Photo: Advocates and consumers at HCFANY’s press conference about how the Governor’s budget would make coverage more affordable, stop surprise bills, and support consumer assistance programs. From left: Gladys Puglla, consumer; Mark Scherzer, New Yorkers for Accessible Health Coverage; Elisabeth Benjamin, Community Service Society; Lara Kassel, Medicaid Matters New York; Bob Cohen, Citizen Action of New York; Oswil Liz, consumer; Kate Breslin, Schuyler Center for Analysis and Advocacy (podium)
It’s budget season, and our advocacy efforts are in full swing. Yesterday, HCFANY members and supporters gathered in Albany from across the state – some trekking 5 hours to get there – to advocate for our key budget priorities:
- Create a Basic Health Program
- Protect consumers from surprise medical bills
- Support consumer assistance programs
We were not alone – the halls and elevators were full of other advocates who came to the capitol to make their case to the legislature. More importantly, we are not alone in our continued efforts to advocate for quality, affordable health care!
Over the past few weeks, HCFANY and allied groups and coalitions have joined forces to make sure that the three proposals above (all in Governor Cuomo’s executive budget) remain in the budget as the process moves forward. We’ve submitted memos of support and organizational sign-on letters on surprise bills and our three budget priorities, and gathered in Albany for advocacy days. We’ve also held two press conferences featuring the real stories of New Yorkers who would be helped by the Governor’s budget proposals. This collaboration helps to amplify our voices in Albany.
Key Budget Priorities Press Conference
We kicked off yesterday’s HCFANY advocacy day with a press conference featuring both advocates and consumers. Members of the HCFANY steering committee – Mark Scherzer of New Yorkers for Accessible Health Coverage, Elisabeth Benjamin from the Community Service Society of New York, and Kate Breslin of Schuyler Center for Analysis and Advocacy – joined Medicaid Matters New York Coalition Coordinator Lara Kassel to outline the benefits of the Basic Health Program, out-of-network protections, and consumer assistance programs. And, we heard from New Yorkers who have been directly affected by these issues:
Oswil Liz, 24, spoke about the challenge of affording health insurance, even with the subsidies available on the Marketplace. Thanks to the ACA, Oswil now has insurance, but with student loans and his wages working as a manager at McDonald’s, the premiums are still difficult for him to afford. A Basic Health Program would benefit Oswil and others in his situation.
Gladys Puglla, a single mother with three children told the stunning story of her experience with surprise medical bills. When Gladys had a stroke in 2012, she received services at two hospitals. Gladys has insurance, but she was unconscious when admitted to both hospitals and so couldn’t give her insurance information. After her treatment, she was hit with $138,000 in surprise medical bills for out-of-network services. Gladys makes $37,000 a year. Thankfully, Gladys was able to seek help from Make the Road New York, part of the Community Health Advocates statewide network of consumer assistance services. With their help, Gladys was able to reduce her bill and received a grant from the New York Times Neediest Cases fund to pay the difference. Many consumers do not have these resources, which is why HCFANY is working to stop surprise bills and support consumer assistance programs like those that helped Gladys.
Surprise Bills Press Conference
Late last week, Bill Ferris of AARP, Blair Horner of New York Public Interest Research Group (NYPIRG), and Chuck Bell of Consumers Union joined HCFANY members Heidi Siegfried of New Yorkers for Accessible Health Coverage, Mike Burgess of the American Cancer Society Cancer Action Network, and Gene Veigl and Aaron Ward of the MS Society at another press conference calling on the Legislature to pass the Governor’s legislation specifically to protect consumers from surprise medical bills.
Claudia Knafo, a concert pianist who received a surprise medical bill seeking $101,000 for neck surgery, for which her health plan offered to pay only $3,500, told her compelling story. You can see coverage by the local nbc affiliate here.
