New Report Recommends Ways to Address Health Care Disparities

disparities_report

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.

 

NYSOH Infographics - Who_0-page1

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.

 

March on!

This week marks the 50th anniversary of the momentous March on Washington for Jobs and Freedom, where hundreds of thousands of Americans mobilized for equal rights.  And, while our nation has made great strides in the 50 years since - much work remains to be done.

Disparities in health and health outcomes persist. Black and Latino Americans have a rate of uninsurance that is nearly three times as high as their White counterparts. Insurance coverage is strongly related to health outcomes, and because of this minority populations are more likely to have worse health outcomes.

But inequality today is not limited to race.  Health disparities and a lack of affordable, quality health insurance also prevails among members of the LGBT community, women, young adults, and people with disabilities.

Factors vary by state, and here in New York we have been working hard to level the playing field in the health arena through implementation of our New York State of Health insurance marketplace.  HCFANY and our fellow advocates, policymakers, and stakeholders have been working hard to make our insurance marketplace as consumer-friendly and affordable as possible.  And while we are ecstatic at the results we are seeing, this is still a work in progress.  It may not be the answer to health disparities in our state, it is at least a beginning.

Let this week be a reminder of Dr. King’s vision and of not just how far we have come since 1963, but also of how far we still need to go.  Here at HCFANY, we will keep marching on.  We hope you will too!

 

 

HCFANY table at PrideFest

Raising Women’s Voices summer interns Delaine Powerful, left, and Olivia Cappello, at the Get Covered New York booth Sunday during NYC’s Pride Fest.
Today’s post comes from guest blogger Lois Uttley, of Raising Women’s Voices

Health equality for LGBT New Yorkers! That was the message Sunday at the Get Covered New York booth during NYC’s annual PrideFest celebration. Staffers and interns from Health Care for All NY (HCFANY) member organizations teamed up with volunteers from NYC for Action under the banner of Get Covered NY to bring LGBT New Yorkers the great news about new, more affordable health coverage options coming this fall. One in four LGBT New Yorkers has no health insurance, and LGBT people suffer a variety of health disparities. When the New York State Health Exchange opens for enrollment October 1, uninsured New Yorkers will be able to apply for free or low-cost coverage under an expanded Medicaid program, or financial aid to help with the cost of a private health insurance plan. “Really? I had no idea!” exclaimed one excited woman who stopped by the Get Covered NY table Sunday. LGBT New Yorkers were especially happy to learn that discrimination on the basis of sexual orientation or gender identity is prohibited under the Affordable Care Act. That means no discrimination in the New York State Exchange and in the health plans to be offered to participating insurers. HCFANY’s LGBT Task Force will be speaking to LGBT organizations around the state and tabling at community events throughout the summer and fall. If you would like to request a presentation or participation in an event, please contact info@raisingwomensvoices.net.