New Study Estimates More than One Million New Yorkers Would Become Uninsured Under ACA Repeal

Red AlertThe Urban Institute released a new report today, which examines the implications of a partial repeal of the Affordable Care Act (ACA) through a process known as budget reconciliation. According the report’s findings, more than 1.1 million New Yorkers would become uninsured by 2019 under a partial repeal of the ACA.

New York State also stands to lose substantial funding from the federal government:

  • The Urban Institute estimates that New York would lose more than $10 billion by 2028 in premium tax credits and cost-sharing reductions, which help make health insurance more affordable for individuals and families.
  • The Urban Institute also estimates that New York would lose approximately $47 billion by 2028 in funding for Medicaid and the Children’s Health Insurance Program (CHIP).
  • Although not included in the study, New York would also lose funding for its Basic Health Plan, branded the Essential Plan, which currently insures nearly 600,000 people.

Nationally, the number of uninsured is estimated to increase by 103 percent or 29.8 million people by 2019 under partial repeal. It is also estimated that there would be 12.9 million fewer people with Medicaid and CHIP coverage in 2019.

If you or someone you know would be affected by any of these issues, please share your story.

Hearing Location

The New York State Department of Financial Services is holding a hearing on September 8 to learn more about how New York could be affected by a merger between Anthem and Cigna. Any interested person can submit comments in writing, or even better, attend a hearing on the issue this Thursday in downtown Manhattan. The hearing starts at 10:00AM, on the 6th floor at 1 State Street.

HCFANY has expressed concerns about this merger before, and will do so again on Thursday. The hearing is completely open to the public (you can review the public notice here). Anyone can testify by signing up in advance (just email public-hearings@dfs.ny.gov, and put “ANTHEM-CIGNA 2016 HEARING” in the subject line).  HCFANY’s testimony recommends that DFS reject the merger, for the following reasons:

  1. The Anthem-Cigna merger will reduce competition in New York State.
  2. Competition produces better services at lower costs, even in the complicated world of health insurance.
  3. Remedies or conditions used by regulators in past health insurance mergers have failed to truly protect consumers.

You can read our talking points here for help in crafting your testimony, but the important thing is to tell your own story – DFS wants to hear from you! HCFANY believes this merger will make issues like customer service and affordability even more difficult for New Yorkers, and we think New Yorkers should let DFS know how those problems are affecting them. Even if you do not want to speak in public about the merger, it is important for consumers to attend the hearing – it shows DFS that we care about this issue. If you cannot attend, you can also submit written testimony up until September 15.

Yay BlogOnce again New York is leading the nation as one of only two states to implement a Basic Health Plan (BHP). As of January 31, 379,599 New Yorkers enrolled in comprehensive, affordable coverage through the New York’s BHP, branded the Essential Plan, which launched in 2016. A few weeks ago, the NY State of Health (NYSOH) released its report on the third open enrollment period, which ran from November 1, 2015 through January 31, 2016. HCFANY is excited to see so many consumers gaining access to health care through the EP in its first year.

The EP is meeting an important need for consumers in New York, particularly for those with incomes between 138 and 200 of the Federal Poverty Level (FPL). Before the implementation of the Essential Plan, individuals at this income level would only have been eligible to purchase Qualified Health Plans (QHP) with financial assistance, and many continued to face financial barriers to coverage. With the EP, low- and moderate income individuals can now receive coverage comparable to that of a QHP for a premium of $0 or $20 and no annual deductible. The average consumer saves over $1,100 compared to QHP coverage. This increased affordability has resulted in high enrollment levels for EP eligible individuals. According to NYSOH’s open enrollment report, 98 percent of individuals determined to be eligible for the Essential Plan enrolled compared to only 58 percent of individuals eligible for QHP.

Essential Plan coverage is also available to individuals under age 65 with incomes below 138 percent of the Federal Poverty Level (FPL) who are lawfully present in the United States, but have not met the five-year bar to qualify for Medicaid as well as lawfully present immigrants with incomes 138 to 200 percent of FPL.

Like Medicaid and Child Health Plus, individuals and families eligible for the EP can enroll throughout the year.

To enroll or learn more about the Essential Plan, contact NYSOH at (855)-355-5777 or www.nystateofhealth.ny.gov.You can also get free one-on-one help from a Navigator or Certified Application Counselor, certified by NY State of Health, who serves your area at http://info.nystateofhealth.ny.gov/IPANavigatorMap. Or contact Community Health Advocates at (888)-614-5400 or http://www.communityhealthadvocates.org/.

CID-NYGuest blog by Heidi Siegfried, Project Director at New Yorkers for Accessible Health Coverage (NYFAHC) and Health Policy Director, Center for Independence of the Disabled. A few days ago, Health Affairs published an article that highlighted how the non-discrimination provisions of the Affordable Care Act (ACA), Section 1557, can protect consumers against benefit designs that discriminate against people with chronic conditions or significant health needs.

New York has long prohibited denial of coverage or premium variation based on health status and the ACA now prohibits charging higher premiums or denying coverage for people with pre-existing conditions. Still, network and formulary designs can have the effect of discriminating against people with serious illnesses and disabilities.

People often overlook the fact that Section 1557 prohibits discrimination based on disability status as well as race, color, national origin, sex, and age.  HCFANY and NYFAHC submitted comments to the U.S. Department of Health and Human Services (HHS) on the proposed rules for Section 1557 in November 2015. In these comments, we asked HHS to specifically define discriminatory benefit design in the regulations implementing Section 1557 and to include all beneficiaries with chronic conditions or serious illnesses.  Although HHS did not provide a definition, they do consider benefit design discrimination on a case-by-case basis and will review complaints of disability-based discrimination. HHS also provides examples of potentially discriminatory benefit designs such as placing all HIV drugs on the highest tier.

The Health Affairs article points out that the Americans with Disabilities Act was amended to define disability as an impairment of major bodily functions such as immune system, normal cell growth, digestive, bladder, neurological, respiratory, and endocrine systems which would reach many people with chronic conditions.  Therefore, when consumers encounter discriminatory formularies, coverage limitations, or plans that exclude certain specialists, they can use Section 1557 to enforce their rights to non-discriminatory benefit design by filing complaints with the Office of Civil Rights at HHS or by challenging the plans in court.