Special enrollment period for pregnant women

pregnant woman doctor

As we celebrate the holidays and ring in the New Year, we now have more reason for merriment – Governor Cuomo has just signed legislation that gives pregnant women the right to enroll in Qualified Health Plans through the State’s Marketplace at any time during the year! Until now, pregnant women had to wait to apply for health insurance until the annual open enrollment period. HCFANY is proud to say that New York is the first state in the nation to adopt such an important law, demonstrating leadership in promoting access to health insurance for all!

The passage and signing of S5972/A6780 is significant and commendable because having health insurance during pregnancy can improve the health of mothers and their babies.   Timely, quality pre-natal care can decrease the likelihood that a pregnant women will face health problems or that her baby will be born premature. According to the March of Dimes, nearly 9% of babies born in New York State are pre-term, which puts them at risk for many health problems. The new legislation should help decrease that percentage, assuring that more babies in New York get a healthy start in life.

The new special enrollment period may also significantly decrease healthcare costs for pregnant women who sign up for health insurance. Charges for pre-natal care and hospital care can be daunting for uninsured women. The costs quickly add up due to numerous pre-natal visits, ultrasounds, blood work and screening tests. Giving birth in a hospital is very expensive. On average, health insurance companies pay $9,800 for a normal delivery and $15,000 for a c-section, according to the International Federation of Health Plans. As of today, women in New York State will not have to worry about the full cost of pre-natal care and giving birth. Thanks to the new law, they will be able to access the full array of health services needed for a healthy pregnancy, birth and healthy baby.

HCFANY applauds New York State lawmakers and Governor Cuomo for working to protect the health of mothers and babies. You can read the governor’s press release here. Pregnant women will now be able to enroll on the Marketplace as soon as a doctor confirms they are expecting by going to the New York State of Health Marketplace. Women can also contact the Community Service Society Navigator Network for free enrollment assistance.

Already more than two million New Yorkers have gained affordable health coverage through the NY State of Health marketplace, but there are still some people (namely women!) who may find themselves left behind. First-in-the-nation legislation providing special insurance enrollment options for pregnant women passed both the State Assembly and State Senate a few weeks ago and awaits the Governor’s signature.baby talking 2

In the past, moderate- and higher-income uninsured women who become pregnant had to wait to enroll in private health insurance. Low-income women can enroll in Medicaid at any time, but their higher-income counterparts can be left without affordable prenatal and maternity care. Lack of coverage can lead poor health outcomes for mom and baby. Improved maternal and child health outcomes support the New York State Prevention Agenda, and it’s the right thing to do.

Senate Bill 5972/Assembly Bill 6780-B creates a special enrollment period (SEP) for uninsured women who become pregnant and seek coverage outside of the open enrollment period. HCFANY urges Governor Cuomo to sign it into law. You can send a message here or call 518-474-8390 to ask him to sign S.5972/A.6780-B today!

Pride table

High rates of un-insurance among lesbian, gay, bisexual and transgender (LGBT) people have finally started to drop because of the affordable, nondiscriminatory health coverage options made possible by the Affordable Care Act (ACA). The LGBT uninsured rate fell from 24.2 percent to under 18 percent in the first year of operation of ACA health marketplaces, according to national Gallup surveys. But that was still significantly higher than the 13.2 percent un-insurance rate for the U.S. population as a whole.

That’s why Health Care for All New York is reaching out to uninsured LGBT New Yorkers as they participate in Pride celebrations in June and July. Raising Women’s Voices-NY, a HCFANY Steering Committee member, will be at every Pride Month celebration in the New York City area, handing out LGBT-specific information, and collecting contact information for uninsured people and connecting them to navigators who specialize in working with LGBT consumers for enrollment assistance.

Big selling points this year are the recent New York State policy announcements requiring health insurers to cover all medically-necessary transgender care. HCFANY’s LGBT Task Force is delighted to see that the New York Department of Financial Services responded to our concerns by issuing a guidance letter covering private health plans. HCFANY is also educating LGBT New Yorkers about the March 2015 partial lifting of transgender exclusions in state Medicaid coverage.

We’re letting LGBT New Yorkers know that if they are getting married, having a baby or experiencing one of a list of “qualifying life events,” they are eligible for a special enrollment period to apply for coverage through the NY State of Health marketplace. Low-income LGBT people can apply for Medicaid or Children’s Health Insurance Program coverage for themselves and their families year-round. The third open enrollment period for ACA health coverage starts on November 15.Pride outreach

RWV-NY Community Organizer Liza Lederer and summer intern Christianna Silva were at the Brooklyn Pride festivities on June 13, handing out materials and talking with uninsured LGBT people about how to get covered. More than 10,000 people attended Brooklyn Pride, which occupied six blocks in Park Slope Community. Many of the vendors at the festival were self-employed people interested in getting health insurance for the first time, reported Lederer. The following day, June 14, RWV-NY participated in Rockland Pride, which was held in the village of Nyack, and was attended by more than 2,000 people from the Rockland LGBT community.

 

Coming up on Saturday, June 27, will be Harlem Pride, where RWV-NY staff will do outreach to uninsured LGBT people in the neighborhood. Then, on Sunday, June 28, is the big Pride Festival in Manhattan, which draws more than 200,000 people from around the country. RWV-NY staff and volunteers will be leafleting and collecting names of uninsured people along the parade route and in the exhibit and vendor area that stretches over five blocks in the West Village. Pride activities in the New York City area will conclude on July 17, when RWV-NY will have a table at Bronx Pride, which will be held from noon to 8 p.m. in Crotona Park.

ACA is working cover

“The Affordable Care Act gave me a chance and ended my six year nightmare of living without health insurance. It was way more simple and affordable than people think.”

Karen E., Ulster County

The Affordable Care Act is working in New York, according to HCFANY’s new publication, The ACA is Working: New Yorkers Tell Their Stories.

The new publication shares stories from New Yorkers like Karen, a single mother from Ulster County, who was finally able to get affordable health coverage for her family after being uninsured for six years, thanks to federal subsidies. Ben, from Broome county got covered thanks to the ACA’s Medicaid Expansion and enrolled in the same plan as his son. And Engracia got help from a local Navigator to enroll in a plan that saves her $4,500 a year.

The ACA is Working: New Yorkers Tell Their Stories features twelve consumer stories and quotes from New Yorkers in all regions of the State who enrolled in private Qualified Health Plans, Medicaid, Child Health Plus, and small business plans, all through the NY State of Health Marketplace during the first Open Enrollment period. Many got help to enroll from Navigators, who offer free, unbiased, in-person enrollment help. The stories are paired with key statistics and facts about how the ACA is working for New York – and most importantly, New Yorkers.

View HCFANY’s full press release here.