HCFANY steering committee members Mark Hannay of Metro New York Health Care for All Campaign and Heidi Sigfried of New Yorkers for Accessible Health Coverage “speak-out” to stop surprise medical bills by sharing consumer stories

Yesterday, HCFANY members joined advocates from Medicaid Matters New York and New Yorkers for Accessible Health Coverage to make a final push for the Basic Health Program, consumer protections from out-of-network surprise medical bills, and much needed consumer assistance program funding. New York’s budget process is set to wrap up in sometime in the coming week, with the goal of a final budget by April 1.

Advocates met with several legislators and staff, emphasizing the importance of creating the Basic Health Program and supporting health consumer assistance, in addition to other issues.

Basic Health Program

The Basic Health Program would have clear benefits for consumers, offering more affordable health insurance to New Yorkers who earn too much to qualify for Medicaid but not enough to afford in insurance through NY State of Health, even with subsidies. Initial reports from the Urban Institute and Community Service Society also projected State savings if the program were implemented, which makes sense given that the program would be largely funded with federal dollars.

Even so, the program was not included in the Senate’s budget proposal and negotiations continue. An updated Urban Institute analysis of the program’s projected fiscal impact is due to be released any day now, but the legislature could pass the bill without this report – the bill includes language that says the State doesn’t have to create the program if it turns out the cost would be too high. Advocates continue to educate legislators about the importance of this program for the health of our residents, as well as the State’s financial health. You can learn more about how to take action for a Basic Health Program on our website.

Consumer Assistance Funding

Also missing from the Senate’s budget proposal is a pass-through of funding for Community Health Advocates (CHA), the state’s consumer assistance program. The proposed funding for the program, which helps New Yorkers use their health insurance once they have it, is entirely from federal sources. Given the past successes of the program – CHA has saved over $12 million for New Yorkers over the past four years – and the fact that no state money would be involved, it is unclear why the program was removed from the budget.

Out-of-Network Protections

The day also involved several activities related to surprise medical bill protections that are currently in the Governor’s, Assembly’s and Senate’s budget proposals, but are yet to be fully resolved. You can read more about the current state of out-of-network negotiations here.

In the morning, partners held a press conference featuring various advocates from HCFANY, New Yorkers for Accessible Health Coverage, American Cancer Society Cancer Action Network, Consumers Union, AARP, and New York Public Interest Research Group. Superintendent Benjamin Lawsky shared his perspective on the importance of protecting consumers from surprise medical bills, an issue he and his staff have championed for several years (See Sup. Lawsky’s report, “An Unwelcome Surprise,” for more).

Consumer Claudia Knafo shared her personal story of surprise medical bills – nearly $100,000 worth – that she received in 2012 after spinal surgery from a doctor she had every reason to believe was in-network. Claudia did extensive research before booking the surgery, and she still got stuck with the bill – it turned out the surgeon, despite his website listings and numerous assurances from staff and her insurance plan, had not been a part of the plan since 1997.

Later in the afternoon, Claudia joined other advocates to hold a “consumer speak-out” to stop surprise medical bills in front of the Assembly Chamber, followed by the Senate Chamber. Participants read dozens of stories from consumers across the state who have faced surprise medical bills for out-of-network services they didn’t know they were receiving. From emergency surgeries to deliveries, these consumer stories represent just a small fraction of New Yorkers who desperately need stronger consumer protections in this area.

Learn how to take action to stop surprise medical bills here.