(Image: WSJ graphic)

Today, the Wall Street Journal’s Greater New York section had an interesting story about New York’s Medicaid program, saying it was on track to hit 5 million enrollees this month.

As many people know, New York spends more on Medicaid than any state in the nation (including the larger states of California and Texas).

Advocates certainly think this is a good thing. New York’s barriers to enrollment are low. For instance, according to the Journal:

New York is one of five states to provide Medicaid to childless adults. In recent years, the state eliminated resources tests, allowing most applicants to attest their family assets. It also stopped requiring face-to-face interviews, switching to mail-in applications.

Last year, the state health department posted online tips explaining how people with too much income for Medicaid can still get into the system.

The Cuomo administration’s Medicaid team is seeking to remove the requirement that applicants submit original documents to enroll. It’s also proposed using technology to recruit more patients and add an “Are you interested?” in Medicaid line on tax return forms.

But what is the potential for fraud? New York’s Medicaid inspector general has a long list of targets. Interviews I’ve conducted in the past suggest that easier enrollment systems not only get qualified people to sign up but also attract many looking to scam the system.

How should a state balance the two competing priorities: Being responsive to the poor while keeping fraud at a minimum?