Since most (all?) of our readers are not members of the press, I thought I would share some more resources from last week’s HCFANY press briefing. Posted above is a video put together by the good folks at New American Media, who co-hosted the event. Click below for copies of the presentations from the event.
- “The Affordable Care Act: What is it & what does it mean for New York?” Elisabeth Benjamin, Community Service Society
- “Update on the New York Health Benefit Exchange,” Sara Rothstein, New York Health Benefit Exchange
- “Latino/a Immigrants and the Affordable Care Act,” Becca Telzak, Make the Road New York
Written by guest blogger Lorraine Gonzalez-Camastra, Director of Health Policy for Children’s Defense Fund-NY and HCFANY Steering Committee Member
In T minus five months, New York State will begin enrollment through its new Health Benefit Exchange. The goal on October 1st, 2013 will be to enroll as many of the 2.6 million uninsured New Yorkers as possible, and eliminate the number of children and youth who are without coverage.
However, the truth is that most New Yorkers don’t understand what health reform entails and many may not have even heard of the Health Benefit Exchange. This is more so for immigrant communities and those with English as a second language. New York prides itself on its diversity, but with rates of uninsurance among racial and ethnic minorities nearly double that of white New Yorkers, getting the word out on the Health Benefit Exchange will need to entail getting the word out in over 175 languages and dialects. 
On Friday, April 26th, HCFANY and NAM co-hosted an informational press briefing geared towards ethnic media to build understanding around the different provisions of the Affordable Care Act (ACA), the New York State Health Benefit Exchange, and what’s at stake for New York’s children and youth. Media outlets representing the Chinese, Indian, Turkish, Haitian, Filipino, Russian, and Latino communities attended the event and engaged in a dialogue about what their communities need from the Health Benefit Exchange and fellow advocates in order to guarantee that their populations are ready to enroll come October 1st. Presentations conducted by staff from the New York State Health Benefit Exchange, Community Service Society, Children’s Defense Fund NY, Make the Road NY, and the Coalition for Asian-American Children and Families detailed New York’s progress and plans for ACA implementation, as well as what advocates and stakeholders on the front lines know to be important elements of implementation for children and families in ethnic communities.
We are planning a similar press briefing for ethnic media outlets upstate in the coming months. Think of anyone we should be reaching out to? Please send press contacts to Arianne Slagle at firstname.lastname@example.org
 United States Census 2010.
Under the ACA, states are allowed the option of creating a Basic Health Plan (BHP) for low-income adults who earn too much to qualify for Medicaid. Ordinarily, if these folks don’t have employer-sponsored coverage then come 2014 they will be able to buy insurance through the Exchange with the help of federal tax credits. But, even with the tax credits this coverage may still be too expensive for them. The BHP then would act as a bridge between the free or low-cost Medicaid coverage and the higher priced options available on the Exchange.
Don’t be fooled by the name though - there is nothing “basic” about it. According to the ACA, BHP coverage must be as affordable and comprehensive as what these adults would have gotten on the Exchange. In New York, coverage would likely resemble that of the Family Health Plus program.
New York currently offers public coverage to low-income adults through its Family Health Plus program, the cost of which is split with the federal government. New York also pays for Medicaid coverage for low-income immigrants without help from the federal government. Through the BHP program, New York would be able to cover both of these groups and have the federal government pay for it all. This would save the state between $500 million and $1 billion per year.
Sounds great, right? Problem is, the federal government still hasn’t released guidance on this program, and isn’t planning on doing so anytime soon. Unfortunately, state policymakers won’t commit to the program until they are sure of all the details. So, until that happens, it is unlikely that New York will get any of the cost-savings and affordability protections that the BHP has to offer.
HCFANY has created a policy brief on this issue to explain it in detail, urge federal policymakers to release BHP guidance, and provide recommendations to state policymakers.
Click here to read HCFANY’s policy brief, titled “The Basic Health Program Option in the Affordable Care Act.”
- A primary care physician failed to find a woman’s breast lump, because the physician always examined her as she sat in her wheelchair.
- Nineteen percent of physicians questioned in a 2007 study reported that they were uncomfortable treating LGBT patients.
- Black New Yorkers have a much higher mortality rate than other groups of New Yorkers, while Hispanic adults have the highest rates of asthma of any group of New Yorkers.
As the four expert panelists at a September 7th Stakeholder Meeting sponsored by the New York State Health Benefit Exchange explained, people of color, women, people with disabilities and other traditionally underserved groups often receive an inferior quality of care from the health system, sometimes resulting in poorer health outcomes. The Stakeholder Meeting was designed to begin a public discussion on the problem of health disparities and how to address it through the exchange.
The agenda and some of the powerpoint presentations from the meeting are available here.
If you missed the meeting, you can watch a webcast here.
The presentations by the diverse group of panelists had two complementary themes:
- Health care exchanges can begin to address health disparities by enrolling more residents and targeting enrollment efforts to key constituencies like people of color and immigrants. Data indicates that the lack of health insurance is a major reason for health disparities. It follows that if the state enrolls over one million additional New Yorkers through the Exchange as projected and targets its enrollment efforts to traditionally underserved groups, one result will be better health outcomes for all New Yorkers, particularly members of traditionally underserved groups.
- However, added enrollment, while extremely important, is not enough. According to the panelists, many factors play a role in discouraging people of color, gays and lesbians, the disabled and members of other traditionally underserved groups from seeking care or receiving quality care. These factors include, among many others: a lack of understanding by doctors and other providers of their particular needs, long wait times for appointments with doctors and other providers, lack of cultural competence or language access, and lack of availability of doctors and other health professionals at times when working people can go to appointments.
Starting in 2014, the Exchange will present an enormous opportunity for New York to address the needs of these groups and to reduce health disparities. HCFANY has proposed that the Exchange consider a number of steps, including: targeted enrollment; collecting and analyzing data on health disparities; outreach, Navigators, and consumer assistance program that uses community-based organizations to reach underserved communities; and cultural competency training.
Participants at the Stakeholder meeting had plenty of feedback for the Exchange – so much so that the time for comment ran out before the comments did. To allow consumers to continue the conversation, the Exchange has asked stakeholders to submit written comments addressing three questions:
1. The insurance exchange will have a number of consumer assistance features that will enable consumers to choose a health plan that works for them. These features include a call center/hotline, website portal, and navigators and other consumer assistors. To ensure that hard to reach and vulnerable populations know about, feel comfortable with, and can access these services, what are examples of consumer service functions that have been successful in other settings? What made them successful?
2. The Exchange will review network adequacy, including the availability of Essential Community Providers, of insurance plans. What are some of the best practices to ensure that hard to reach and vulnerable populations have access to health services such as primary care, vision and dental care?
3. Data collection is an important tool for documenting health disparities on a population level. What are best practices on data collection (at the insurance plan level) to reduce disparities? What kinds of data should be collected, from whom should it be collected, and how should it be reported? Are there best practices on translating data into practice? If consumers are sensitive to providing personal data, how can this be addressed?
If you would like to submit comments on these questions, you can do so through the page with the meeting webcast. To view the meeting or to submit a comment, click on “Click here to play” under Health Benefit Exchange Stakeholder Meeting heading. Once the meeting site is accessed, comments can be submitted by selecting the “Participate” tab.
HCFANY will be submitting comments on these issues and more, and asking the Exchange to establish an ongoing process to identify and implement ways that the Exchange can increase health equity for all New Yorkers.