DFS Calls for Hearing on Anthem-Cigna Merger

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Late last week, the New York State Department of Financial Services (DFS) called for a hearing to discuss the consequences of a merger of the Anthem and Cigna health insurance companies. HCFANY applauds DFS for this action. HCFANY wrote to DFS in early March shortly after the potential merger was announced. In the letter, HCFANY urged the Department to carefully review this merger and hold a public hearing on how it affects competition in the state Marketplace, which ultimately impacts the costs of premiums and quality of care for consumers.

This merger would combine the second-largest and fourth-largest health insurers in the country and reduce the number of major health insurers in the U.S. from five to three. According to a recent article in Politico, this would mean that Anthem’s total market share would increase to 31 percent in New York State. In the New York Metropolitan area, Anthem would control almost 70 percent of the commercial self-insured market in three of the five boroughs. Increased market share would give Anthem the ability to dictate prices for providers and likely have a negative impact on access to health care for New York’s consumers.

If you would like to weigh in on the proposed Anthem-Cigna merger, there will be a public hearing held on Thursday, September 8 at 10:00 AM in New York City. If you are interested in testifying at the hearing, please write to DFS at New York State Department of Financial Services, Public Affairs Office – Anthem-Cigna Merger New York, NY 10004 OR e-mail public-hearings@dfs.ny.gov with the subject line: “ANTHEM-CIGNA 2016 HEARING.” Requests to testify must be received at least five business days prior to the hearing.

CCF

Two weeks ago, children’s health advocates from across the country came together in Washington, DC for the Georgetown University Health Policy Institute Center for Children and Families Annual Conference. The conference provides an excellent opportunity for national and state advocates to share their experiences and learn from one another. This year’s conference theme was “Clear Skies or Foggy Times Ahead for Child and Family Coverage?” Topics included the future of children’s health coverage, strengthening and expanding Medicaid, and improving the quality and delivery of children’s health services.

We heard from experts in the field about the impact of perception, race, and bias on Medicaid, avenues for improving network adequacy, and the final Medicaid managed care regulations and what they mean for children and families.

HCFANY’s Children, Youth, and Families Task Force represented New York consumer advocates at the conference. HCFANY’s Elisabeth Benjamin, Vice President of Health Initiatives at the Community Service Society of New York, spoke on a panel that explored the means by which advocates can work to improve access to care in both public and private coverage programs.

CHP Picture

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.

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Guest blog by Max Hadler, Health Advocacy Specialist at The New York Immigration Coalition

Despite the major health care coverage gains achieved under the Affordable Care Act, more than 450,000 New Yorkers remain uninsured because their immigration status makes them ineligible for affordable coverage. As a result of the continued failure to approve federal immigration reform or lift health coverage restrictions on many groups of immigrants, it continues to fall to state and local governments to pick up the slack. Health Care For All New York has responded to the dire lack of coverage options for immigrants by launching the Coverage 4 All campaign under the leadership of two of the coalition’s member organizations, Make the Road New York and the New York Immigration Coalition.

The campaign’s mission is to obtain affordable coverage options for all New Yorkers, regardless of immigration status. A shorter-term goal is to expand coverage to a smaller group of immigrants who are “permanently residing under color of law” (PRUCOL). These are people whose presence in the U.S. is known and may be unauthorized, and who have received confirmation from the federal government that it has no intention of deporting them. In New York, immigrants who are PRUCOL are eligible for state-funded Medicaid when they meet the income requirements (less than $16,242 annual income for a single person). However, the same people are not currently eligible for the Essential Plan, New York’s low-cost, comprehensive coverage program for low-income residents whose incomes are too high for Medicaid (up to $23,540 annually for a single person). This restriction runs counter to New York’s history of providing coverage to many immigrants who are excluded from federally-funded programs.

Most immigrants who are PRUCOL are young adults who grew up in the U.S. and have Deferred Action for Childhood Arrivals (DACA) as a result of President Obama’s 2012 executive order providing them two-year work authorizations and a reprieve from deportation. These young people are encouraged to work as a result of their DACA status but are then faced with a dearth of affordable coverage options when their incomes increase beyond the Medicaid threshold because they are ineligible for the Essential Plan and prohibited from accessing tax credits through the New York State of Health insurance marketplace.

To begin to remedy these coverage gaps, the New York State Assembly is working to expand Essential Plan eligibility to include immigrants who are PRUCOL. The Assembly included $10.3 million in its 2016-17 budget to provide this coverage, but the funding was ultimately cut in budget negotiations. Assemblymembers Richard Gottfried and Marcos Crespo have since introduced legislation that would expand Essential Plan eligibility to include immigrants who are PRUCOL. Bill A10054 was successfully voted out of the Assembly Health Committee on May 17 and is now awaiting a vote by the Ways and Means Committee. HCFANY has submitted a memorandum of support for the bill. Others are encouraged to submit their own memorandums and to borrow language from the HCFANY memo as needed. Please contact me at the New York Immigration Coalition if interested in registering your support (mhadler@nyic.org).