NEW: NY’s Non-Profit Hospitals Withhold Patient Wages at an Alarming Rate

This summer, New York leaders passed two key pieces of legislation that would provide much-needed relief to patients burdened by medical debt:

  1. S.6522A/A.7363A: Prohibits a lien being placed on a person’s primary residence for medical debt judgments and prohibits wage garnishment for medical debt judgments.
  2. S.2521C/A.3470C: Requires hospitals to disclose additional “facility fees,” which cover overhead costs, before providing treatment; bans “facility fees” for preventive services.

The Governor has until the end of the year to sign these important bills into law – that’s just three months. 

55 organizations signed on to a letter sent to the Governor last week. Calling her office is key to making our message heard. That’s why we’re starting a push every Monday from October through December to call upon the Governor to take these important steps for patients and #EndMedicalDebt now.

Join us! Use the Phone2Action tool at cssny.org/EndMedicalDebt. Calling is simple: You will get a call from 516-701-2538, listen to a set of talking points, and then be connected to the Governor’s office.

Here’s what we recommend for your call:

Hi, I am [your Name] from [your town/city] and I want the Governor two sign two important bills to help End Medical Debt and relieve the burden that is crushing New Yorkers.
 
As soon as possible, we need Governor Hochul to sign into law:
– The bill to Ban Medical Liens and Wage Garnishments, S6522A/A7363 and
– The bill to Regulate Facility Fees, S2521C/A3470C.
 
Thank you.

Good luck and happy #MedicalDebtMonday!

Guest Post By Missy Genadri, Economic Mobility and Health Policy Associate | Children’s Defense Fund – New York

The COVID-19 pandemic has unequivocally laid bare the deep-rooted and irrefutable racial and ethnic health disparities that have long negatively impacted New Yorkers of color – and the devastating consequences such disparities can have.  But our State’s wide-ranging racial inequities are not limited to health outcomes or access to care; they encompass such broad areas as economic security and mobility, educational opportunity, involvement in the child welfare system and workforce disparities.  In fact, in a national comparison of state structural inequities, New York was recently classified as having among the highest structural racism and income inequality indexes in the United States.  Black New Yorkers are more than twice as likely as whites to die in their first year of life, almost twice as likely to not finish high school and almost five times as likely to be incarcerated.  Latinx New Yorkers have an unemployment rate more than double that of whites and have experienced pandemic-related food insecurity at rates three times higher than those of white New Yorkers.  Asian Americans have the highest poverty rates in New York City.  In Manhattan, Black and Latinx children are 10 to 13 times more likely to live in poverty than white children, and Asian children are 5 times more likely to live in poverty than white children.

Enacting new State legislation and rules without first evaluating their potential to disproportionately impact New York’s communities of color only perpetuates such disparities.  Just as our legislators consider the fiscal and environmental impacts of new laws, so too must they examine the potential racial and ethnic impact of all proposed legislation and rule-making activity through the preparation of racial impact statements.  In the absence of such assessment, even legislation that might “appear” race-neutral at face value will, in practice, adversely – and disparately – affect New York’s children and families of color.

By embedding racial impact analysis into our State’s legislative and rule-making processes through the preparation of racial and ethnic impact statements, New York would join a growing rank of states acting to center racial equity in policymaking.  Doing so would also enable our State to build on progress made in advancing racial equity in New York City through such efforts as EquityNYC and the NYC Racial Justice Commission.  Since 2008, 22 states (including New York) have proposed racial and ethnic impact statement legislation and eight states – Colorado, Connecticut, Iowa, Maine, Maryland, New Jersey, Oregon and Virginia – have passed laws requiring racial impact statements in certain circumstances.  However, these impact statements are either limited in the scope and quantity of the legislation they touch, are largely informational, are not publicly available or are only created temporarily as part of a pilot program.  (Read Leveraging Racial & Ethnic Impact Statements to Achieve Racial Equity in All Policies: National Context.)

As no state yet requires the production of racial impact statements for all legislation and rules, New York could lead the nation in aiming towards equity in all policies.  To do so, New York should require all bills and amendments to bills in the legislature as well as all proposed rules to be accompanied by a racial and ethnic impact statement and should consider establishing an independent office to produce these statements.  Furthermore, our State must prohibit the adoption of bills and rules that have the potential to increase racial or ethnic disparities.  Doing so would enable New York to only legislate policies that uplift – not harm – our most marginalized communities.

