Analysis by Medicaid Inspector General shows that recipients fell to 253,000 countywide as recertification process trims rolls; Erie County is in the middle of all NY counties for Medicaid enrollment
About 27% of Erie County residents’ health insurance is now being provided by Medicaid
GOP’s “One Big Beautiful Bill” passed earlier this year cuts Medicaid funding by nearly $1 trillion over ten years, increases the administrative burden on Medicaid clients; millions of Americans will lose healthcare
ERIE COUNTY, NY— An analysis of 2025 Medicaid data in Erie County completed by the office of the county’s Medicaid Inspector General provides a revealing snapshot of current Medicaid usage in Erie County while also acknowledging worrisome trends for the future due to the implementation of the GOP’s “One Big Beautiful Bill.” While the reinstituted recertification process following the COVID-19 pandemic has trimmed the county’s Medicaid population to roughly 253,000 people the cost has increased; from 2020 to the end of 2024, Medicaid costs in Erie County have risen by more than $540 million. In that same period, Erie County’s portion of those costs rose by more than $14 million. At the current rate of growth, Medicaid costs in Erie County could surpass $3 billion annually by 2027.
Erie County Executive Mark C. Poloncarz today joined Erie County Medicaid Inspector General Michael Szukala to review the analysis and discuss its impact on county residents.
“The good news from this analysis is that Medicaid enrollment has dropped in Erie County over the past year to just over 253,000 individuals being covered, down from a high of over 280,000 in 2021, and we are exactly in the middle of the state, #31 out of 63 counties, for percentage of population on Medicaid. Despite being a large county, our percentage is lower than that of our neighbors, Cattaraugus and Chautauqua counties,” said Erie County Executive Mark C. Poloncarz. “While we have been assiduous in removing people from the Medicaid rolls that shouldn’t be there, the reality is that costs will continue to rise even with the most scrupulous record keeping. Along with those rising costs are other hurdles and barricades to health care being put in front of the most vulnerable Americans by the current regime in Washington. We will continue to work to see as many people are covered as possible for as long as possible.”
During the COVID-19 pandemic, the federal government placed all recertifications on hold, thereby increasing the number of people on Medicaid. That ended post-COVID. In 2024, Erie County and NYS counted 253,923 people on Medicaid as of December 31. If all people who were on Medicaid at one time in 2024 but were removed by the recertification process at some point later in 2024 were counted, that figure would be 328,769. The recertification process removes clients from the Medicaid rolls for several reasons, the most common being that they no longer qualify.
Erie County Medicaid Inspector General Michael Szukala added, “Despite the fact that we have reduced the number of individuals receiving Medicaid to slightly over 250,000 that still means roughly one-quarter of the county’s population is on Medicaid. Still that significant reduction shows the administration and Erie County Social Services are successfully walking a tightrope of managing the number of Medicaid clients while still providing needed services.”
After years of being the number one prescribed Medicaid-funded drug in Erie County, Hydrocodone and its related drugs have seen a dramatic drop in usage, no longer appearing in the top ten most filled prescriptions. In 2025 the top ten most filled prescriptions for Medicaid patients were Albuterol Sulfate, Atorvastatin Calcium, Ibuprofen, Vitamin D, Acetaminophen, Metformin HCL, Omeprazole, Gabapentin, Fluticasone Propionate, and Vitamin D3.
In a troubling trend, while the overall Medicaid population has dipped, the number of Medicaid clients with chronic conditions continues to climb. Especially worrisome is an increase in clients with diagnosed mental health issues such as depression. The growth in Medicaid recipients with chronic mental health conditions has implications for long-term program costs, as these conditions typically require ongoing treatment and monitoring. When care is inconsistent or delayed, individuals are more likely to rely on emergency and inpatient services, which carry significantly higher costs. Investments in timely, community-based mental health care help stabilize service use and reduce avoidable Medicaid expenditures over time. Additionally, onerous new work requirements for clients are projected to account for nearly 12 million people losing coverage.
Szukala added, “Medicaid clients with chronic conditions have increased over the past five years. While it is good that clients who need help with diabetes, asthma and some mental health issues have sought and are receiving treatment, any cut in Medicaid funding will hurt these people disproportionately. Every time there is a change in policy payment management there is a direct trickle-down effect that causes large system disruption.”
“This Medicaid analysis lays out in stark detail what is happening today with our Medicaid population and what will be happening in the next few years when the destructive effects of the GOP’s ‘Big Shift’ are felt more fully. With $1 trillion in spending cuts being shifted to the states, Republicans in Washington have clearly shown that ordinary Americans, especially the sickest among us, are not their priority,” said Erie County Executive Mark C. Poloncarz. “As the report shows, here in Erie County we have been rigorous in administering Medicaid and, as the last few years have shown, in removing people who shouldn’t be on the rolls for one reason or another. However, even our best efforts to ensure that the people who really need Medicaid actually receive it will be hamstrung by the federal government’s cruel budget cuts.’
Since September 2012 the Erie County Medicaid Inspector General Team has completed or is in the process of completing 56 audits covering more than $113 million in Medicaid payments. These audits were performed on Medicaid vendors covering ambulette transportation, assisted living programs, durable medical equipment, long-term home healthcare, pharmacy, and taxi transportation.
For more information:
On the Erie County Medicaid Inspector General, visit https://www3.erie.gov/medicaid/
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