A new survey found that most New Yorkers still struggle to afford healthcare and are worried about affording care in the future. This probably isn’t news to many of us – but the findings make the state budget’s lack of action on health care even more glaring.

New York has traditionally been a healthcare leader, and we have one of the lowest uninsured rates in the country. But insurance isn’t enough. Many of the survey questions were asked of insured New Yorkers. They are having trouble managing the costs of their premiums, co-pays and deductibles.

The survey shows the toll this takes – almost half of New Yorkers (45 percent) have avoided care or taken drastic actions like cutting pills in half or not filling prescriptions. Over a third of New Yorkers (35 percent) reported serious financial repercussions including using up all or most of their savings, being put in collections, or being unable to pay for food, heat, or housing on top of medical bills.

New Yorkers blame health plans, the pharmaceutical industry, and providers like hospitals almost equally. They are ready for the government to step up and do something. But the only proposal in the governor’s budget that could address costs is one that would license pharmacy benefit managers. That’s a great start in reining in prescription drug costs, but it’s a step many other states have already taken. The state could do a lot more to help New Yorkers manage this problem, including a state premium assistance program, a drug utilization board that could set prescription drug rates, or creating a public option for the lowest-income people in the individual market (see our budget testimony here for more information).

Guest post by Heidi Siegfried, MSW, J.D.,  Project Director of New Yorkers for Accessible Health Coverage.

Survey results were released last week showing that a majority of New Yorkers living with chronic or rare medical conditions have had the experience their insurance company changing their drug coverage in the middle of the year. They do this by eliminating a drug from the formulary or changing the co-pay – a practice that raises costs on consumers and can disrupt their medical treatment.

On behalf of 36 patient and provider groups, Global Healthy Living conducted a survey that found that nearly two–thirds (65%) of New York residents with chronic illnesses had to switch to a different medication than the one that was prescribed due to a change in coverage.

• 54% had to try multiple medications before finding another medication that worked for them
• 72% reported that their new medication worked somewhat or much worse than the originally prescribed medication
• 51% experienced side effects after switching
• 35% reported seeing their health care provider or going to the emergency room due to the complications following a switch
• 10% reported being hospitalized after a switch

Disrupting the continuity of care and delaying effective treatment can result in detrimental life threatening consequences and can actually lead to more medical complications, expensive hospitalizations, emergency room use, and higher health care costs.  It can also discourage consumers from continuing with needed treatment due to side effects or because drug failure erodes their trust in medication. Few health plans have robust exceptions or appeals processes to protect consumers who may depend upon particular drugs for their care when formularies are changed.  However, it this happens to you and you need help to use your plan’s appeal process, you can contact Consumer Health Advocates for assistance.
Patient and Consumer Advocates like Center for Independence of the Disabled, doctors, and legislators are calling for passage of legislation, S5022-C (Serino)/A2317-C (Peoples-Stokes) to prohibit insurance companies and pharmacy benefit managers (PBMs) from switching drug coverage in the middle of the year when patients cannot change their health insurance until the next open enrollment period.  The Assembly passed the legislation earlier this year and has approved it the last four years.

Last night, Senate Republicans failed in their last ditch effort to repeal the ACA and dismantle Medicaid. A huge thank you to our members, partners, and friends for all of your hard work and activism over the last nine months.

Your resistance is the reason they keep failing.

Unfortunately, the fight is not over. The President is still threatening to end Cost Sharing Reduction payments that reduce out of pocket costs for moderate income Americans and there is a House budget proposal that would cut trillions of dollars from Medicaid and other health care and entitlement programs over the next 10 years.

Seven of NY’s Representatives voted to pass an anti-health care bill in the House: Chris Collins, John Faso, Peter King, Tom Reed, Claudia Tenney, and Lee Zeldin. They may soon have another chance to decide our fate through the budget process – this Saturday, show them in person that those first votes were a mistake!

Here’s what you ca do to stay engaged:

1. Join people across the country at demonstrations. We already know about events in places like Beacon, Kingston, Delhi, New Hartford, New York City, and Glens Falls. We’ll add events to our eventspage as soon as we learn about them so keep checking!
2. You could also plan your own event! The Our Lives on the Linesite has some tools to help you do this, but all you really need to do is show up at your Representatives’ offices with signs or letters telling them not to support any bill that takes health care away from people.

We’ve come so far – and we won’t stop fighting now!

The coverage gains and consumer protections achieved under the ACA and the Medicaid program that covers the most vulnerable New Yorkers are all at risk. The Senate could be voting on their Better Health Care Reconciliation Act that would take coverage away from more than 22 million people and end the Medicaid program as we know it as early as next week.

Join HCFANY MONDAY, July 17 at 1:15 PM for the “Take a Stand for Health Care” rally with Governor Andrew Cuomo at Mount Sinai’s Icahn School of Medicine in New York City to defend the ACA and Medicaid. Please register here.

Stern Auditorium

Icahn School of Medicine

Mt. Sinai Hospital

1468 Madison Avenue

New York, NY 10029