Key Takeaways from New NYS Report on Maternal Mortality

The New York State Department of Health (DOH) Maternal Mortality Review Board has released a new report, providing a detailed review of maternal deaths across the state between 2018 and 2020. Here are the findings:

Overall, the prevalence of maternal mortality in New York State remains below the national average; however, racial disparities in maternal outcomes unfortunately tell a different story. Nationally, Black mothers die at more than double the rate of White mothers. In New York, Black mothers die at five times the rate of White mothers. Black mothers in New York have a higher prevalence of maternal mortality than the national average.

The state recorded 121 pregnancy-related deaths between 2018 and 2020. The review found that almost 74% of these maternal deaths were preventable. In addition, discrimination was a likely contributing factor in almost half of maternal deaths.

It is imperative that the state continues to take action to eliminate preventable maternal deaths and improve outcomes for women of color, particularly Black women. HCFANY will continue to advocate for interventions to reduce racial disparities and overall mortality of birthing New Yorkers.

The One-House Budgets are released! The Senate One-House Budget includes a significant portion of the HCFANY policy agenda, building on the Governor’s proposals in the Executive Budget. We’re still studying what is included in each bill, here’s what we know so far:

Good news: the Senate and Assembly One-House Budgets both:

  • Ban cost-sharing for insulin for enrollees in State-regulated health insurance plans
  • Improve affordability of Marketplace plans via premium assistance/ cost-sharing subsidies
  • Adopt Kids Coverage to ensure children up to age 6 remain continuously covered in Medicaid or Child Health Plus
  • Include Coverage4All, using federal funding to cover income-eligible immigrants in the Essential Plan

Even better, the Senate One-House Budget improves on the Governor’s budget by incorporating all of the HFAL improvements in the Ounce of Protection Act, including:

  • Expanding Hospital Financial Assistance eligibility to individuals making up to 600 percent FPL
  • Banning Hospitals from suing patients making under 600 percent FPL for medical debt
  • Incorporating time-limited debt repayment plans so patients who make an agreed upon number of payments don’t have to spend their lives in debt

Bad news: the Assembly Budget completely cuts the Governor’s proposed medical debt reforms.

Take Action: Use the Phone2Action tool to call your legislators.

  • Thank your Senators and ask them to fight to keep the Senate One-House Budget consumer health and medical debt reforms in the final budget.
  • Ask your Assembly members to tell Assembly leadership to fight medical debt and fix our broken Hospital Financial Assistance Law.

HCFANY is grateful to have had the opportunity to testify at the 2024 Joint Legislative Budget Hearing on Health. Our detailed written comments are linked here. The Executive Budget includes many positive proposals that will help protect consumers from medical debt and enhance their ability to access affordable health coverage, including:

  • Modernizing the State’s Hospital Financial Assistance Law
  • Eliminating all cost-sharing for insulin for New York State-regulated plans
  • Guaranteeing continuous health coverage for children up to 6 years of age
  • Improving subsidies and benefits for public health coverage
  • Informed consent for payment reform
  • Banning hospitals from suing patients with incomes below 400% of the federal poverty level

In addition to addressing these important reforms in the FY25 Budget, HCFANY also urges the Legislature to provide additional funding to ensure more New Yorkers can enroll in, and use their coverage, including:

  • Expanding Hospital Financial Assistance to 600% of the federal poverty level and incorporating time-limited debt repayment plans as would occur if the Ounce of Prevention Act (S1366B/A6027A) were enacted
  • Prohibiting state-operated hospitals from suing patients for medical debt by adopting the provisions of the Stop Suny Suing Bill (A8170/S7778)
  • Ensuring coverage for low-income immigrants with Section 1332 Waiver surplus pass-through funding
  • Funding Community Health Advocates at $5.5 million
  • Enhancing outreach funding for Navigators

Today, Governor Hochul delivered her 2024 ‘State of the State’ address. HCFANY commends the governor for proposing sweeping protections for consumers and patients across the state. HCFANY advocacy goals are prominently featured among the governor’s proposals, including:

Medical Debt

HCFANY commends the governor for her continued commitment to protecting the over 700,000 New Yorkers that face medical debt. Governor Hochul’s proposed legislation would bring them relief by expanding eligibility for hospital financial assistance while limiting monthly payments and the interest providers can charge on medical debt. These policies are among the protections included in the Ounce of Prevention bill (S1366A/A6027A) that HCFANY has advocated for the past couple of years. In addition, the governor announced protections for low-income New Yorkers that will prevent them from being sued for medical debt. HCFANY hopes to work with the governor on another important piece of legislation (A8170/S7778) that would prohibit the state-operated hospitals from suing patients for medical debt.

