Statement on the Adopted 2021-22 Health and Medicaid Budget

Medicaid Matters New York and Health Care for All New York – the two major statewide health care consumer advocacy coalitions – applaud the State Legislature for several historic additions to the adopted state budget for 2021-22 related to funding for public schools and universities, rental and mortgage assistance, assistance to undocumented essential workers and small businesses, and taking some first steps toward restoring progressivity to the state’s tax system.  Millions of low-income New Yorkers who rely on our state’s public health insurance programs will benefit from these improvements to the Governor’s initial set of budget proposals.

However, our State leaders failed to break ground in health care, which is disappointing in light of a decade of austerity budgets and the ongoing nature of the COVID-19 public health crisis.  Medicaid Matters and HCFANY are specifically concerned about the following issues: 

  • The arbitrary Medicaid global spending cap was extended for another year.  As a consequence, Medicaid continues to be approached with an austerity mindset.  For ten years, Medicaid has suffered from unnecessary cuts, impacting access to services for low-income people, families, people with disabilities and communities.
  • Public health insurance coverage was not expanded to low-income immigrants who have had COVID-19.  Instead, those who are undocumented remain reliant solely on Emergency Medicaid for acute care and charity care programs for ongoing treatment.  As a consequence, many will likely forego seeking necessary care, thereby prolonging illness and suffering, risking death, and incurring medical bills they cannot pay.
  • The home care crisis and institutional bias remain unaddressed.  Home care workers play a vital role in serving and protecting disabled New Yorkers and seniors living independently, a role that became even more critical and evident during the pandemic.  However, New York’s failure to invest in home care has created a “worst in the nation” workforce crisis that prevents meaningful access to home care services for thousands of people and results in greater institutionalization.
  • This is the first time in decades that New York State has adopted a discriminatory maternity coverage policy.  Instead, only citizen and lawfully residing immigrant women will enroll in free (state-funded) Marketplace coverage after their Medicaid ends—continuing a system that allows for disruptions in care. 
  • No new initiatives were created to address inequities that are wide-spread throughout our state’s public health, health care, and health coverage systems, despite significant federal pandemic-related funds the state has received over the past year to address these disparities.  The pandemic has revealed them clearly, and they can no longer be ignored.

On the positive side, we thank both the Governor and Legislature for these new initiatives:

  • Eliminating all premiums in the state’s Essential Plan that provides insurance coverage to low-income people and families who are not eligible for Medicaid.  This move will enable them to keep medical, dental, and vision coverage in place without financial barriers, an important step during the ongoing pandemic.
  • Protecting the financial stability of community health centers and other safety net providers by delaying the implementation of the planned pharmacy carve-out from the state’s Medicaid Managed Care program.

We also acknowledge and appreciate restorations in funding cuts initially proposed by Governor Cuomo that made no sense given our ongoing pandemic:

  • An across-the-board Medicaid rate cut that particularly threatened safety net hospitals that serve large numbers of Medicaid and uninsured patients.
  • Elimination of Indigent Care Pool funding to public hospitals.
  • Cuts to the state’s Vital Access Provider Assistance Program that keeps certain safety net and rural hospitals financially afloat.
  • Additional cuts to Article VI public health funding to New York City.
  • Allowing insurers to impose restrictions on the ability of doctors to prescribe certain drugs to Medicaid patients (elimination of the provision known as “prescriber prevails”).
  • Another 25% cut to home care workforce recruitment and retention money that would have further harmed community-based long-term care.
  • Cuts to programs serving adult home residents.

While as a whole and on the surface it may appear that New York continues to meet the needs of those enrolled in our state’s public health insurance programs and the providers they rely on, the 2021-22 adopted budget fails to make needed investments to turn away from austerity politics, protect all immigrants, expand community-based long-term care, and promote health equity.  A lack of harm must not be confused with a budget that provides for what New Yorkers need.  We can do better, and we must.

There are lots of opportunities coming up over the next couple of weeks to learn more about health policy priorities and how to take action. Here’s a few of them!

