A gift for new parents for the New Year

mom baby docter

On December 22, 2015 Governor Cuomo signed into law S4745/A7155, a bill that will allow babies born into low and middle-income New York families eligible for the Child Health Plus (CHP) from the day that they are born. This is great news for families across the state, and a first-of-its-kind bill nationwide!

Parents who apply before the baby is born, or within 60 days of the birth, will have coverage for their newborn from the date of birth, whereas those who submit an application more than 60 days after the birth will be covered from the date of the application.

The new law – one that HCFANY is proud to have strongly advocated – is a significant victory for thousands of families in New York State. Child Health Plus is a wonderful program that has been helping New York children access healthcare since 1991. Until today, however, there was a significant gap in the program. Under the old system, it took up to 45 days from the day that parents applied for CHP for enrollment to kick-in. That meant that babies could go over a month without health insurance coverage during the vulnerable newborn period when timely access to health care is essential.

The American Academy of Pediatrics recommends that all babies be examined by a pediatrician three times in the first two months of life. Babies born with health problems may need more frequent care. Some may need urgent care for emergency situations. In the past, many parents, fearful of large medical bills, were hesitant to seek health services for their babies during the waiting period between CHP application and enrollment. Now, they will be able to obtain the care that their infants need without concern about being burdened by potentially high medical bills.

Children in New York State may be eligible for Child Health Plus if they’re not eligible for Medicaid, a public employee state health benefit plan or another insurance plan (such as a plan through a parent’s employer). Families with incomes up to 400% of the federal poverty level receive free or low cost health insurance this way. In 2015, a family of four earning under $38,796 a year could obtain free insurance for their children.   Families with higher incomes paid a reasonable monthly premium of $9, $15, $30, $45, or $60 per child per month, depending on family size and income. Plus, there is no deductible or co-payments with CHP, so parents do not have to pay anything when their child visits the doctor!

This new effective date provision won’t go into effect until January 1, 2017. In the meantime, parents who would like to enroll a child in CHP can do so through the New York State Marketplace or by connecting the Community Service Society Navigator Network at (888) 614-5400 or through their website for free enrollment assistance.

A happy and very healthy New Year to the littlest New Yorkers and their families!

pregnant woman doctor

As we celebrate the holidays and ring in the New Year, we now have more reason for merriment – Governor Cuomo has just signed legislation that gives pregnant women the right to enroll in Qualified Health Plans through the State’s Marketplace at any time during the year! Until now, pregnant women had to wait to apply for health insurance until the annual open enrollment period. HCFANY is proud to say that New York is the first state in the nation to adopt such an important law, demonstrating leadership in promoting access to health insurance for all!

The passage and signing of S5972/A6780 is significant and commendable because having health insurance during pregnancy can improve the health of mothers and their babies.   Timely, quality pre-natal care can decrease the likelihood that a pregnant women will face health problems or that her baby will be born premature. According to the March of Dimes, nearly 9% of babies born in New York State are pre-term, which puts them at risk for many health problems. The new legislation should help decrease that percentage, assuring that more babies in New York get a healthy start in life.

The new special enrollment period may also significantly decrease healthcare costs for pregnant women who sign up for health insurance. Charges for pre-natal care and hospital care can be daunting for uninsured women. The costs quickly add up due to numerous pre-natal visits, ultrasounds, blood work and screening tests. Giving birth in a hospital is very expensive. On average, health insurance companies pay $9,800 for a normal delivery and $15,000 for a c-section, according to the International Federation of Health Plans. As of today, women in New York State will not have to worry about the full cost of pre-natal care and giving birth. Thanks to the new law, they will be able to access the full array of health services needed for a healthy pregnancy, birth and healthy baby.

