New York’s Medicaid Crisis: Nassau Taxpayers Are Paying the Price
There’s a fiscal crisis unfolding in New York—and it’s emptying the pockets of Nassau County residents.
Medicaid now accounts for 41.8% of the State’s $252 billion budget, totaling $105.4 billion annually. That’s more than two out of every five dollars spent by the State—allocated to fund a Medicaid program that continues to grow faster than the population or the tax base. And Nassau is being forced to shoulder an unfair share due to decisions made in Albany and costs driven by New York City’s reckless policies.
In 2025 alone, Nassau will be forced by New York State to spend $254 million of local taxpayer dollars on Medicaid. That’s money coming directly from your property taxes. It’s roughly $544 per household—the equivalent of a monthly grocery bill, car payment, or several utility bills. Simply put, you’re subsidizing a Medicaid system that lacks transparency, is riddled with budget gimmicks, and is expanding with no end in sight.
Since 2010, the cost of Medicaid in New York has risen by 300%, while enrollment has increased just 50%. These figures reflect a program growing at a pace that far outstrips population growth, or taxpayers’ ability to keep up.
Despite having fewer residents than Florida or Texas, New York spends more on Medicaid than both states combined—underscoring how outsized and unsustainable the program has become. New York’s Medicaid program now covers more than 1 in 3 New Yorkers. Add in the Essential Plan, and nearly 43% of the state’s population is on a public health plan. When almost half the population is on government-funded health care—and a shrinking base of taxpayers are footing the bill due to a mass exodus to southern states—the math no longer works. Even the State Comptroller has stated that this growth is unsustainable.[1]
New York continues to push the envelope. As of 2024, the state now provides full Medicaid benefits—including long-term care—to undocumented immigrants aged 65+. That’s a benefit most states don’t offer even to legal residents unless they meet strict criteria. Yet, Albany lawmakers have chosen to saddle you with this enormous new cost - spending your tax dollars without any public debate.
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Let’s be clear: Nassau isn’t the driver of excessive spending. New York City accounts for nearly 60% of all Medicaid enrollees statewide, yet Albany requires counties like ours to contribute heavily—without any control over how those funds are spent, and without the proportional benefit.
In Nassau County, we’ve done the hard work of holding the line on the County portion of property taxes for the past 3 years and budgeting responsibly, while providing top-tier services and properly funding police. Albany continues to make our job more difficult as they use Nassau taxpayers as a piggy bank.
It’s time for the State to protect all New Yorkers from a fiscal crisis of its own making. Nassau families deserve better.
🔗 Read the full op-ed by Comptroller Elaine Phillips: New York’s Medicaid Crisis: Nassau Taxpayers Are Paying the Price | Open Nassau
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[1] OSC February 2025: Report on the State Fiscal Year 2025-2026
Supporting and Empowering Nassau County Seniors
Comptroller Elaine Phillips remains committed to supporting Nassau County residents through transparency, education, and public outreach. In partnership with Town of Oyster Bay Supervisor Joseph Saladino and Town of Hempstead Supervisor Donald Clavin, the Comptroller hosted a series of free Senior Informational Workshops to help residents stay safe, informed, and empowered.
These workshops covered critical topics such as self-defense, emergency preparedness, avoiding scams, and accessing unclaimed funds—giving seniors the tools they need to live more securely and confidently each day. Supporting and educating our seniors is a top priority in building a stronger Nassau community.
Comptroller Phillips also regularly speaks at senior centers, civic groups, chambers of commerce, and libraries across the County. To request a visit for your group, call (516) 571-2386 or email nccomptroller@nassaucountyny.gov.
Photos, clockwise from upper left: Nassau County Comptroller Elaine Phillips speaks at West Hempstead Senior Scam Workshop, Hicksville Community Center Informational Workshop, Levittown Hall Senior Scam Workshop, Oyster Bay Informational Workshop.
In Case You Missed It
In case you missed it: Comptroller Phillips launched a Nassau County Senior Discount Program in conjunction with the Nassau Council of Chambers of Commerce to connect seniors with Nassau County businesses that offer senior discounts.
If you have a business in Nassau County and offer a senior discount, you can register your business here.
If you are interested in locating businesses that offer senior discounts, click here.
Printed copies of the directory are also available at community events and senior centers across Nassau County
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