Today’s Presidential Budget Proposal is Devastating for Medicaid and Children’s Health Insurance

xrayThe first budget proposed by President Trump adds over $600 billion in cuts to Medicaid to the $880 billion included in the American Health Care Act. This would cut the program in half. The budget also cuts the Children’s Health Insurance Program (CHIP), insurance for kids who do not qualify for Medicaid but cannot afford health care, by 21 percent.

Medicaid provides health insurance for 74 million Americans who do not make enough money to buy private coverage. There is simply no way to cut Medicaid by over a trillion dollars without drastically changing who is eligible for the program and what services they can receive. And those people include our most vulnerable. Over half of the children born in the US come into the world with Medicaid coverage. Over 60 percent of the money spent on Medicaid supports the elderly and people with disabilities – kicking every single non-disabled adult and child off would still not even approach covering cuts of this magnitude.[1]

You can find out how many people in your county get Medicaid or our CHIP program (called Child Health Plus) here. And you can talk to your friends and family about how they get health insurance – almost everyone knows someone who has benefited from Medicaid.[2] More than half of Americans say Medicaid is important for their family – including 43 percent of Republicans and 57 percent of Independents.[3]

Politicians often say Medicaid is a “broken” program – but Medicaid is a program that makes life better for millions of people. Talking to your friends, family, and elected officials about how Medicaid helps you, your family, or your community is vital for changing the conversation and protecting the program. Maybe Medicaid let you get health care and still pay your other bills, or helped you survive a health emergency without hurting your family financially. Maybe Medicaid helped you have a healthy pregnancy, or is keeping your loved one safe in a nursing home. Let people know! You can also share your story with us.

 

 

[1] Mary Beth Musumeci and Katherine Young, State Variation in Medicaid Per Enrollee Spending for Seniors and People with Disabilities, Kaiser Family Foundation, May 1, 2017, http://kff.org/medicaid/issue-brief/state-variation-in-medicaid-per-enrollee-spending-for-seniors-and-people-with-disabilities/.

[2] See Figure 8, Kaiser Health Tracking Poll: Future Directions for the ACA and Medicaid, February 24, 2017, http://kff.org/health-reform/poll-finding/kaiser-health-tracking-poll-future-directions-for-the-aca-and-medicaid/?utm_campaign=KFF-2017-March-Polling-Beyond-The-ACA&utm_content=54701829&utm_medium=social&utm_source=twitter

[3] See Figure 9 in the Kaiser Health Tracking Poll.

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                             Times 16!

New York’s Attorney General joined 15 others yesterday in taking legal action to protect a part of the Affordable Care Act (ACA) called cost-sharing reductions (CSRs).Cost-sharing reductions (CSRs) help low- and moderate-income people manage high out-of-pocket costs, such as high deductibles or co-payments. Around 730,000 New Yorkers are benefiting from CSRs this year, either because their out-of-pocket costs were lowered or because they are signed up for our Essential Plan. The Essential Plan covers low-income people at very low costs and is funded in part through the CSRs.

The attorneys general are asking the courts to let them defend the CSRs against a lawsuit filed by House Republicans against the Obama Administration. The House’s lawsuit argues that funding for CSRs should be voted on each year in Congress instead of being automatically funded. The Obama Administration was fighting that idea in the courts – but now that President Trump is in charge, he can simply stop defending against the lawsuit. That would immediately mean no CSRs for this year because of a court ruling that asked the Administration to stop paying them until the matter gets settled. (UPDATE: HHS used a required status check on May 22 to ask the courts for more time to consider its options, so the court case is once again paused. Another check-in is required in 90 days. In the meantime, the Trump Administration can chose to pay the CSRs or not pay them.) In the long run it would leave the matter of CSRs to Congress. Stopping the CSRs is a way of dismantling the ACA without passing legislation – so a Congress whose majority party is hostile towards the ACA is unlikely to fund them.

The affidavits filed in support of the motion are a reminder of just how much New York has benefited from the ACA. Two of New York’s major insurance companies provided affidavits stating that premiums will go up for everyone without the CSRs. This is partially because insurance companies are required to lower cost-sharing for eligible customers at least through this year, even if Congress and the President decide not to pay them for it. They will make up that burden by collecting more from customers. Premiums will also go up because many people who get cost-sharing reductions will not be able to afford insurance without them, which means insurance companies will have to spread costs across a much smaller group of customers.

