Executive Order Could Mean Trouble in 2018

UrgentAlthough it has no immediate effect, the executive order the President signed yesterday morning instructs several federal agencies to consider proposals that could destabilize the individual insurance markets established under the Affordable Care Act (ACA).

The executive order instructs relevant agencies to propose regulations that would:

  • Expand the use of association health plans, which allow small businesses to group together to purchase health insurance;
  • Allow more people to enroll in short-term limited duration insurance, which are exempt from ACA consumer protections, for longer periods of time; and
  • Allow the sale of health insurance across state lines.

The expansion of association and short-term limited duration health plans would both create loopholes for younger, healthier consumers to purchase one of these plans instead of plans offered through the Marketplace. If younger, healthier people leave the Marketplace, premiums will rise for consumers that remain and may become unaffordable.

Selling insurance across state lines presents a different problem, especially for states like New York. New York has worked really hard to pass insurance regulations that protect consumers. Insurance sales across state lines would essentially allow insurance companies to choose their regulators, which would make insurance less available and less accountable to the needs of New Yorkers and consumers across the country.

If federal agencies do propose these rules as the President instructs, there will be an official notice of proposed rulemaking and at least a 30-day comment period before any new regulation would go into effect. It is therefore unlikely that any changes will take place before 2018.

This does not affect the upcoming open enrollment period, which will begin on November 1. If you or someone you know needs help enrolling in health insurance, please call (888) 614.5400 for in-person assistance in your area. Don’t forget, consumers enrolling in Medicaid, the Essential Plan, and Child Health Plus can enroll year-round.

You can check out additional resources on the executive order here.

orange-light-alarm-mdA new proposal from Senators Lindsey Graham (R-SC) and Bill Cassidy (R-LA) that would devastate New York and the nation could pass as early as next week. An updated analysis from the Center on Budget and Policy Priorities (CBPP) estimates that New York State would lose more than $33 billion by 2027 under the Graham-Cassidy amendment – a last-ditch effort by the Senate to repeal and replace the Affordable Care Act (ACA) before September 30. CBPP says that beginning in 2027, Graham-Cassidy “would likely be even more damaging” than repealing the ACA without a replacement, which would have caused an estimated 32 million people to lose their health coverage.

The Graham-Cassidy amendment would:

  • End Medicaid Expansion and Advanced Premium Tax Credits (APTCs) that help make insurance more affordable in 2020 and convert all funds to a block-grant.
  • Require a state match to use any block-grant funds.
  • End the Medicaid program as we know it, by capping how much states can spend on each Medicaid recipient.

Graham-Cassidy would replace the federal funding for Medicaid Expansion and APTCs with a block-grant to states. According to CBPP, this block-grant would include a 17 percent cut to current federal funding levels by 2026 and would not be adjusted based on the size of a state’s Medicaid population or changes in a state’s funding needs. New York would experience the second largest funding cut in the nation. There is also no requirement in the amendment that states use this money on health coverage. This block-grant would completely disappear in 2027.

Your Representatives in Congress need to hear from you. Please call 844.898.1199 and tell your Representative to vote “NO” on this devastating proposal.

open enrollment graphicYesterday, the NY State of Health, New York State’s official health plan Marketplace announced in a press release that Open Enrollment for the 2018 plan year would begin on November 1, 2017 and last for a full three months, ending on January 31, 2018. As you may have heard in the spring, the federal government slashed Open Enrollment to just six weeks. This move is much better for consumers who are often overwhelmed during the busy holiday season. With this action, New York joins others progressive states like California, Washington, and Minnesota in extending the 2018 enrollment period.

If you or someone you know needs help selecting and enrolling in a health insurance plan, Navigators are available to assist. Please call (888) 614.5400 for in-person assistance in your area. Don’t forget, consumers enrolling in Medicaid, the Essential Plan, and Child Health Plus can enroll year-round!

NYIC_Logo-RV_Mar13,2012Guest post by Max Hadler, Senior Health Policy Manager at the New York Immigration Coalition. On Tuesday, September 5, the Trump administration announced that it was terminating the Deferred Action for Childhood Arrivals (DACA) program in six months. The announcement sets in motion a process to further disrupt the lives of 800,000 individuals who President Trump has been threatening since he launched his campaign in 2015. Created by an executive order signed by President Barack Obama in 2012, DACA provides two-year work authorizations and deferral of deportation to DREAMers – people who came to the U.S. before the age of 16, have resided in the country continuously since 2007, do not have a criminal record, and have either graduated from high school, are currently enrolled in an educational program, or have served in the U.S. military.

The cruelty and inhumanity of Trump’s DACA decision have serious health implications. Most acutely, the stress and anxiety caused by the uncertainty around DACA have created an immediate need for mental health services for recipients and their families. The rescission undermines the powerful emotional healing effect DACA has had on U.S. citizen children with DACAmented mothers, an impact recently highlighted in this Science article.

At a time when DACA recipients most need access to comprehensive health coverage, the termination of the program profoundly threatens their eligibility for any coverage at all. As a result of the work authorizations granted by their DACA status, many of the 42,000 DACAmented New Yorkers are covered by employer-sponsored insurance. Once their work authorizations expire, these individuals will lose access to both their jobs and their health insurance.

The impending end of DACA is particularly important in New York. Our state considers DACA recipients to be “permanently residing under color of law,” or PRUCOL, and thus eligible for state-funded Medicaid. As a result, between 5,000 and 10,000 DACAmented New Yorkers have Medicaid coverage. Many advocates believe there is a legal argument that DACA recipients should still be considered PRUCOL after they lose DACA status, but it remains unclear if the State agrees.

Even without a specific legal underpinning, the state can and should continue to cover this population. The Department of Health seemed to acknowledge this by releasing a statement on Tuesday that read in part, “New York State believes it has a legal and moral obligation to exhaust every available avenue to protect immigrants and their families by providing comprehensive access to health care, regardless of circumstance.”

The Coverage 4 All campaign has proposed a number of solutions for New York State. To start, New York can ensure the continued coverage of DACA recipients through state-financed Medicaid. There are also existing policy proposals that would protect a broader range of young adult immigrants, including those who lose their employer-sponsored insurance. Assembly Bill 8054 would expand the Child Health Plus program to age 29, extending New York’s universal children’s coverage program to young adults currently excluded because of their status, including many of the DREAMers who stand to lose their coverage when their DACA authorizations expire.

The DACA decision is only the latest attack on immigrant communities from the Trump administration. In this hostile environment, it is imperative that New York State take action to meaningfully protect and promote the health coverage of its immigrant residents.

*Anyone in New York City in need of mental health services should call NYC WELL, a hotline staffed by licensed counselors trained to help with anxiety, depression, and other issues. NYC WELL counselors have been specifically trained to work with call-ins related to DACA.