Testimony on Governor Hochul’s 2024-25 Budget Proposal
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.