Guest Post: Andrew Leonard, Senior Health Policy Associate, Children’s Defense Fund-NY
Even with the expansion of affordable coverage to over two million New Yorkers, work remains to eliminate persistent health disparities across economic, racial and ethnic lines.
As advocates and consumers, we work to foster a New York where children are not just insured, but healthy and happy. We believe that coverage must lead to care, and care must lead to health and wellness for all New York children.
One of the most promising models for connecting children and families to care involves the delivery of health care services in schools. While schools are primarily educational institutions, they are uniquely positioned to be effective health care access points. Schools are a gathering place for practically all children and offer a comfortable space in which students can receive primary, dental and behavioral health care services that may be hard to find in their own communities.
In recent years, schools have swiftly developed the capacity to provide preventive and primary care services along with robust chronic disease management, all while keeping a child from missing precious academic seat time. School health services can include health clinics adjacent to classrooms, nurses performing complex medication management, and much more.
Schools are particularly adept health care access points for immigrant children. For families who are new to the United States and lack connectivity to existing health care providers, schools can facilitate enrollment in an affordable health plan and provide immigrant children with their first contact to essential health services in the US. School-based mental health care fosters a space in which immigrant children can receive needed services as they go through the process of adjusting to a new culture and, often times, a new family dynamic. Schools have played a tremendously important health care role for the nearly 6,000 unaccompanied immigrant children that arrived in New York State in 2014 after escaping violence and economic inopportunity in Central America.
School-based health clinics are also effective vehicles for eliminating racial and ethnic disparities in the communities that they serve. In New York State, approximately 25% of these clinics serve communities where more than one-third of the population lives below 100% of the Federal Poverty Level. Seventy-nine percent of students in schools with centers are non-white with more than 30% identified as Black or African-American.
With such an ability to provide services, schools must be considered an integral player in the larger children’s health infrastructure. That is why we at The Children’s Defense Fund – New York are excited about our new report on school health in New York City: Health + Education = Opportunity: An Equation that Works. The report, made possible with financial support from the Altman Foundation, describes the city’s current school health system and explores ways to better expand this care.
CDF-NY is hosting an event on Friday, May 15th called, The Winning Equation: A Panel Discussion on the Role of Healthcare Services in NYC Schools, to further dive into this topic. Please, join us if you can! Click here for more info.
Guest Post: Bob Cohen, Policy Director at Public Policy and Education Fund and Citizen Action – New York, and Peter Scatena, Intern at Public Policy and Education Fund
The Affordable Care Act has resulted in the enrollment of an impressive 20 million people nationwide, but we still have a long way to end health disparities, according to a new report by the Alliance for a Just Society (AJS), a national advocacy organization.
The report, Breaking Barriers: Improving Health Insurance Enrollment and Access to Health Care, based on a year-long survey of over a thousand low-income Americans in ten states (New York is not included), found numerous obstacles to enrollment of racial minorities and rural residents. The largest of these obstacles is the failure of four of the ten states in the study to expand Medicaid, an important ACA provision. In the four states that expanded Medicaid there was a 4.1% decline in the number of uninsured residents, as compared with 2.9% for the six non-expansion states. The report found other obstacles to enrollment for low-income communities and communities of color, including cost, technology, language barriers, and difficulty understanding their new coverage.
While New York is doing well in enrollment compared to some states, this report has some lessons for our state. Medicaid enrollment is a plus in New York: within the first two years of the NY State of Health’s implementation, more than 1.5 million New Yorkers have enrolled in Medicaid, in part due to the state’s decision to expand Medicaid. While it’s hard to make definitive conclusions about enrollment disparities based on race, as roughly one-quarter of applicants to NY State of Health opted not to state their race and demographic data is only available for the first year of enrollment, here too, the available data is positive: 15% of New Yorkers are African-American and 15% of those newly enrolled stated indicated they were African-American. However, areas of concern remain in New York. Those reporting that their preferred written language was Korean, Russian, French, French Creole, or Italian were almost completely absent from those enrolled in the first year, despite the fact that substantial numbers of New Yorkers speak these languages.
As in the states covered by the Breaking Barriers report, New York also places barriers on enrollment for those whose language is not English. To this day, the NY State of Health web page only is translated into Spanish. And certainly, New Yorkers who are low-income, immigrants, and live in rural areas also face barriers like lack of equal access to the Internet and gaps in their understanding of health coverage, as do their counterparts in other states. Some of the solutions to addressing health disparities in New York were outlined in a report issued last year by the Public Policy and Education Fund, AJS and Make the Road New York.
Breaking news on this Friday afternoon: the NY State of Health just posted its 2016 Plan Invitation! This is the document that includes requirements for insurers to be certified and re-certified to participate on the Marketplace for the 2016 plan year. This year, in addition to requirements for Qualified Health Plans and Stand-alone Dental Plans, the Invitation includes requirements for the State’s new Basic Health Program.
HCFANY is delighted that our recommendations were considered in the development of this year’s plan invitation.
Check it out here!
Need health coverage? Many New Yorkers still have options to enroll in health coverage on the NY State of Health Marketplace!
Open enrollment for 2015 coverage officially ended on February 15, 2015. But those eligible for Medicaid and Child Health Plus (CHPlus) can enroll all year long. And, others who experience a “Qualifying Life Event” (marriage, divorce, aging off of a parent’s plan, etc.) can receive a Special Enrollment Period (SEP) of 60 days to enroll in a Qualified Health Plan through the Marketplace. There is also a one-time tax-related SEP through April 30 of this year for those who face a health care related tax penalty.
The NY State of Health recently updated its Special Enrollment Period webpage (also available in Spanish, Chinese, Korean, Russian, Italian, Haitian Creole and French), with new and updated resources on SEPs, including:
- New consumer video describing qualifying life events and special enrollment periods (view the English version above. We’re told a Spanish video is coming soon!);
- Full list of qualifying life events;
- Updated consumer SEP fact sheet that can be downloaded and printed (Quantities for in-person assistors can be ordered here: http://info.nystateofhealth.ny.gov/resource/materials-and-publications-order-form);
- Links to FAQ documents on SEP; and
- Dates of the 2016 open enrollment period (enrollment will start November 1 this year).
Join us, and spread the word about qualifying life events, Medicaid and CHPlus!