Yesterday, the NY State of Health, New York State’s official health plan Marketplace announced in a press release that Open Enrollment for the 2018 plan year would begin on November 1, 2017 and last for a full three months, ending on January 31, 2018. As you may have heard in the spring, the federal government slashed Open Enrollment to just six weeks. This move is much better for consumers who are often overwhelmed during the busy holiday season. With this action, New York joins others progressive states like California, Washington, and Minnesota in extending the 2018 enrollment period.
If you or someone you know needs help selecting and enrolling in a health insurance plan, Navigators are available to assist. Please call (888) 614.5400 for in-person assistance in your area. Don’t forget, consumers enrolling in Medicaid, the Essential Plan, and Child Health Plus can enroll year-round!
Many of you may have heard reports that the Trump Administration will be cutting federal funding for the Navigator program for the upcoming year. Navigators are individuals or organizations specially trained and certified to help consumers shop for and enroll in health insurance coverage through the Marketplace.
These cuts do not affect New York. New York State runs its own state-based Marketplace, the New York State of Health (NYSOH), and thanks to the continued support of the State government, New York also funds its own Navigator program and will not be affected by federal cuts.
Navigators and other in-person assistors are available to help consumers in every county in New York State. According to the 2017 NYSOH Open Enrollment Report, there were 526 Navigators and more than 5,000 Certified Application Counselors (CAC) and Facilitated Enrollers (FE) in New York as of January 31, 2017. Among consumers who enrolled in coverage through NYSOH, 72 percent did so with the help of a Navigator, CAC, or FE. An even greater proportion of consumers used in-person assistance when enrolling in public coverage through the Marketplace. Seventy-seven percent of consumers who enrolled in Medicaid, 74 percent of consumers who enrolled in Child Health Plus, and 83 percent of consumers who enrolled in the Essential Plan all used in-person assistance to choose the best plan for their needs.
Open Enrollment for the 2018 plan year begins on November 1, 2017. If you or someone you know needs help selecting and enrolling in a health insurance plan, please call (888) 614.5400 for in-person assistance in your area. Remember, consumers enrolling in Medicaid, the Essential Plan, and Child Health Plus can enroll year-round!
Here is a quick summary of how we did:
Full funding for Community Health Advocates (CHA)
HCFANY Recommendation: Provide $4.75 million in funding for CHA to help people and small businesses obtain, use, and keep their health insurance coverage.
Result: The final budget included $3.5 million for CHA – $2.5 million from the Executive and $1 million from the Assembly. The total funding is an increase of $250,000 from the past year.
Expansion of Child Health Plus (CHP) to Age 29
HCFANY Recommendation: Increase the age limit for CHP from 19 to 29 to create an affordable coverage option for young adults who are not eligible for subsidized health insurance because of their immigration status.
Result: This measure was not included in the enacted budget.
Essential Plan Premiums and Cost-Sharing
HCFANY Recommendation: HCFANY opposed increasing premiums and cost-sharing for consumers enrolled in the Essential Plan (EP), New York’s Basic Health Program for consumers with incomes just above the Medicaid limit.
Result: There were no changes to EP premiums, and there will be no increases in cost-sharing through at least March 2018.
Medicaid Beneficiary Protections
HCFANY Recommendation: HCFANY opposed the following threats to Medicaid beneficiaries: (1) increase in copayments for preferred, non-preferred, and over-the-counter drugs; (2) elimination of spousal/parental refusal, a reduction of resources that spouses and parents of people in managed long-term care or nursing homes can keep; and (3) repeal of “prescriber prevails.”
Result: (1) The budget increased copayments for preferred prescription drugs from $1 to $2.50 and decreased copayments for non-preferred drugs from $3 to $2.50. There were no changes to copayments for over-the-counter drugs; (2) there were no changes to spousal refusal; and (3) there were no changes to “prescriber prevails.”
Enhanced Reimbursement for Safety Net Hospitals
HCFANY Recommendation: Provide an enhanced reimbursement rate for hospitals that: (1) have at least 50 percent Medicaid or uninsured patients; (2) have at least 40 percent of inpatient discharges covered by Medicaid; (3) have no more than 25 percent of patients commercially insured; and (4) are facilities that are part of the state’s five public health systems or federally designated as critical access or sole community hospitals.
Result: The final budget includes $40 million for safety net hospitals that meet the criteria above for fiscal year 2018.
Health Care Regulation Modernization Team
HCFANY Recommendation: Designate at least 20 percent of the seats on this team for health care consumers or advocates and require consumer representation on all team subgroups. Limit the team’s role to making recommendations that would then be taken up by the legislature.
Result: The Health Care Regulation Modernization Team was not included in the final enacted budget.
A few weeks ago, HCFANY members served on the “Challenges and Opportunities of the Trump Era: Healthcare for Special Populations” panel at the New York State Association of Black and Puerto Rican Legislators’ 46th Annual Legislative Caucus Weekend. Senator Gustavo Rivera facilitated the panel, which included a distinguished selection of labor, health care providers, advocates, and social service providers including: District Council 37’s Henry Garrido, Therese Rodriquez of Apicha Community Health Center, and Wendy Stark of Callen-Lorde Community Health Center.
Claudia Calhoon from the New York Immigration Coalition and Amanda Lugg of African Services Committee represented HCFANY’s Coverage 4 All Campaign. Arline Cruz from Make the Road New York and Juan Pinzon from the Community Service Society spoke on behalf of funding for the Community Health Advocates, New York State’s Health Consumer Assistance Program.
The conversation focused on the ways that drastic federal changes in health and immigration policy will affect health access and coverage for low-income, LGBTQ, and immigrant populations. New York State residents from these groups will be profoundly affected by proposed reductions in federal financing for health care promised by ACA repeal and proposed Medicaid cuts. Increased immigration enforcement activities have recently created paralyzing fear among immigrant communities and have discouraged people from visiting hospitals or sending their children to school.
In particular, the panel focused on the importance of three critical initiatives:
- Enhanced Safety Net Hospital legislation (A9476/S6948A), passed unanimously by both houses in 2016, that would create a new category of safety net hospital that reflects the actual quantity of indigent and low-income care provided and sustains those institutions;
- Expanding coverage to young adults regardless of immigration status by raising the eligibility of the Child Health Plus program to age 29;
- Fully funding the New York State’s Community Health Advocates consumer assistance program so that their sites may continue to distribute information in the face of potential change to healthcare.
In the face of these major changes, New York State has the opportunity to lead the nation by ensuring that its most vulnerable populations can access the full range of health care services from preventive to specialty care when they need them, as well as ensuring that they have the information they need to navigate and use their health coverage. It is also critical to strengthen the financial well-being of public hospitals and federally-qualified health centers across New York State that care for many immigrant and LGBTQ populations.
HCFANY looks forward to working with all its partners to protect health care access and coverage in the face of uncertainty and change on these and other priorities. Organizations interested in signing on to the Coverage 4 All campaign can do so here.