Learn more about our budget priorities:
New Yorkers have a LOT to smile about this morning! The proposed health insurance rates for the New York Health Benefit Exchange have been released and show that prices on the individual market will soon be dropping by a whopping 50%.
This means that New Yorkers who currently buy coverage on their own, costing more than $1,000 per month in most cases, will be able to save thousands on health insurance next year without having to compromise on quality.
Health Care For All New York (HCFANY) had the pleasure of reviewing the proposed rates for the non-Exchange plans, which were released last month, and found the average Silver-level plan to be about $500 per month. These same plans sold on the Exchange will be even more affordable for New Yorkers who qualify for premium tax credits to further lower costs. You can read HCFANY’s comments on the proposed non-Exchange plans by clicking here.
The premium rates for all health insurance plans in New York can be found on the Department of Financial Services website. As with the annual rate review process, everyone is encouraged to look over the proposed rates and supporting documentation and submit comments online. You can find the proposed rates by clicking here.
The New York Times has produced stellar coverage of this phenomenon in an article out today, “Health Plan Cost for New Yorkers Set to Fall 50%.” They have also posted a great document that shows all of the proposed rates for Exchange plans. You can find that document by clicking here.
There is an article out in the Associated Press that seems to be raising a lot of eyebrows across the internet this morning. Titled, “Like your insurance? You may be losing it,” it explains how a lot of folks who currently have limited benefit health coverage may have to upgrade this coming fall.
This information may seem to fly in the face of what many folks have been told about Obamacare: “If you like your coverage, you can keep it.” While this may still hold true for a lot of folks, the devil – as always - is in the details.
Most health plans that existed before the ACA was signed in March of 2010 were eligible for grandfathered status. This means that they are exempt from having to provide most (but not all) of the comprehensive benefits and consumer protections that the ACA requires. But, if in the past three years or so, the insurer or the employer have made significant changes to a plan’s benefits or how much members have to pay, then the plan would have lost its grandfathered status.
So, there you go.
This should not be cause for panic. Chances are, if your current health plan is a good one, then it probably meets the requirements set forth in the ACA (or has already changed to do so), in which case you are fine. Those who may have to get a new health plan are the folks with non-grandfathered plans that have not changed to meet the new requirements.
This is not a bad thing. Yes, folks might be confused about it at first. Yes, some folks will end up having to pay more. But the new benefits and consumer protections will mean better health insurance and greater financial protections for you when you get sick. And you will get sick.*
The important thing to keep in mind here is that people need to be vigilant of their health insurance. Talk to your HR department and find out if your plan is changing (which may or may not be due to Obamacare). If you buy coverage on your own, just keep an eye out in the mailbox for a notice from your insurer or the Department of Financial Services. If your insurance is being discontinued, and you need help figuring out your options, you can always get free help from Community Health Advocates by calling (888) 614-5400.
*I use the term “sick” catch-all term for any illness or injury (even good ones like childbirth) - physical, mental or dental - or even just plain growing old.
Today’s post comes from guest blogger Maryanne Tomazic, Field Coordinator at Raising Women’s Voices.
When the New York Health Benefit Exchange opens for enrollment this October, we know it’s going to be especially important to reach out to mothers. They play a huge role in our families’ health, as they often are the decision makers and coordinators of care for our families. They should be armed with information on how to get health insurance that provides care to our families, without breaking the bank.
On Sunday, May 19th, from 11 to 5, Health Care for All New York will be at the Mamapalooza Festival in Riverside Park, Manhattan (entrance at West 68th and the Hudson River). Stop by our table where you can get more information about how the health care law helps moms and our families get the care they need to get and stay healthy. We’ll also have information about some of the new coverage options coming this fall, and how you can sign up for more information. We’ll have some great giveaways too – for both moms and kids – so be sure to swing by!
Can’t wait till then? Join us on Twitter today (@hcfany) and follow the hashtag #mamasays. We and health care advocates across the country will be tweeting tips that #mamasays about your health and invite you to do the same!