Diabetes Care

We’re pleased to see Governor Hochul recognize the need to address health care costs for New Yorkers who have diabetes, which disproportionately affects people of color and rural New Yorkers. Current state law caps co-pays for insulin at $100 per member per month. The governor’s nation-leading plan would eliminate insurance co-pays for insulin for commercial plans regulated by the state. Research indicates that the elimination of cost-sharing will increase medication adherence, leading to vastly improved health outcomes and overall health care system savings. This plan will be the most expansive insulin cost-sharing prohibition in the nation — providing relief to nearly over 500,000 New Yorkers who use insulin out of 1.6 million New Yorkers who have diabetes. According to the Hochul Administration, this proposal will save New Yorkers $14 million in 2025 alone.

Better yet, the governor has proposed to eliminate cost-sharing requirements for chronic conditions and pregnancy-related visits in both the Essential Plan and Qualified Health Plans and (covering around 1.4 million New Yorkers). With the goal of promoting better management of chronic conditions, including Type 2 Diabetes, elimination of cost sharing will allow New Yorkers to access office visits, laboratory work and testing, pharmaceuticals, and other supplies and services related to their chronic condition.

Children’s Access to Care

The governor announced that New York is submitting a waiver request to the federal government to provide continuous Medicaid and Children’s Health Insurance Program coverage for any eligible child up to six years old to ensure that no child in need misses out on critical health care services due to a lapse in health insurance coverage. Paperwork snafus would no longer result in coverage gaps. HCFANY is a proud advocate of this policy and thrilled to see the governor include improving coverage for children in her address.

Reproductive Health Care

HCFANY is enthusiastic about Governor Hochul’s proposal to expand New York State’s Paid Family Leave program to cover 40 hours of additional paid leave for pre-natal medical appointments, establishing the nation’s first statewide paid pre-natal leave benefit.

The governor will also propose legislation to enable the Commissioner of Health to issue a standing order allowing New Yorkers to access doula services without the current requirement of a recommendation from a physician.

In addition, Governor Hochul announced that she will amend the Reproductive Health Act to affirm minors’ right to receive contraceptive services and confidentially receive reproductive health care services.

Make Health Care More Affordable and Improve Access

HCFANY is thrilled that the governor announced that New York will develop state-based subsidies to ensure that Marketplace plans are more affordable—a measure that HCFANY has proposed for years.

The governor also seeks to improve access to mental health and substance use disorder care for state-regulated health plans. First, the Department of Health and the Department of Financial Services will establish a workgroup to revisit and update provider network adequacy standards. Pursuant to legislation passed last year, New York will promulgate regulations for both commercial and Medicaid insurers to strengthen network adequacy requirements for mental health and substance use disorder services. Second, Governor Hochul emphasized her commitment to improving access to mental health care offered by health insurance plans. The governor plans to improve enforcement mechanisms for mental health parity requirements, as insurance companies are legally required to provide insured individuals with access to behavioral health services that are comparable to other medical services, but too often fail to do so. To improve enforcement of parity laws, the governor proposes to fund additional staff to bring enforcement actions and introduce legislation to double fines for insurers who break the law. Further, the governor plans to increase commercial reimbursement rates for mental health services.

Unfortunately, the Governor did not include the expansion of coverage to low-income immigrants who are currently ineligible for health coverage in her State of the State address. HCFANY will continue to advocate for New York State doing so with no cost to the state using the $7.8 billion surplus that will be generated through the 1332 Waiver, pending before the federal government.