Statement on Anti-Asian Hate

HCFANY is thankful to have the opportunity to testify at the 2025 Joint Legislative Budget Hearing on Health. Our fully detailed written comments are here. The Executive Budget includes many proposals to help protect and enhance New Yorker’s access to affordable health coverage. However, the current federal landscape on health care access is uncertain, as proposed cuts to federal health programs could cost the State $10 billion to maintain health coverage for New Yorkers (Learn how these federal threats affect New Yorkers statewide and by Congressional District here).  

The Managed Care Organization (MCO) tax revenue provides an opportunity for the State to ensure New Yorkers have access to and can afford health care. HCFANY urges the Legislature to consider alternatives to the distribution of $1.4 billion of this tax revenue, which currently does not include direct support for patients.  

HCFANY recommends:  

  1. Expanding subsidies for Child Health Plus to eliminate premium cliffs and align coverage start dates to the first day of the month of application.  

This would help ensure that middle-income families can afford their children’s health insurance. Once families surpass the 400% Federal Poverty Level (FPL) income threshold, their children’s annual insurance premiums increase by around $3,000 per child. Additionally, the State should follow similar rules as Medicaid and the Essential Plan for CHP coverage start dates. 

  1. Addressing New York’s expensive health care system.  

New York is ranked second in the nation for the most health care spending per person, and HCFANY proposes three solutions to remedy this: 

  1. Implement an independent New York Office of Health Care Affordability, like the model created in California.  
  1. Include provisions of the Fair Pricing Act (S705|A2140) to ensure consumers and payers are charged a fair reimbursement rate for routine medical services, regardless of where the patient gets care.  
  1. Improve patient outcomes and reduce inequities by including the provision of the Primary Care Investment Act (S1634|A1915A).  
  1. Creating a principal reserve or a rainy-day fund to ensure New Yorker’s access to care is protected from the threats of federal cuts.  

This funding could help keep lawfully present immigrants enrolled in Medicaid covered if the federal government cuts access to health insurance for this population.  

  1. Increasing funding for consumer assistance programs like Navigators and the Community Health Advocates (CHA) program.  

These are only a few initiatives that HCFANY is urging the Legislature to consider, please see our full written testimony here. 

Health Care for All New York is delighted that the new budget deal includes key HCFANY legislative agenda items, including: the reform of our State’s broken Hospital Financial Assistance Law (HFAL); the elimination of cost-sharing for insulin; a program to provide enhanced subsidies to help offset the costs or premiums of cost-sharing in the Marketplace; and continuous coverage for children up to age six in our State’s public health insurance programs. But HCFANY is hugely disappointed to see that Coverage4All was not included in the final deal. And in a break with the Assembly’s historic support for Community Health Advocates, it maintained over a 50 percent cut to its allocation ($1 million in 2023 decreased to $469,000 in 2025). 

The Budget deal reforming our state’s broken HFAL will provide enormous relief to New Yorkers. Over the past 7 years, New York’s “charitable” hospitals have sued over 80,000 patients contributing to the grim statistic that 760,000 people have medical debt. The ubiquity of these lawsuits will now be significantly curtailed. The new law outright bans lawsuits against patients with incomes below 400% of the federal poverty level (FPL), which is about $60,000 for an individual. It also requires hospitals to provide free care to patients with incomes up to 200% of FPL ($30,000 for an individual), and heavily discounted care between 10-20% of the Medicaid rate – for patients up to 400% of FPL. Further, hospital payment plans cannot charge more than 5% of a patient’s gross family income in a year. And it eliminates burdensome “asset” test rules that became a cover for bureaucratic applications where patients have to prove the negative: that they are not secretly stashing their wealth in an effort to get help paying for healthcare. Finally, hospitals will be barred from including “immigration” eligibility tests for financial assistance.

Another positive aspect of the budget for healthcare consumers is the inclusion of a law that eliminates cost-sharing for insulin for enrollees in state-regulated health insurance plans. More than 1.5 million New Yorkers have diabetes, of which about 500,000 people rely on insulin. This provision will help many diabetics, but especially people of color, seniors, and people who live in low-income households, who disproportionately suffer from diabetes complications, including kidney failure, blindness, and loss of limbs.

Two key coverage provisions were also included in the final budget. First, New York will join the states of Oregon and Washington to guarantee continuous public insurance (Medicaid and Child Health Plus) coverage of children up to the age of six. This provision will help families avoid costly gaps in health coverage.  Second, the budget includes authorization to improve cost-sharing or premium assistance programs for people enrolling through the Marketplace. Few details are out, but HCFANY will post about these measures as they are finalized.  

