Medicaid on the rise in Niagara County

James Neiss/staff photographerThe William L. Ross County Office Building on East Avenue in Lockport provides services to Niagara County residents. the county oversees roughly 7,500 people on Community Medicaid. 

Like it has with so many other things, the COVID-19 crisis has impacted Niagara County's dealing with Medicaid.

Burt Marshall, director of Social Services in Niagara County, said, in terms of the Medicaid department, which he oversees, his office has seen an uptick of 1,500 new recipients since the spring.

There’s a couple different reasons for this.

“Since March they’ve just been extending everyone’s Medicaid,” Marshall said. “Right now they’ve extended it to the end of this year. How many cases would we have knocked off if they weren’t eligible? If the state didn’t just automatically renew everybody?”

Marshall said, all the same, this uptick brings the total to 7,500 people the Niagara County oversees on Community Medicaid.

“That’s since COVID, you have to take that for what it’s worth because people were out of a job and coming in. It’s a fact,” he said. “When you lose your job, you lose your health insurance. … Some of them may have health issues that need to be addressed. We need health insurance.”

Not everyone is treated the same. Some are handled by the state, or the federal government. Marshall’s office deals with those who are on Medicaid through the county.

“Some of the people on the New York Health Exchange (the federal marketplace) are on Medicaid (versus private insurance plans) and we have our own community Medicaid for people who aren’t eligible for the Exchange that we handle with a significant amount of people,” he said. This includes those in nursing homes and on social security income.

As of Jan. 2019 there are more than 32,000 Medicaid recipients in Niagara County being served by New York state. Another 7,000 get insurance through the Affordable Care Act, which is made up of those on the Essential Plan or Qualified Health Plan.

Marshall said the figures for those who have Medicaid through the state or federal marketplaces right now are not in for this year until January, but after working with Medicaid for 35 years, he’s sure more cases are coming in.

“Medicaid is the biggest provider, even from the state’s perspective.” he said. “The people who are on Medicaid on the state, they’re healthy individuals, they’re just getting Medicaid. People we’re dealing with out here have different issues, or their cases are more complex so the state gives them to us to handle.”

Marshall said also what determines their eligibility is their income. That includes pensions or social security.

“If they want the Medicaid from us, they have to give us a certain amount of money, called a spend-down, and that’s the money they have to give us at the first of the month in order for us to give them coverage,” Marshall said. “The state can’t do that, so the county does that. People will send off the checks and then they’ve got Medicaid coverage. Especially if they have medical needs, it’s well worth paying it to do it.”

Marshall said Niagara County is a Medicaid Managed Care county, which means many people are enrolled in managed care plans, where the county is paying the premium.

“You could be on Medicaid, but you could choose to be on a managed care plan. Not everybody on Medicaid in Niagara County is on a managed care plan,” he said. “There’s also nursing home Medicaid that we handle, and those on Social Security Income, we handle those, as well.”

The bottom line, Marshall said, is that not everyone will have the same experience with health insurance right now.

“If you’re on unemployment, you’re going to apply (for help),” Marshall said. “Depending on what you’re unemployment is you’re either going to be sent to Medicaid or the Essential Plan, or the Qualified Plan.”

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