Hochul’s Medicaid Spending Surges, With Persistent Focus on Quality by Experts

Governor Kathy Hochul has added $17 billion in new state Medicaid spending over four years, a 61% increase that outpaces all other state-funded programs combined. Despite this unprecedented investment, according to a newly published article by the Empire Center.

While most of Hochul's funding has gone toward bolstering the workforce and raising reimbursements—priorities aligned with hospitals and 1199 SEIU, the state’s dominant health care union. According to the Empire Center, New York’s hospitals rank poorly on quality metrics, emergency department wait times are long, and nursing home conditions have drawn legal scrutiny. Efforts to consolidate the Consumer Directed Personal Assistance Program (CDPAP) have caused service disruptions while delivering modest savings and positioning 1199 SEIU to expand its membership.

A Commission on the Future of Health Care, created in 2023 and chaired by NYU Wagner dean Sherry Glied, is expected to recommend reforms, with a focus on improving hospital quality. For managed care experts, payers, and clinicians, the paradox is clear: record-breaking Medicaid spending has yet to translate into better outcomes, underscoring the urgency of policy shifts beyond funding increases.

Key Takeaways for Managed Care Stakeholders Historic Medicaid growth:

• $17B added under Hochul, a 61% increase since 2022.
• Notable Challenges: Low hospital quality, long ER waits, and poor nursing home conditions remain.
• Industry alignment: Spending priorities closely match hospital and union interests.
• Future outlook: Reform commission may finally shift focus from spending to measurable quality improvement.

Reference

Hammond B. Hochul's $17B Medicaid surge leaves little to brag about. The Empire Center. Published August 27, 2025. Accessed August 27, 2025. https://www.empirecenter.org/publications/hochuls-17b-medicaid-surge/