Victory! NY takes steps to protect transgender New Yorkers

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It’s been a good week for health equity in New York!

Yesterday, New York State’s Department of Financial Services sent guidance to all commercial insurers in the state barring denials of medically necessary treatment for gender dysphoria. Gender dysphoria is a condition when a person’s identity at birth is different than who they know themselves to be on the inside. The guidance essentially says if an insurer covers a particular service (a double mastectomy, for example), the insurer can’t deny that service to a transgender person, purely on the basis of their gender identity.  Read our full press release here.

And earlier this week, the New York City Council voted to pass legislation that will allow trangender New Yorkers to change the sex on their birth certificate without providing proof of gender confirmation surgery. New York State made a similar policy change this past June. This legislation will help combat discrimination transgender New Yorkers might otherwise experience in healthcare access, as well as housing, employment, and other areas of their lives.

Equal access to health care for transgender people has been a key policy priority for HCFANY and its LGBT task force. These two policy victories signal important steps forward for the health of transgender New Yorkers.

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“The Affordable Care Act gave me a chance and ended my six year nightmare of living without health insurance. It was way more simple and affordable than people think.”

-Karen E., Ulster County

The Affordable Care Act is working in New York, according to HCFANY’s new publication, The ACA is Working: New Yorkers Tell Their Stories.

The new publication shares stories from New Yorkers like Karen, a single mother from Ulster County, who was finally able to get affordable health coverage for her family after being uninsured for six years, thanks to federal subsidies. Ben, from Broome county got covered thanks to the ACA’s Medicaid Expansion and enrolled in the same plan as his son. And Engracia got help from a local Navigator to enroll in a plan that saves her $4,500 a year.

The ACA is Working: New Yorkers Tell Their Stories features twelve consumer stories and quotes from New Yorkers in all regions of the State who enrolled in private Qualified Health Plans, Medicaid, Child Health Plus, and small business plans, all through the NY State of Health Marketplace during the first Open Enrollment period. Many got help to enroll from Navigators, who offer free, unbiased, in-person enrollment help. The stories are paired with key statistics and facts about how the ACA is working for New York – and most importantly, New Yorkers.

View HCFANY’s full press release here.

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Guest post:
Bob Cohen, Policy Director, Citizen Action of New York/Public Policy and Education Fund;
Theo Oshiro, Deputy Director, Make the Road New York

New York took a big leap forward in enrolling nearly a million New Yorkers in health coverage during the first open enrollment period under the ACA that ended in March, but we still have a lot to do to ensure that all New Yorkers, including traditionally excluded communities, fully benefit from the federal law. This is the simple message of a new “white paper” released in June by two HCFANY partners, the Public Policy and Education Fund and Make the Road New York, in conjunction with the Alliance for a Just Society, a national network for research, policy and organizing.

The report, Addressing Health Disparities Through the Marketplace: An Action Agenda for New York State of Health,” applauds NY State of Health for a number of steps it has already taken, like easing enrollment in emergency Medicaid. The white paper establishes a broad agenda with 11 recommendations for further actions by NYSOH and the Legislature. For example, the report recommends a greater focus on outreach aimed at reaching diverse communities through steps like stronger targeting of ethnic media and reexamining current restrictions on navigators on contacting New Yorkers in their homes. It suggests that public numerical targets be set for enrollment of groups like immigrants and people of color, that NYSOH move forward aggressively with translating its website into languages other than English, stronger enforcement of requirements that health plans develop clear strategies to address health disparities, and the establishment of  a stakeholder task force focused on the reduction of disparities.

 

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We already knew that nearly a million New Yorkers had enrolled through NY State of Health during the first open enrollment period from October 1 to March 31. But now we know more than ever about who they were, where they live, and how they enrolled. That’s thanks to the new enrollment report released yesterday by NY State of Health, the official health plan marketplace, which includes eagerly awaited demographics data such as age, race and ethnicity of enrollees.

HCFANY issued a press release, highlighting key findings from the data, such as the importance of in-person assistors in helping New Yorkers obtain health insurance. Nearly 50% of insurance applications were completed with help of in-person assistors, including Navigators, Certified Application Counselors, and brokers. In-person assistance was particularly critical for low-income New Yorkers: more than half (59%) of the Medicaid enrollees used in-person assistance to complete their application.

For the first time, the report offers a glimpse into the race and ethnicity, as well as preferred language, of New York enrollees. Though the data is incomplete – about one in four enrollees chose not to respond to the application on race – it nonetheless will help direct future outreach and enrollment efforts across the state. About 37% of enrollees who answered the question reported their race as Black/African American, Asian/Pacific Islander, or “other” non-white race. About 20% of Medicaid enrollees chose a language other than English, but no enrollees reported their preferred language as Korean, Russian, or French Creole, pointing to potential gaps in these communities. As useful as this data is, it only provides a statewide picture – there is still a need for race, ethnicity and preferred language by county in order to target outreach to the communities that need it most.

Financial assistance was key to the high enrollment numbers in Qualified Health Plans (private health insurance). Nearly 3/4 of enrollees got private health plans with financial assistance in the form of Advanced Premium Tax Credits (APTC) or a combination of both APTC and cost-sharing reductions. An average New Yorker who was eligible for financial assistance saved $215 per month in premium.

And, while some enrollees (about 13%) clearly benefited from the Medicaid expansion that made them newly eligible for public insurance, a whopping 93% of Medicaid enrollees were newly insured overall. That means many of those who enrolled in Medicaid were previously eligible but, for whatever reason, had been unable to enroll. New York clearly did something right in building it’s health insurance marketplace – the single, streamlined web application our State officials built is working. And, boy, did New Yorkers come.