The affidavit provided by the Greater New York Hospital Association cites a 41 percent reduction in admissions of people without insurance, and a 23 percent reduction in visits to the emergency room by uninsured patients since 2013 (the first year New Yorkers could buy insurance on our ACA marketplace). Uninsured patients are a huge cost for hospitals. Suddenly ending insurance coverage for 730,000 New Yorkers will again make hospitals responsible for treating large numbers of people who cannot possibly pay.

yellow-strar-mdOver 3.6 million New Yorkers signed up for health insurance this year using the New York State of Health (NYSOH), the insurance marketplace created by the Affordable Care Act (ACA). This represents 18 percent of everyone in the state, and is nearly 800,000 more people than last year. Since NYSOH opened in 2013, the state’s rate of uninsured people has dropped from 10 percent to only five percent.

Before the ACA and NYSOH, fewer than 21,000 people bought individual insurance plans and the cheapest option cost over $1,000 a month.[1] This year, over 240,000 people bought individual plans, and their average premium is almost 50 percent lower. The plans that those people purchased provide a standard set of benefits because of the ACA’s Essential Health Benefits, cost the same for everyone regardless of previous health problems, and came without any annual or lifetime limits on care. They also came with help for those whose premiums are still too high for their income – over half of the people who bought individual plans through NYSOH received tax credits, an average of $233 a month. Another 665,000 people used NYSOH to sign up for the Essential Plan, a low-cost option for those who do not qualify for Medicaid.

People signing up for health insurance using NYSOH also benefited from free assistance provided by Navigators, Facilitated Enrollers, and Certified Application Counselors.  Navigators, who are trained and certified by the state, helped over 72,000 people and small businesses sign up for coverage. Their assistance is available in-person all across New York and in at least 43 different languages – you can find help in your own community by calling 888-614-5400.

 

[1] Peter Newell and Nikhita Thaper, “Affordable Care Act Brings New Life – and Covered Lives – to New York’s Individual Market,” United Hospital Fund, May 2016, https://www.uhfnyc.org/publications/881127.

keep goingLast Thursday, the House of Representatives passed the American Health Care Act (AHCA). If the AHCA were to become law, 2.7 New Yorkers would lose their health insurance, Medicaid would be cut by more than $800 billion, and protections for people with pre-existing conditions would be severely weakened. Seven of New York State’s nine Republican Representatives voted in favor of the bill; two Republicans voted against it; and all 18 Democrats voted against it. The bill is now in the Senate for further consideration and revision.

However, the conversation on the AHCA and what it will mean for New Yorkers is not over! Members of Congress left for recess shortly after the vote and came home to face constituents, many of whom were dismayed by the passage of the devastating legislation.

In the days following the vote, town halls took place in the districts of Representatives King, Faso, Stefanik and Reed, who all voted in favor of the AHCA. Representatives King and Faso did not attend the town halls in their districts, and Representatives Collins, Tenney, and Zeldin, who also voted in favor of the bill, did not host town halls. This video from the town hall in Representative Reed’s district provides some insight into how some constituents are feeling about the AHCA and how they think it would affect their care.

It is not too late to call your Representatives and tell them how you feel about the AHCA and about their votes. You can call your Representatives in their districts using the numbers listed here:

Voted Against the AHCA (Thank you!!)

  • Congressman Dan Donovan
    • Brooklyn Office (718) 630-5277
    • Staten Island Office (718) 351-1062
  • Congressman John Katko
    • Auburn/Lyons Offices (315) 253-4068
    • Oswego/Syracuse Offices (315) 423-5657

Voted for the AHCA (Start defending the health of constituents over tax cuts!)

  • Congressman Pete King
    • Massapequa Office (516) 541-6602
  • Congressman Tom Reed
    • Corning Office  (607) 654-7566
    • Geneva Office (315) 759-5229
    • Ithaca Office (607) 222-2027
    • Jamestown Office (716) 708-6369
    • Olean Office (716) 806-1069
  • Congresswoman Elise Stefanik
    • Glens Falls Office (518) 743-0964
    • Plattsburgh Office (518) 561-2324
    • Watertown Office (315) 782-1291
  • Congresswoman Claudia Tenney
    • Binghamton Office (607) 376-6002
    • New Hartford Office (315) 732-0713
  • Congressman  Lee Zeldin
    • Patchogue Office (631) 289-1097
    • East End Office (631) 209-4235