A busy summer of outreach to the uninsured in NYC

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Outreach Worker Engracia Jamieson and Volunteer Jan Kenyon at Great Day in Harlem  (above) and   RWV-NY Community Organizer Liza Lederer (right) at Brooklyn Pride

This coming Labor Day Weekend marks the unofficial end of summer, and it’s been a busy one for health coverage advocates and volunteers! Here’s an update from the field from the Get Covered NY Campaign, a grassroots effort to raise awareness about the new insurance options available through NY State of Health, and help NYC residents get covered. Get Covered NY is a project of Health Care For All New York, Greater NYC for Change, and Raising Women’s Voices – NY.

Guest Post by Aliza Lederer-Plaskett, Community Organizer for Raising Women’s Voices-NY

Raising Women’s Voices and our partners in the Get Covered NY initiative are wrapping up a busy summer of outreach to uninsured New Yorkers. We have tabled and leafleted at a wide variety of events in low-income communities in Upper Manhattan, Brooklyn and the Bronx, as well as Westchester and Rockland counties.

We’ve been to the Hunts Point Summer Fish Festival in the Bronx. We’ve reached out to LGBT people by tabling at Pride Festivals in Harlem, Brooklyn, the Bronx, Rockland County and lower Manhattan. We’ve been to book fairs, Harlem Week and back-to-school events where we can reach families with children who may be eligible for Child Health Plus. In Westchester and Rockland Counties, we have done outreach at cultural festivals and presentations on the Affordable Care Act and NY State of Health for members and staff of local nonprofit organizations.

Our dedicated and trained Get Covered New York volunteers have been taking clipboards and handouts around the events, interacting with attendees and taking down the names of people who would like to be contacted by a Navigator to begin the application process. Through this hands-on approach, we have collected more than 900 names of uninsured and underinsured individuals throughout July and August.

As we speak with uninsured people in the field and collect their information, we have noted who has experienced a major life change – which may qualify them for a special open enrollment period. We also flag people who we think might qualify for Medicaid, for which there is year-round enrollment. We then forward their contact information directly to a Navigator at the Community Service Society.  Other uninsured individuals are entered into the Get Covered NY database, to be called by volunteers at phone banks that will start up again as the November 15 start of the next open enrollment period draws closer.

We have begun to pack our September and October schedule chock full of community events to ensure that we can reach as many people as possible prior to the start of the new enrollment period.  Got an event you’d like to see us at?  Interested in becoming a volunteer? Please contact Liza Lederer at liza@raisingwomensvoices.net and we’ll get you set up to help get New York covered!

birth_control_supreme_courtGuest post by Lois Uttley, Director, Raising Women’s Voices – NY

The Supreme Court’s decision this week in the Hobby Lobby case is a blow to the hard-fought campaign to ensure that women have affordable health insurance coverage for contraception. The court, in a 5-4 ruling, said that family-run corporations like the crafts chain store Hobby Lobby can refuse to provide contraceptive coverage to their employees if the owners say contraception violates their religious beliefs.

Women’s health advocates are concerned that the decision could begin to undermine valuable gains for women’s health and economic well-being that we’ve started to see as a result of the Affordable Care Act’s Women’s Preventive Services provisions. Last year, the share of women with no out-of-pocket costs for the types of contraception covered by the law increased to 56 percent from 14 percent only one year earlier. The contraceptive coverage mandate saved women an estimated $483 million in out-of-pocket spending last year, according to the IMS Institute for Healthcare Informatics.

Prior to the Hobby Lobby decision, the Obama administration already had exempted purely-religious organizations, such as churches and seminaries, from complying with the contraceptive mandate. In addition, the administration had fashioned an accommodation for religiously-affiliated non-profits, such as Catholic hospitals and nursing homes, that allows them to shift the burden of providing contraceptive coverage to their insurance companies or third-party health plan administrators.

The court’s ruling carves out an exception to the contraceptive coverage mandate for another type of employer (so-called “closely-held corporations” in which more than half the stock is held by five or fewer people), when the owners of the company (such as the conservative Christians who own Hobby Lobby) have religious objections to contraception. By some estimates, as many as 90 percent of all corporations are closely-held entities, and they employ about half of American workers. Hobby Lobby runs more than 600 stores across the country, with 13,000 employees.

Justice Samuel Alito, who authored the majority opinion by five male judges in the Hobby Lobby case, suggested that the employees of corporations like Hobby Lobby could still get contraceptive coverage if the government granted those companies the kind of accommodation already in place for religiously-affiliated employers, or if the government simply paid for their contraception. However, the accommodation is being challenged in separate lawsuits by religious entities. Moreover, Justice Ruth Bader Ginsburg, who authored the dissent that was joined by the other two female justices, wondered:  “Where is the stopping point to the “let the government pay” alternative?  Suppose an employer’s sincerely held religious belief is offended by health coverage of vaccines or paying the minimum wage [...] or according women equal pay for substantially similar work [...]?”