Undoing generations of institutionalized racism demands our active examination of the role which legislative and regulatory action plays in perpetuating inequality in our State.  The longer we go without incorporating racial and ethnic analysis into our legislative and rulemaking processes, the longer we will continue to pass laws that disparately harm New Yorkers of color – both in the immediate future and for generations to come.  It is well past time for our State to take urgent and decisive action towards the moral imperative of ending systemic racism – and towards creating a more equitable future for New York’s children and youth.

Read Leveraging Racial & Ethnic Impact Statements to Achieve Racial Equity in All Policies: National Context here.

To learn more about CDF-NY’s efforts to incorporate racial and ethnic impact analysis into lawmaking or to join our statewide workgroup, please contact Missy Genadri at mgenadri@childrensdefense.org.

We are proud to partner in this work with a growing group of organizations including Hispanic Federation, Health Care for All New York (HCFANY) Coalition, FPWA, Community Service Society of New York, United Way of New York City, Coalition for Asian American Children & Families, NAACP New York State Conference, New York Urban League, Robin Hood, Metro New York Health Care for All Campaign, Make the Road New York and Brookings Institution.

New Yorkers who buy health insurance in the individual market will see premiums go up by an average of 9.7% in 2023. Health plans originally requested an average increase of 18.7%, but this was reduced by almost half through New York’s prior approval process. The table below shows the plan’s requests and the rates that were approved. (You can find our comments on each rate request here.)

Prior approval is an important tool—the reduction will save consumers an estimated $167.1 million. However, for consumers, a 9.7% rate increase is still too high. New York should do more to protect consumers from premium increases outside of the rate review process. For example, Connecticut, Delaware, Massachusetts, Nevada, New Jersey, Oregon, Rhode Island, and Washington State have Health Care Cost Containment task forces or agencies. California created an Office of Health Care Affordability in its most recent state budget.

Are you worried about affording health insurance? Most New Yorkers who buy their own health insurance receive subsidies to help pay their premiums. You can explore your options at the NY State of Health enrollment site. You can also get free help switching plans or enrolling in affordable health insurance through the Navigator program by calling 888-614-5400 or emailing enroll@cssny.org.

2023 Individual Market Rate Changes
PlanRequested IncreaseApproved IncreaseChange
Emblem/HIP34.6%9.0%-11.9%
CDPHP28.4%16.5%-25.6%
NYQHC/Fidelis23.2%12.4%-10.8%
Highmark20.5%12.8%-7.7%
MVP19.2%10.1%-9.1%
Unitedhealthcare16.1%9.2%-6.9%
Oscar14.6%6.5%-8.1%
Excellus14.0%10.0%-4.0%
Healthfirst13.0%8.3%-4.7%
MetroPlus13.0%8.1%-4.9%
Independent Health10.2%6.1%-4.1%
HealthPlus (previously Empire)6.9%0.5%-6.4%
Overall18.7%9.7%-9.0%

New York’s non-profit hospitals can seize up to 10% of a patients’ wages to collect medical debt, an aggressive tactic that puts the health and well-being of low-income New Yorkers at risk. 

The Community Service Society of NY’s latest research reveals that five of New York’s nonprofit hospitals garnished the wages of 2,216 patients – between 6% and 46% of lawsuit cases – over unpaid medical bills. 

Disproportionately, these folks work low-wage jobs in health care and social services, manufacturing, and retail. This is consistent with national research that indicates medical debt disproportionately impacts people with low incomes and people of color, deepening long-standing inequities.

Meanwhile, the hospitals CSS investigated reported providing only $6 million in financial assistance despite receiving $19 million in state funding meant to cover the costs of patients who can’t afford their care. Non-profit hospitals are required to evaluate patients for financial assistance before garnishing wages, but past CSS research suggests this does not always take place.

Ten states already prohibit the placement of liens on debtors’ primary residences and four states prohibit wage garnishments. Now it’s our turn. A bill recently passed in the New York State legislature (S6522A/A7363A) would ban hospitals from garnishing patients’ wages or imposing liens on their primary residence. The bill awaits Governor Hochul’s signature, and we urge her to sign it immediately.