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Health exchange enrollment pushes Genesee County’s Medicaid population to nearly 12,000

BATAVIA – Enrollment through New York State’s health insurance exchange has increased Genesee County’s Medicaid population to nearly 12,000, a number that mystifies its county’s social services commissioner.

“That’s the number that the state is giving us and, honestly, I find it incredible,” Eileen M. Kirkpatrick said Tuesday, a day after giving a report to the County Legislature’s Human Service Committee.

Kirkpatrick said that from January through March, 3,559 people enrolled through the exchange set up under the federal Affordable Care Act were eligible for Medicaid, and an additional 8,333 came in through the county’s Welfare Management System, for a total of 11,892.

Genesee County has a total population of about 60,000.

The commissioner noted that a “big explosion” took place when people did their taxes this year and received penalties because they had no health insurance. Since then, many of these uninsured people applied through the state’s exchange and were told that were eligible for governmental assistance for a variety of health-related expenses.

“We have been told that 72 percent of the people who apply through the New York State health insurance exchange end up on Medicaid,” Kirkpatrick said. Although the numbers are way up, she said, her staff’s workload has not increased accordingly because the state is “handling the new cases.”

“Gradually, the state is taking away our eligibility functions by processing cases involving modified adjusted gross income and recertification,” she said. “What haven’t slowed down for us are cases where we have to look at resources, transfers of funds and cases where people have to spend down before they can receive Medicaid.”

The cost to the county has not been affected only because three years ago, state lawmakers put a cap on counties’ share of Medicaid, based on the amount that counties spent on Medicaid in 2005.

Genesee County’s share is about $9.5 million per year.

According to County Manager Jay A. Gsell, counties could end up paying more since the cap is not etched in stone.

“We look at Medicaid with cautious skepticism because it’s only a piece of legislation that is looked at every year,” Gsell said. “If the state wants more than the $7.5 billion it gets now from the counties, we could see double-digit increases in our share.”