New York’s 2021-2022 budget includes some important provisions that will help patients access affordable health care. But the state could have done so much more given its 31 percent increase in tax revenue and budget surplus.

Successful coverage expansions that were advocated for by HCFANY include:

• Essential Plan: The budget increases the eligibility limit for the Essential Plan from 200% to 250% of the federal poverty level (about $34,000 a year for one person).  The popular Essential Plan currently covers over 900,000 people with no premiums or deductibles. The eligibility increase will mean an estimated 14,000 uninsured New Yorkers will get health insurance, and another 92,000 will have lower cost health care.
• Medicaid for people over 65 and those with disabilities:  People over 65 and who have disabilities have only been eligible for Medicaid if their incomes are below 84% of the federal poverty level (FPL), even everyone else can quality with incomes up to  138% of FPL (around $18,700 for an individual). They have also faced an asset test, which is not required for everyone else.  The budget increases their eligibility limit to 138% of the federal poverty level to match that of other New Yorkers. It leaves the asset test in place, but increases the value of allowable assets.
• Medicare Savings Program: The budget also increases the income limit for the Medicare Savings Program from 135% of the federal poverty level to 186% ($25,277 for one person). This means more people will get help paying for their Medicare Part B premiums (currently $170 a month) and paying for prescription drugs. 
• Post-pregnancy Medicaid: The budget extends post-pregnancy Medicaid coverage to one full year from 60 days for all New Yorkers, regardless of immigration status.

The budget includes other changes that improve the health care system for New Yorkers:

• The Child Health Plus program will no longer have premiums for households earning below 223% of the federal poverty level (about $62,000 a year for a household of 4). These premiums were associated with the annual loss of health coverage for nearly 70,000 children.  Benefits for Child Health Plus were also improved to cover mental health and orthodontia.
• The budget increases funding for the Community Health Advocates (to $5.2 million) and the Community Health Access to Addiction and Mental Healthcare Project programs (to $3 million). These programs provide post enrollment assistance, such as helping people appeal insurance denials, medical billing problems or locating in-network care.

Immigrant Coverage

The budget expands Medicaid coverage to all New Yorkers over 65 regardless of immigration status. While the budget did not include HCFANY’s #1 priority, Coverage 4 All, the expansion for older adults is a first step that moves New York closer to states that lead on immigrant coverage, such as California. The budget also includes everyone in the post-pregnancy Medicaid coverage regardless of immigration status, a change from the Governor’s original proposal which excluded some immigrants.

No one should be excluded from health coverage because of their immigration status. The #Coverage4All bill (A880A/S1572A) would have created a health insurance option for low-income immigrants who would be eligible for the Essential Plan just like other low-income New Yorkers but for their immigration status. HCFANY will continue to advocate for the enactment of the Coverage4All stand-alone bill and stands ready to work with the Hochul Administration to secure federal funds for immigrant coverage.

What’s Next

The state legislature is in session until June 2. New York has a lot to do before then! Priorities for health care include:

• A6058/S5474, the New York Health Act, would create a universal single-payer health care system in New York. It would eliminate barriers to eligibility based on immigration and income. It would also eliminate the medical billing chaos that causes so much grief for so many New Yorkers.
• A7363A/S6522A would ban medical providers from placing liens on patients’ homes or garnishing their wages to recoup a medical debt judgment. This bill has already passed the Assembly – now we just need to get it through the Senate! Other medical debt bills include A8441A/S6522A, which reforms the hospital financial assistance law so patients can avoid debt, and A3470C/S2521C that would ban facility fees for preventive care and provide for better disclosure. 
• A6883/S5954 would use $300 million from the state’s indigent care pool to increase Medicaid rates for Enhanced Safety Net Hospitals and qualified safety net hospitals.
• A2251A/S3131A would require public notice and a public hearing in advance of a planned hospital closure.