportation and therefore greater access to specialized care, but said he'd love to hear from experts.
As for the overall number of county residents on Medicaid, Szukala attributed the decline to an improving economy and the fact that residents interested and eligible for Medicaid under the Affordable Care Act in 2013 have already done so. Given the trend, Szukala said he no longer predicts that a full third of Erie County residents will be on Medicaid by 2021.
But the tapering of local Medicaid recipients has not led to a smaller bill for New York State, which has the second highest Medicaid enrollment rate in the nation at one-third of all residents, according to PolitiFact.
Last year's Medicaid bill for Erie County stood at nearly $1.89 billion. That compares with $1.78 billion two years ago and $1.2 billion in 2008, the earliest year for which the county electronically tracked the data.
Erie County is responsible for paying only a fraction of the direct cost of Medicaid. In 2016, Erie County paid 11 percent of the total Medicaid bill, $205.5 million. This year, the county is expected to pay $203.8 million.
"The county's portion is capped, but ultimately as taxpayers, we are paying for this," Szukala said. "I think $2 billion is an indicator of how many problems there are in the health care delivery system in the United States."
Medicaid recipients are spread throughout Erie County, though the greatest concentrations of recipients remain in poorer communities in the cities of Buffalo, Lackawanna and Tonawanda, as well as parts of the towns of Cheektowaga, Tonawanda, Amherst, West Seneca and Hamburg.