June 6, 2026
It’s no secret that Medicaid spending in New York State keeps eating up taxpayer dollars at an unprecedented pace, with no end in sight.
The newly enacted state budget increases Medicaid spending by $11 billion or roughly 8.5%. Alarmingly, that’s no longer surprising in this state. Spending on Medicaid now accounts for nearly one-half of the entire state budget. Nearly one-half, or upwards of $125 billion. Under Governor Hochul and this all-Democrat Legislature over the past several years alone, spending on Medicaid has increased 90%. It’s the highest Medicaid spending per-resident of any state in America, by far. According to federal statistics, per-resident Medicaid spending in New York was nearly 25 percent higher than any other state and 77 percent above the national average.
And yet, this budget takes no new actions, not one, to redouble the state’s efforts to root out the abuse, fraud, and waste that everyone knows plagues the system and costs taxpayers billions of dollars. Why not? It simply remains outrageous and inexcusable. It’s not like fiscal watchdogs inside and outside of the state Legislature haven’t been banging the drum on abuse, fraud, and waste within New York’s hugely expensive (and expansive) Medicaid system for as long as I can recall, yet year after year brings additional reports of ongoing fraud and waste.
How is this level of inaction to combat abuse, fraud, and waste responsible to taxpayers? The fact is it’s nothing new. New York State’s system of Medicaid lacks accountability and transparency yet continues to demand more and more from state and local taxpayers and governments. Now, though, we are witnessing a system of government, along with the bureaucracy that’s been built up around it, coming apart, running out of choices, and perpetuating this state’s decline.
I’ve previously highlighted in this column that Medicaid spending nearly stands alone as the crown jewel of out-of-control spending in New York. Yet accompanying state efforts to rein in this spending, to make it more efficient or effective, or to root out the abuse, fraud, and waste in the system have, at best, taken a back seat as far as priorities are concerned.
Just over the past year, for example, reports from the state comptroller and others have shown:
$68 million in Medicaid fraud committed by a Brooklyn adult daycare operator uncovered by the federal Department of Justice last August;
the state improperly paid over $2.6 billion in Medicaid premiums for people who do not live in New York;
$13 million in Medicaid fraud for transporting patients to medical appointments; and
$7 million in Medicaid fraud for fraudulent billing.
That’s just a brief list of the abuses that have been brought to light. Ensuring residency and immediately fixing mistakes seem like the very least we can do for state and local taxpayers and if it’s not being done, routinely and steadfastly, what else is going unchecked and uncovered?
Don’t taxpayers deserve a “zero tolerance” policy on abuse, fraud, and waste? Alarmingly, there’s been a glaring lack of interest at the state level in taking steps to make this system more responsible to taxpayers, particularly over the past several years during which state spending alone on Medicaid has skyrocketed more than 60 percent including, although the state conveniently does not report it, what’s estimated to be in the range of $1 billion annually to provide taxpayer-funded health care to illegal immigrants.
Back in January, our Senate Republican Conference made it clear: There have been alarming reports of widespread fraud involving taxpayer dollars in the state of Minnesota and other places across the nation. Wouldn’t it be common sense here in New York to take a fresh look at our own state government considering what we’re reading and hearing about what’s been going on in other places? We have called for an independent audit that would assure New York’s taxpayers, without a shred of doubt, that their tax dollars are being allocated, distributed, and spent in the most responsible, effective, legal, and accountable ways.
The new state budget includes nothing of the sort. In fact, it simply continues the apparent policy of this governor and this Democrat-led Legislature to simply wash their hands of any heightened responsibility for Medicaid oversight. For the most part, they simply point to the Office of the Medicaid Inspector General (OMIG) and the Medicaid Fraud Control Unit (MFCU) within the state Attorney General’s office and say: It’s their job, not ours.
Except that the job isn’t getting done.
According to Bill Hammond, Senior Fellow at the Albany-based Empire Center for Public Policy and a highly regarded expert and fiscal watchdog on the Medicaid system, Medicaid fraud investigations in New York State are sorely lacking. Despite having the second-highest Medicaid budget in America while spending more per resident than any other state, New York State:
Ranks 48th in the nation in terms of Medicaid fraud investigations per billion spent;
Ranks 49th out of the nation’s 50 states in Medicaid fraud indictments per billion spent; and
Ranks 50th, dead last, in convictions per billion.
At a budget hearing earlier this year, Hammond stated in written testimony, “Instead of simply pouring more tax dollars into an already well-funded health care industry, the state’s leaders should be looking for ways to constrain Medicaid costs and achieve better value for consumers.”
Looking for ways to constrain Medicaid costs and achieving better value for taxpayers is nowhere to be found in the new, $270 billion state budget. We’re talking about billions of taxpayer dollars being lost to apparent inaction and carelessness in a state where taxpayers, at every level, are already overtaxed and overburdened, and have been for a long time.
