Advocates Are Sounding the Alarm on Graham-Cassidy Proposal

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.

megaphoneGuest post by Ann Danforth, Progressive States Advocacy and Policy Manager at Raising Women’s Voices-NY. A recent analysis by the Commonwealth Fund confirms what many women already know — the Affordable Care Act (ACA) has dramatically improved our rates of health coverage and our access to care. The Commonwealth Fund used data from its biennial health insurance surveys to compare women’s health coverage and health care experiences before and after the ACA, and the results make one thing clear: the ACA is working.

The uninsured rate for women in the U.S. is at an all-time low

Thanks to the ACA, the number of uninsured working-age women fell by almost half from 2010-2016, dropping from 20% (19 million) in 2010 to 11% (11 million) in 2016. Low-income women across all races and ethnicities made the greatest gains, while young women ages 19-36 made larger gains in coverage than women in other age groups. After the ACA went into effect, the percent of women reporting difficulty finding an affordable health plan that meets their needs fell by nearly half, the Commonwealth Fund found.

Women in states that expanded Medicaid under the ACA, like New York, have higher rates of insurance than women in states that chose not to expand Medicaid. As you can see in the graph below, the rates of uninsurance among women here in New York, a state that fully embraced Medicaid expansion, are five times lower than for women in Texas, a state that did not expand Medicaid. Commonwealth Fund Chart RWV blog August 2017Women in New York have expanded coverage options, since our state was the first in the country to establish a Basic Health plan called the Essential Plan, as permitted under the ACA. This extremely affordable coverage option for low-income New Yorkers, which HCFANY and RWV-NY successfully advocated for, went into effect in early 2016. As of January 2017, 665,324 New Yorkers have enrolled in New York’s Essential Plan, 54% of whom are women.

ACA consumer protections and subsidies improve access to care

The ACA put in place requirements that insurers cover 10 Essential Health Benefits, including maternity and newborn care, as well as preventive services. Under this requirement, insurers must cover a number of women’s preventive services with no cost-sharing, like contraceptive coverage, cervical cancer screenings and well-woman visits.  Although New York had contraceptive coverage requirements prior to the ACA, the ACA expanded them by prohibiting insurers from charging women co-pays for contraceptive coverage and counseling.

These consumer protections, along with the ACA’s health insurance subsidies, have made it easier for women to find affordable health plans that cover their needs.

New York builds on the ACA’s success by protecting and expanding key provisions of the ACA that impact women

 The Cuomo Administration, responding to requests from RWV-NY and other women’s advocacy groups, recently finalized regulations to keep in place the ACA’s contraceptive coverage protections, even if the ACA is repealed. These regulations require coverage without co-pays for one type of contraception in each of the 18 FDA-approved categories (the federal ACA standard) and allow for the dispensing of 12 months of contraception after an initial three-month allotment.

More recently, the Cuomo Administration proposed a rule that would require insurance carriers offering health plans in New York’s individual and small group market to continue to cover the ACA’s 10 Essential Health Benefits, regardless of what happens at the federal level. The proposed rule also includes a non-discrimination provision, which includes discrimination based on race, color, creed, national origin, sex (including sex stereotyping and gender identity), age, marital status, disability and preexisting conditions. RWV-NY has joined other members of the Health Care for All NY coalition in praising these proposed measures, while urging the addition of sexual orientation to the non-discrimination policy.

 There is still more work to do!

The Commonwealth Fund report adds to overwhelming evidence that the ACA is working for women here in New York and nationwide. But the survey results suggest there is still work to do to make health care more accessible and affordable for women. In the U.S., there are almost 11 million working-age women who are still uninsured and large proportions of women who find it difficult to afford comprehensive health plans. As the ACA faces new challenges, including a hostile Administration that aims to “let Obamacare fail,” it is critical that we inform the public about the ACA’s successes while continuing to advocate for affordable and quality health care for all.