Last week, The Atlantic published an article entitled “The Unconscionable Difficulty of Getting Health Insurance for a Newborn.” The article tells the story of contributing writer Ester Bloom and her difficulties getting immediate Child Health Plus (CHP) insurance coverage for her newborn son. Coverage for Bloom’s son did not begin until six weeks after his birth, and in the interim she instead had to pay for much more expensive individual coverage through the Marketplace.
However, the original article neglected to mention the passage of Bill S4745/A7155 in December of 2015, which allows babies born into low and middle-income families eligible for Child Health Plus from the day they are born. Under this law, which takes effect January 1, 2017, parents who apply before the baby is born, or within 60 days of birth, will have CHP coverage for the newborn from the date of birth. Those who submit an application more than 60 days after the birth will be covered from the date of application. This law addresses the 45 day gap between parent application and newborn enrollment in CHP that Bloom describes in the article. For more details please see HCFANY’s original blog post from December 28, 2015.
We were excited to see a correction published on June 21, which included information about the law and how it will improve coverage for newborns under CHP.
This article also highlights the many challenges that consumers face when navigating the health insurance system as well as the importance of the trained assistance that health care Navigators, Certified Application Counselors, and Community Health Advocates can provide. New York State has been a leader in offering consumer assistance through these programs.
Parents who would like to enroll a child in CHP can do so through the New York State of Health Marketplace or by connecting to the Community Service Society Navigator Network at (888) 614-5400 or through their website.
Eighty representatives of HCFANY member groups gendand supporters came to Albany to network with other advocates, get updates on the fight for quality, affordable health care in New York, and plan strategy at HCFANY’s Annual Meeting on January 8.
Our guest speakers emphasized the continuing strong progress health reform is making, statewide and nationally. Danielle Holahan, the Deputy Director of the NY State of Health, reported that the number of uninsured New Yorkers has declined by an estimated 700,000, lowering the uninsured rate to its lowest point in decades. Jackie Cornell-Bechelli, the Regional Director of the U.S. Department of Health and Human Services, similarly pointed to major gains in enrollment on the national level.
However, as a panel of HCFANY leaders emphasized, there’s still more work for us do to ensure that all New Yorkers have health insurance, that the coverage and care we receive is of high quality, and that consumers can effectively use their coverage. They outlined HCFANY’s Legislative Agenda for 2016, including:
- state funding for Community Health Advocates, a program that helps consumers understand and effectively use their coverage and access care;
- the creation of a new program to fund community groups and small business-serving groups to do outreach to consumers in “hard to reach” communities; and
- funding to cover a small group of New York immigrants who are lawful residents but not covered under the new Essential Plan.
In the afternoon, participants broke into Planning Groups to develop strong campaigns to take action on HCFANY’s priority 2016 issues. At the immigrant coverage breakout, advocates discussed the name and structure of this exciting new campaign and new partners we should reach out to. The outreach and consumer assistance breakout discussed best practices for reaching the uninsured. The network adequacy group identified issues relating to network adequacy that diverse communities in New York experience, including rural communities and artists. Finally, the payment and delivery system reform breakout talked about opportunities to bring consumer voices into the state’s transformation efforts, including organizing a caucus of consumer advocates participating in the payment and delivery system reform workgroups.
For more information on any of these initiatives, please contact Carrie Tracy at email@example.com.
Children, Youth, and Families Task Force
Invites you to participate in a webinar on:
Children and Payment & Delivery System Reform in New York State
Friday, December 18th, 2015
11:00 a.m. – 12:00 p.m.
Andrew Leonard, M.P.A.
Sr. Health Policy Associate
Children’s Defense Fund – New York
On Friday, December 18th at 11am, the Children’s Defense Fund – New York, through its work with the Children, Youth and Families Task Force of Health Care For All New York, will host a webinar on payment and delivery system reforms in New York State. The 1-hour webinar will provide a brief overview of some of the state’s current payment and delivery reforms, such as the Delivery System Reform Incentive Payment Program (DSRIP), the State Health Innovation Plan (SHIP), Value-Based Payments (VBP) and others. Additionally, the webinar will discuss gaps in the current delivery system that foster negative health outcomes among children. The webinar will then focus on a number of key principles for guiding children successfully through payment and delivery system reforms and ensuring all children have opportunities for physical and mental wellness. The webinar is intended for children’s health providers, advocates and stakeholders, and all others interested in learning more about efforts under way in New York to transform how children and families receive care.
Call 212-697-2323 ext. 203 or firstname.lastname@example.org
Today the New York State of Health Marketplace announced which health insurance carriers will be offering plans on the Marketplace for 2016. This encompasses Qualified Health Plans for both individuals and small businesses, the new Essential Plan, and stand-alone dental plans.
The 200,000 individuals who hold policies with Health Republic will have to go shopping for new plans when Open Enrollment begins on November 1st. The CO-OP is winding down operations and no longer issuing renewals. The good news is that sixteen carriers will offer individual QHPs in 2016, and eight for the Small Business Marketplace (SHOP). The definition of a small business is new for 2016: firms with 100 or fewer full time equivalent employees can use SHOP – up from 50 employees in 2015.
While insurers and consumers alike are new to the Essential Plan, there is a strong show of support with 13 carriers offering plans for 2016. Consumers can use this interactive map to see which plans are offered in their county. Some counties, like the Bronx, have eight plans on offer, while New Yorkers in other counties, like Putnam and Schoharie, will only have one plan option if they qualify for the Essential Plan.
The stand-alone dental market is largely the same as 2015, with 11 carriers offering plans, 3 of which offer plans in every county in the state. The maps for dental, individual, and small business plans are available here.