HCFANY applauds New York State lawmakers and Governor Cuomo for working to protect the health of mothers and babies. You can read the governor’s press release here. Pregnant women will now be able to enroll on the Marketplace as soon as a doctor confirms they are expecting by going to the New York State of Health Marketplace. Women can also contact the Community Service Society Navigator Network for free enrollment assistance.

uncle sam

The time to enroll or renew your coverage on the NY State of Health (NYSOH) Marketplace is just a few days away! Nearly 2.6 million people have enrolled in the Marketplace since its launch in 2013. We can continue to make progress by making sure more New Yorkers get enrolled and those who are covered maintain their coverage.

How it works and what you can do:

  • Visit the Marketplace and look at available options – even if you are satisfied with your current coverage. The Marketplace continues to change, and this year you may find a plan that better suits your needs.
  • See if you qualify for the new Essential plan for low- and moderate- income New Yorkers. You could get comprehensive coverage for yourself and your family for $0 or $20 per person per month!
  • There are options to make the process of enrollment or renewal easier. You may go online and search through the Marketplace, call the Community Health Advocates helpline at 1-888-614-5400, or visit an in-person assistor in your community.

A few important dates for new enrollees:

  • The Third Open Enrollment Period begins on November 1, 2015, and continues through January 31, 2016.
  • To get coverage that begins January 1, 2015 you must enroll by December 15, 2015.
  • For coverage starting February 1, 2016 you must enroll between December 16, 2015 and January 15, 2016.
  • For coverage starting March 1, 2016 you must enroll between January 16, 2016 and January 31, 2016.

For returning consumers, the re-certification period begins on November 15, 2015:

  • To make sure you do not have a gap in coverage, you must renew your coverage between November 15, 2015 and December 15, 2015 for coverage that begins on January 1, 2016.

If you miss the re-certification deadline, your coverage stop after December 31, 2015 and you will not be insured for a certain time period:

  • For coverage that begins on February 1, 2016 you must renew your coverage between December 16, 2015 and January 15, 2015 (coverage gap is 1 month).
  • If you renew your coverage between January 15, 2016 and January 31, 2016, your coverage will begin on March 1, 2016 (coverage gap is 2 months).

Make sure to get coverage to stay healthy and avoid the increasing tax penalty. Remember, the penalty for not being covered is rising to the greater of $695 per person ($347.50 per child under 18) or 2.5% of your family yearly taxable income in 2016!

A report released this week by Kaiser Family Foundation shows that 58% of uninsured New Yorkers are eligible for free or subsidized health coverage. The majority of them – 548,000 people – are eligible but not enrolled in Medicaid. There are several reasons why people who are eligible for Medicaid have not enrolled: some do not know they’re now eligible under the Affordable Care Act’s Medicaid expansion, some avoid Medicaid because of the stigma of poverty attached to the program, and some have had their income drop since they last applied for coverage.

The 317,000 New Yorkers who are uninsured but would qualify for financial assistance (such as Cost Sharing Reductions and Advance Premium Tax Credits) on the Marketplace includes consumers who are newly-eligible for the Essential Plan, New York’s forthcoming Basic Health Program. Consumers enrolled in the Essential Plan will have monthly premiums of $0 or $20 a month, no deductible, and very low copays; this combination should assuage the fears of people who believe health coverage is too expensive. The New York State of Health hopes to draw consumers back during the third Open Enrollment period, which begins on November 1, by highlighting these new levels of affordability. They’ll be targeting these 317,000 New Yorkers with videos, social media campaigns, and catchy new graphics (stay tuned for more!).

Nearly a third of uninsured New Yorkers – 457,000 people – are unauthorized immigrants. New York City Mayor Bill de Blasio’s recent announcement on connecting immigrants to care through a “Direct Access” program was a crucial first step for those immigrants living in the City, and Health Care for All New York will continue to advocate for comprehensive health insurance coverage for our undocumented neighbors. New York State has done a fabulous job in the first two Open Enrollment periods in connecting people to coverage, and the rollout of the Essential Plan will be another step in the right direction. A critical next step for closing the coverage gap in New York will be expanding affordable coverage to New Yorkers who are excluded from coverage options because of immigration status.