While the Budget news is mostly good, HCFANY is hugely disappointed that the Assembly Leadership has broken with its storied tradition of standing up for healthcare consumers in two important areas. First, the Budget deal failed to include Coverage4All, a foregone conclusion by the Assembly’s omission in its one-house budget bill. Second, the Assembly continued to maintain over a 50% cut in its share of funding for the Community Health Advocates program which serves over 35,000 consumers a year, saving them $36 million in health care costs. 

Our work is not done!  For the remainder of the session, which ends on June 6, HCFANY will focus on trying to secure the passage of the stand-alone Coverage4All bill (S2237B|A3020), which would authorize the Governor to amend the 1332 Waiver to secure funding for covering up to 150,000 immigrant New Yorkers, as well as the “Stop SUNY Suing” Act (A8170|S7778), which would prevent the five state-operated hospitals from suing their patients with medical debt. 

One Pager: New York’s Reformed HFAL

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.

Across the United States, communities are struggling to overcome a global pandemic. And at the same time, Black, Indigenous, and peoples of color are once again disproportionately impacted due to systemic racism. In addition to overcoming the numerous inequities that have long been ignored, in the time of COVID-19, Asian Americans — particularly those who are East Asian-presenting — have seen an explosion of xenophobia and racial violence. Health Care For All New York (HCFANY) condemns this racial violence and urges our elected officials to enact policies that advance health equity. HCFANY is a statewide coalition of 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.

According to Stop AAPI Hate, a joint initiative that has been tracking Coronavirus-related incidents of harassment, hate speech, and/or violence against Asian Americans and Pacific Islanders, there were 3,795 reported incidents in the US from March 19, 2020 to February 28, 2021. Over 500 of these incidents (14%) took place in New York. NYPD data shows there were at least six attacks on Asian Americans in January and February 2021, compared to none during those months in 2020. Additionally, many bias-based incidents continue to go unreported.

Hate crimes themselves perpetuate health equity issues. Discrimination-related stress has been shown to result in health disparities, and victims of hate crimes suffer long-term effects like depression, anxiety and post-traumatic stress disorder (PTSD).

There is a long history of racism and xenophobia against Asian Americans in the U.S., particularly during times of economic hardship, alleged threats to national security, and/or disease. And there is a long history of anti-Asian racism being enacted into law, such as the Chinese Exclusion Act and the incarceration of Japanese Americans during World War II. Underlying these policies are racist and harmful stereotypes of Asians as a “model minority,” pitting communities of color against each other and rendering those who struggle invisible; or Asian Americans as perpetual foreigners and un-American in their own communities. The COVID-related hate incidents of today, fueled by racist statements and misplaced anger towards those perceived as Chinese, perpetuate this history.

Inequities faced by Asian Americans and other communities of color have also been demonstrated through the inadequacy of COVID-19 data reporting and subsequent public health response efforts. Data collection and reporting on race and ethnicity can be vastly different across state, county, and local health systems. For example, Asians are sometimes classified as “Other” and/or aggregated with other racial groups due to their smaller population size. And even when Asian American population data is collected and reported, failure to disaggregate the data by Asian ethnicity erases the variations in economic, social, and cultural diversity among Asian subgroups.

These differences have an effect on whether certain Asian populations, especially immigrants, are likely to have health insurance coverage, whether they may be at increased risk of certain chronic conditions or diseases, and what interventions may be more successful. It is impossible to address these issues without access to data that accurately defines the problem.

Immigrant communities also face barriers to COVID-19 testing, care, and vaccination because of the lack of language access and cultural relevance of accurate information on prevention, testing, and vaccines. Additionally, anti-immigrant attacks, from hate crimes to Trump-era attempts to curtail immigrant access to care, intensify fears and create barriers to care for members of multi-generational households, especially those with mixed immigration status.

To advance health equity, we must come together to fight for racial justice. We need to hold policy makers at all levels of government to be accountable to the needs of communities that are most impacted by systemic racism, and also be committed to creating systemic changes to ensure equitable access to healthcare. HCFANY applauds the State’s commitment to providing $13 Million to support Asian American community-based organizations and to support implementation of data disaggregation of diverse Asian ethnic groups. HCFANY urges state and local leaders to: (1) work in partnership with the Coalition for Asian American Children and Families (CACF) and partnering Asian American community organizations in implementing the robust collection, monitoring, and reporting of disaggregated health data; (2) expand affordable Essential Plan coverage to all New Yorkers, regardless of immigration status; (3) support safety net hospitals that treat diverse New Yorkers of all race, ethnic, national origin, and language backgrounds; and (4) ensure equity and access (especially language access) to COVID-19 information, testing, treatment, and vaccines through community-based measures like pop-up vaccine sites with appropriate in-person interpretation and translation in hard-to-reach AAPI and other underserved communities.