Aging Long Islanders swell Medicaid rolls

Data Point

Aging Long Islanders swell Medicaid rolls

There are 132,000 more Long Islanders enrolled in Medicaid today than a decade ago. With the region’s graying population, that trend and its costs are expected to climb.

More than 675,000 Long Island residents, or 23.3% of the region’s population, currently have access to health care through Medicaid, according to May 2025 data from the New York State Department of Health. Alone or in combination with a Medicare plan, 308,354 people in Nassau County, and 367,087 residents in Suffolk are currently enrolled in Medicaid. Click here to see an interactive version of the chart above.

This is a sizable jump from 2015, when 542,667 Long Islanders were enrolled in Medicaid. Years of efforts by organizations to expand insurance coverage among eligible residents, and an increase in enrollment during the COVID-19 pandemic helped boost these numbers. A detailed breakdown of enrollment by age for Long Island was not immediately available.

Medicaid is best understood to serve the needs of low-income populations. However, it is also the primary insurer to cover nursing home and other health care costs for most seniors and people with disabilities. On Long Island, where the senior population growth rate is higher than other age groups, Medicaid enrollment and the inevitable costs to fund it have been trending upward.

And that trend results in higher costs for everyone.

"Medicaid and Medicare reimburses health care providers at less than the cost of providing care, which means the costs get shifted to the commercial health insurance," Wendy D. Darwell, who runs the Suburban Hospital Alliance of NYS, told The Point. "Hospitals are seeing the impact of having an aging population, with an increase in eligible seniors getting both Medicare and Medicaid."

A 2024 report from the Fiscal Policy Institute stated that seniors or people with disabilities accounted for just 20.7% of all Medicaid enrollees in New York in 2021 but accounted for 59% of Medicaid spending. The national rate for Medicaid spending for seniors and people with disabilities was 52.3%.

Nursing home care can cost as much as $170,000 annually in the New York City-Long Island region, according to data from the American Council on Aging, a price that many seniors who are otherwise not considered low-income, would find unaffordable. Nearly twice as many seniors are enrolled in Medicaid in New York than the national average, causing New York to spend more on long-term care than most other states.

New York’s total Medicaid spending for the 2024-25 fiscal year was $115.6 billion, of which 60% was footed by the federal government. With the announcement of recent cuts to Medicaid, Medicare and other social support programs in the One Big Beautiful Bill Act, it is unlikely the state can cover the cost of funding Medicaid on its own, even with the help of county contributions. The projected Medicaid spending for the year by the state Division of the Budget for 2028-29 is $133.7 billion.

There could be significant industrywide changes to health care across the state, including  Long Island, because of the budget cuts. Aside from Medicaid funding cuts, the bill is expected to slash medical student loan funding at a time when there is a shortage of skilled labor in the health care sector on Long Island, and limit retroactive Medicaid funding for health care providers.

Darwell is certain providers are going to be forced to make cuts that impact everyone. She added: "Laying off a doctor or nurse is not laying off a doctor or nurse who exclusively takes care of a Medicaid patient. There is less access for everyone regardless of what kind of insurance you have."

— Karthika Namboothiri karthika.namboothiri@newsday.com

Pencil Point

Maxwell's way out

For more cartoons, visit www.newsday.com/augustnationalcartoons

Subscribe to The Point here and browse past editions of The Point here.