The Hobby Lobby decision was the first time that corporations were granted legal protections under the federal Religious Freedom Restoration Act for the religious beliefs of their owners, a step that was very troubling to Ginsburg and the dissenters. “The exemption for these employers from the requirement to provide contraceptive coverage would deny legions of women who do not hold their employers’ beliefs access to contraceptive coverage that the ACA would otherwise secure,” Ginsburg wrote.

Fortunately for women in New York State, the decision and the federal RFRA does not apply to state contraceptive coverage laws, such as the Women’s Health and Wellness Act in New York. The Women’s Health and Wellness Act requires employers to cover contraception, as well as other important women’s health services. This state law was upheld by the state’s highest court, the Court of Appeals, which rejected a challenge by religious groups in our state.

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We already knew that nearly a million New Yorkers had enrolled through NY State of Health during the first open enrollment period from October 1 to March 31. But now we know more than ever about who they were, where they live, and how they enrolled. That’s thanks to the new enrollment report released yesterday by NY State of Health, the official health plan marketplace, which includes eagerly awaited demographics data such as age, race and ethnicity of enrollees.

HCFANY issued a press release, highlighting key findings from the data, such as the importance of in-person assistors in helping New Yorkers obtain health insurance. Nearly 50% of insurance applications were completed with help of in-person assistors, including Navigators, Certified Application Counselors, and brokers. In-person assistance was particularly critical for low-income New Yorkers: more than half (59%) of the Medicaid enrollees used in-person assistance to complete their application.

For the first time, the report offers a glimpse into the race and ethnicity, as well as preferred language, of New York enrollees. Though the data is incomplete – about one in four enrollees chose not to respond to the application on race – it nonetheless will help direct future outreach and enrollment efforts across the state. About 37% of enrollees who answered the question reported their race as Black/African American, Asian/Pacific Islander, or “other” non-white race. About 20% of Medicaid enrollees chose a language other than English, but no enrollees reported their preferred language as Korean, Russian, or French Creole, pointing to potential gaps in these communities. As useful as this data is, it only provides a statewide picture – there is still a need for race, ethnicity and preferred language by county in order to target outreach to the communities that need it most.

Financial assistance was key to the high enrollment numbers in Qualified Health Plans (private health insurance). Nearly 3/4 of enrollees got private health plans with financial assistance in the form of Advanced Premium Tax Credits (APTC) or a combination of both APTC and cost-sharing reductions. An average New Yorker who was eligible for financial assistance saved $215 per month in premium.

And, while some enrollees (about 13%) clearly benefited from the Medicaid expansion that made them newly eligible for public insurance, a whopping 93% of Medicaid enrollees were newly insured overall. That means many of those who enrolled in Medicaid were previously eligible but, for whatever reason, had been unable to enroll. New York clearly did something right in building it’s health insurance marketplace – the single, streamlined web application our State officials built is working. And, boy, did New Yorkers come.

 

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From left to right, Elisabeth Benjamin, CSSNY; Judy Arnold, NYSDOH; Kate Breslin, SCAA; Lorraine Gonzalez-Camastra, CDF-NY
 

HCFANY’s Children, Youth & Families Task Force presented the first Children’s Health Champion to Judy Arnold, Director of the Division of Eligibility and Marketplace Integration at the NYS Department of Health.  The award is well deserved. Under Ms. Arnold’s leadership, New York increased the number of children with health coverage; initiated the facilitated enrollment program, the predecessor to NY’s navigator program; and has worked to remove barriers to coverage and streamline enrollment. Congratulations to Judy!

The award presentation happened as a part of the spring meeting of HCFANY’s Children, Youth & Families Task Force on Wednesday, May 28. Advocates gathered in Albany to share important policy updates and to plan the next steps to secure universal health coverage for all children in New York.

The day also included a panel discussion moderated by Kate Breslin from the Schuyler Center for Analysis and Advocacy. Two important health care funders, The Atlantic Philanthropies and New York State Health Foundation, were present to share their perspectives, panel-style, on upcoming priorities for the health of NY’s children and families. Jim Knickman, President and CEO New York State Health Foundation, identified oral health, asthma, behavioral health, and obesity as top priorities for children’s health in New York. Kimberley Chin, Programme Executive at Atlantic Philanthropies, reflected upon the impact of the foundation’s work as it enters its final phase of grant making, and invests in projects that will provide sustainable solutions.

Additionally, attendees celebrated recent HCFANY budget wins and a stellar open enrollment period (over 960,000 New Yorkers enrolled)! They also heard updates from HCFANY’s Public Programs Group, which monitors Exchange implementation and challenges related to Medicaid, Child Health Plus, and other public insurance programs.

Much important work is on the horizon for this task force, including coverage for undocumented immigrants and adolescents, behavioral and oral health coverage, monitoring New York’s Delivery System Reform Incentive Payment Program (DSRIP), and other key priorities. On a national level, members will keep an eye on federal funding for the Children’s Health Insurance Program (CHIP), which provides comprehensive and affordable coverage to more the 8 million children across America. Funding expires as of September 30, 2015, unless congress takes action.