Governor Cuomo proposal to eliminate premiums for 400,000 New Yorkers

If you tuned in to Governor Cuomo’s State of the State address today, you heard him say that he will eliminate premiums for 400,000 New Yorkers! HCFANY applauds this proposal which will eliminate the $20 monthly premium for some Essential Plan enrollees with incomes up to $25,500 per year. Currently, people with household incomes at 150-200% FPL ($25,520 for a single person or $52,400 for a household of four) pay a $20 monthly premium for Essential Plan coverage.

While a $20 premium may seem relatively affordable, it results in nearly 100,000 New Yorkers per year losing coverage for failing to pay. This proposal, which is mostly federally funded, can be implemented without a huge price tag for New York’s tax payers. 

The legislature should move quickly to adopt Governor Cuomo’s proposal to ensure nearly all low-income New Yorkers can access premium-free coverage. Now let’s just try to do the same for immigrant New Yorkers who remain ineligible. 

Health Care for All New York (HCFANY) is a statewide coalition of over 170 consumer-focused organizations dedicated to achieving quality, affordable health coverage for all New Yorkers, and ensuring that the concerns of real New Yorkers are heard and reflected in policy conversations.

HCFANY commends Governor Cuomo for including three important health care initiatives in the 2020 State of the State. The first measure would help address the ever-escalating costs of prescription drugs by: capping monthly co-payments at $100 per month for insured patients who have diabetes; increasing public accountability and government enforcement of out-of-control prescription drug price hikes; and the establishment of a commission to explore the importation of lower cost drugs from Canada. The second measure is to establish a consumer-friendly health care transparency website where patients can compare health care costs and quality. The third measure would cut the statute of limitations for providers to sue their patients from six to three years and improve the state’s Surprise Bill law. HCFANY applauds the Governor’s steps to call attention to these issues and looks forward to reviewing these proposals.

HCFANY is disappointed, however, that the Administration did not take this important moment to address health care costs and affordability more squarely and urges it to do so in the upcoming Budget. Specifically, HCFANY urges Governor Cuomo to follow California’s lead and address the need to provide health coverage for our immigrant residents, who face increasing attacks at the federal level (S.3900/A.5974).  In addition, HFCANY urges the Governor to make health care more affordable through the New York State of Health Marketplace by establishing a state premium assistance program.  Finally, HCFANY asks the Governor to protect patients from medical debt by adopting proposals in the Patient Medical Debt Protection Act (S.6757/A.8639) including: simplifying medical billing, curbing hospital collection abuses, closing the misinformation loophole in our Surprise Bill law, and simplifying the State Hospital Financial Assistance Law. 

These measures are needed now more than ever because of immigration and affordability barriers to healthcare as well as spiking insurance premiums, deductibles and co-pays.  More than a third of New Yorkers are dealing with serious financial repercussions because of medical bills, including racking up credit card debt, using up their savings, or being put into collections. A third of consumers report paying medical bills they did not owe because they did not know how to fight them.  New Yorkers deserve coverage expansions and medical debt protections and this is the Legislative Session to achieve them.

The new 2018 census data numbers are out this this morning. 

The bad news is that uninsurance numbers increased across the country by 1.9 million in 2018, despite the positive economy. This was the first increase in uninsured since the Affordable Care Act was fully implemented in 2014. Here’s a New York Times article with more details.

BUT, there’s great news in New York, which was one of just three states in the country to have a decline in our uninsurance numbers, from 1,113,000 in 2017 to 1,041,000 in 2018 (our uninsurance rate declined from 5.7% to 5.4%). 

New York’s continued decline in uninsured residents is inextricably linked to its adoption of the high quality, affordable, Essential Plan, which saw an increase in enrollment from 665,000 in 2017 to 739,000 in 2018.  Other important factors include:

  • One-stop shopping: you can apply for the full spectrum of coverage, including Medicaid, Emergency Medicaid, Child Health Plus, the Essential Plan, Qualified Health Plans and tax credits, all through the same NY State of Health application
  • Robust Navigator funding of $27 million a year

Congratulations New Yorkers! And let’s keep up the good work!

Guest blog by Emily Balkan, Policy and Client Services Associate at the Medicare Rights Center. Do you or a loved one have Medicare and Medicaid and long-term care needs? If so, you may have recently experienced a change to the way you receive your coverage. If the way you receive Medicare and Medicaid, including long-term care or personal care services, has recently changed, the Medicare Rights Center’s Coalition to Protect the Rights of New York’s Dually Eligible (CPRNYDE) needs to hear your story.

You may have heard about or are currently enrolled in New York’s Managed Long Term Care (MLTC) plans. New Yorkers with Medicare and Medicaid who have long-term care needs may qualify for an MLTC plan if they are over age 18, have both Medicare and Medicaid, and receive 4 months or more (120+ days) of long-term care services, including personal care at home, or nursing care in a nursing facility. Individuals who qualify for MLTC and live in New York City (the Bronx, Brooklyn, Queens, Manhattan or Staten Island), Long Island, or Westchester County may also qualify for a Fully Integrated Duals Advantage (FIDA) plan. The FIDA program gives you the option of enrolling in a plan that provides both your Medicare and your Medicaid benefits, including your Medicare Part D prescriptions and your Medicaid long-term care services.

If you would like to share your experience, good or bad, with this new coverage, we want to hear from you! CPRNYDE is a diverse group of professional advocates working to shape New York’s Managed Long-Term Care (MLTC) and Fully Integrated Duals Advantage (FIDA) programs to provide quality care for the state’s unique population of individuals enrolled in both Medicare and Medicaid. As a part of our advocacy work, we formed a group of consumers and caregivers who, together with CPRNYDE professionals, are working together to ensure that your voice is heard by policymakers. Additionally, CPRNYDE releases monthly blog posts, such as this one, and we are exploring other ways to engage with consumers through social media.

We are currently recruiting consumers and caregivers throughout New York State to join our group. Each member has the opportunity to speak directly to a CPRNYDE professional to discuss their experiences with their health care coverage. In addition to these one-on-one calls, members are encouraged to participate in monthly group calls with other consumers and caregivers. During these calls, consumers and caregivers discuss their satisfactions and dissatisfactions with their coverage, and together the group makes plans to improve health care coverage in New York State.

For example, one new project the group is working on is providing comments and feedback to the State Department of Health about whether letters from the State Medicaid Office are easy to understand. As a group, we are suggesting changes to the State to help them make the notices easier to understand for all New Yorkers.

Does this project seem interesting to you? Do you want to improve health care for yourself, your loved ones, and other New Yorkers with Medicare and Medicaid? Then we want to learn from your first-hand experience and work with you to advocate for your rights as well as the rights of all New Yorkers with Medicare and Medicaid with long-term care needs. For more information, you can view our fact sheet. If you have questions about our work, want to share your story, or want to know more about our consumer group, email your questions to us here:

If you are a professional working with individuals with Medicare, Medicaid, and long-term care needs in New York, we want to hear from you as well. CPRNYDE offers in-person forums, during which we engage in a dialog with the audience about their care. For more information, you can see our fact sheet, or email us: