HCFANY’s Executive Budget Update: What We Won and What We Lost.

 

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HCFANY worked hard on a series of important priorities this budget season, described in this policy brief.  The final enacted budget can be found here.

Here’s the quick summary of how we did:

Comprehensive coverage for immigrants

HCFANY Recommendation: Provide $10.3 million in State funding to offer Essential Plan (EP) to legal immigrants who are barred from federally-funded EP.

Result: Although the Assembly One House bill included the $10.3 million in State funding, the proposal did not make it in the final budget.sad face

Full funding for Community Health Advocates (CHA)

HCFANY Recommendation: Provide $4 million in funding for CHA to help people with their insurance problems and access to health care problems, when they occur.

Result: The final budget included $3.25 million for CHA–$2.5 million from the Executive and $750,000 from the Assembly.  Due to the intricacies of State contracting, this means that the CHA program faces an 18% cut from the past year.

Prior Approval of insurance plan rate increases

HCFANY Recommendation: Reject a Senate One House bill proposal to repeal the State’s right to review proposed insurance premium increases.

Result: The measure was not included in the enacted budget.1_emoji2

Health Guaranty Fund

HCFANY Recommendation: Support with modifications the Senate and Assembly stand-alone bill which sought to set up a Health Guaranty fund to reimburse providers in the wake of a health plan closing (e.g. Health Republic).

Result: The budget establishes a fund that will be financed through “settlement funds” to reimburse providers. The process for distributing the funds is unknown and it appears to include no public representation and/or public reporting on the distributions.sad face

Medicaid beneficiary protections

HCFANY Recommendation: HCFANY opposed the following threats to Medicaid beneficiaries: elimination of spousal/parental refusal, reduction of resources that spouses of people in MLTC or nursing homes can keep, and the repeal of “prescriber prevails.”

Result: None of these proposals made the final budget. That means spousal/parental refusal remains intact, spouses of people in MLTC or nursing homes will not see a cut in the amount of resources they can keep, and “prescriber prevails” will continue to be available in Medicaid. 1_emoji2

 

capitolHCFANY leaders are heading to the State Capitol today to speak to legislative leaders about our 2016 Policy Agenda. Here are a few of HCFANY’s ideas for ways that New York can continue to build on our successes to increase access to affordable quality health care for all.

Comprehensive Coverage for All Immigrants: New York can offer Essential Plan (EP) coverage for the roughly 5,500 New Yorkers who are ineligible for federal EP funding because of their immigration status by allocating $10.3 million in state-only funding for next year. New York should also explore ways to cover all immigrants, including those who are undocumented.

Consumer Assistance:  Community Health Advocates (CHA) helps New Yorkers understand, use and keep their insurance by providing a central, toll-free helpline and community and small business-serving agencies throughout the State. Last year, New York provided $3 million in funding for a 9-month period. This year, New York should provide $4 million to ensure a year-round CHA program.

Consumer Outreach:  While New York has exceeded enrollment expectations, 8% of New Yorkers remain uninsured. New York should build on its success by providing $2 million in funding for outreach and education by community-based organizations (CBOs) and small business-serving groups to reach the remaining uninsured. You can read more about these ideas in HCFANY’s Legislative Agenda Policy Brief and HCFANY Health/Medicaid Testimony on the 2016-2017 NYS Executive Budget.

Welcome to National LGBT Week of Action for Enrollment! The U.S. Department of Health and Human Services (HHS), the White House, Out2Enroll and partners across the country and New York State are collaborating this week to reach uninsured LGBT people and get them enrolled in health insurance for 2016. The deadline to apply for coverage that starts January 1 is next week, December 15.out to enroll

Members of the Health Care For All New York (HCFANY) LGBT Task Force are providing culturally competent enrollment assistance for LGBT New Yorkers, helping them apply for coverage through the NY State of Health Marketplace. These Task Force members include the Community Service Society, Callen Lorde Community Health Center, the LGBT Community Center in Manhattan and its partner in Queens, Voces Latinas, GMHC and Make the Road New York.

The National LGBT Week of Action for Enrollment celebrate the immense progress for LGBT health policy over the last few years since passage of the Affordable Care Act (ACA). HHS LGBT Issues Coordinating Committee Co-Chairs Kathy Greenlee and Wanda Jones took the opportunity this week to launch the 2015 HHS LGBT Annual Report and described new potential efforts to require electronic medical records systems to collect information on gender identity, sex assigned at birth and sexual orientation by 2018. Other exciting advancements include (1) proposed regulations implementing section 1557 of the ACA will bar discrimination against LGBT people in health care coverage and access, (2) a proposed Center for Medicare and Medicaid Services (CMS) National Coverage Determination Criteria Guideline for transgender medical care services, and (3) efforts to institute data collection on the basis of sexual orientation and gender identity.

HCFANY’s LGBT Task Force is working hard on many of these same issues at the state level. The Task Force has provided LGBT cultural competency training to more than 150 Navigators across the state so they can better serve LGBT people who want to apply for coverage. The Task Force also advocated for issuance of state policies requiring coverage of medically-necessary care that transgender people need by both private insurance and Medicaid. Listening sessions have been helping the Task Force and state officials identify needed follow up action to ensure compliance with these transgender coverage policies.

Want to learn more about coverage for yourself or an LGBT loved one? Contact the Community Health Advocates hotline at 888-614-5400, or visit the NY State of Health website to learn about your coverage options, which include the new very low-cost Essential Plan.

The December 15th deadline to enroll in health insurance starting January 1, 2016 is fast approaching. To make sure you don’t have a gap in coverage, log on to the New York State of Health Marketplace today! You can shop around and compare plans to see which is right for you and your family.

If you need help enrolling or renewing your coverage you can call the Community Health Advocates helpline at 1-888-614-5400, or visit an in-person assistor in your community.

You may be eligible for the new Essential Plan, which includes high quality coverage for $0 or $20 per person per month. There’s no deductible, very low copays, and optional vision and dental coverage too. Many low- and middle-income New Yorkers between the ages of 19 and 64 will qualify.

If your New Year’s resolution includes getting or staying healthy, don’t wait to enroll! It will also help you avoid the tax penalty, which is rising to 2.5% of your family’s yearly taxable income or $695 per person (whichever is higher) this year.

 

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