TODAY: Statewide Day of Action for Guaranteed Healthcare (link)

The Campaign for New York Health is holding a day of action for the New York Health Act, which would provide comprehensive health coverage for everyone who lives or works full-time in New York. Look for #PassNYHealth to see what people are saying and join in!

  • Learn more about why we need the New York Health Act here.
  • If you missed the day of action you can always show your support for the New York Health Act by clicking this link and telling your State Assemblymember and Senator to support the bill. If they already do, the link will give you an opportunity to thank them!

Tomorrow: #Coverage4All Virtual Day of Action

There are 400,000 New Yorkers without insurance because of their immigration status. A1585/S2549 would guarantee that all New Yorkers can access life-saving health coverage if they have had COVID-19. Look for #Coverage4All and #PassA1585 all day tomorrow to help get the word out!

What else can you do?

  • Sign up for campaign updates here.
  • Become listed as a supporting organization here.
  • Contact your legislator any time using the instructions here.

Friday, 11:00-12:00: Budget Briefing for Health Justice Advocates

Join the Campaign for NY Health, the Consumer Directed Personal Assistance Association of New York State, Coverage4All, Health Care for All NY, and Medicaid Matters NY for an overview of the FY22 Executive Budget Proposal and its implications for healthcare in New York. Register here.

Friday, February 5 1:00-3:00: HCFANY Annual Meeting

What can we expect from legislative session this year? How do we push forward and ensure quality, affordable health care for everyone in New York State during a pandemic and a budget crisis? Join us to learn more about our legislative and budget priorities for 2021 and how you can take action yourself! Click here to register!

During this virtual meeting we will:

  • Award Senator Gustavo Rivera as this year’s Consumer Champion and present a posthumous Lifetime Achievement award to Kristin Sinclair, Director of the Senate Health Committee.
  • Share information about the state budget and our legislative priorities, including expanding health coverage to all New Yorkers, ending medical debt, and addressing systemic inequity in our health care system.
  • Talk about future workshops that will offer deep dives on different health policy issues and opportunities to take action.

While Governor Cuomo has been a strong leader in battling COVID-19, his administration still wants to move forward with $2.5 billion in cuts to the Medicaid program. These cuts will harm 6.3 million New Yorkers who need Medicaid for their health care, including children, individuals with disabilities, and seniors.

We are also particularly concerned with his administration’s efforts to change federal disaster relief legislation to obtain the authority to enact these cuts. The damage, should the administration succeed, would extend far beyond New York. 

So we need your help – take action to #ProtectMedicaid today! Here’s how:

1. E-mail your State Senator and Assemblymember’s Albany Office. Your Senator’s e-mail address can be found here, and your Assemblymember’s e-mail address can be found here. (Not sure who represents you? Look up your Senator here and your Assemblymember here!). In your e-mail, say something like: 

  • “I am your constituent and I need you to protect Medicaid. We should not cut Medicaid during a public health crisis. Instead of cutting Medicaid we could raise revenues from the ultra-rich. Please consider supporting both things publicly – and please speak to your leadership in the Senate/Assembly and tell them that your constituents are demanding to protect Medicaid and raise revenue.” Add your own stories about why Medicaid is important! 

2. Call Senators Schumer and Gillibrand. Say something like “As your constituent, I want to thank you for providing additional Medicaid funding to New York. We need to keep Medicaid strong during this crisis and prevent states from cutting Medicaid.”

3. Tweet @ Legislative Leaders using the hashtags #NoMedicaidCuts and #ProtectMedicaid

Sample Tweet:   In the face of the #COVID-19 pandemic, New Yorkers need Medicaid now more than ever.  We must #ProtectMedicaid at all costs and urge #NoMedicaidCuts – the lives of New Yorkers are on the line. @CarlHeastie @AndreaSCousins #NoMedicaidCuts #ProtectMedicaid

Sample Tweet:  ATTN: @CarlHeastie @AndreaSCousins Please urge @NYGovCuomo to accept $6.7 billion in federal emergency Medicaid funding and to abandon Medicaid cuts at this critical time! We must preserve the Medicaid Maintenance of Effort to #ProtectMedicaid

Sample Tweet: 6.3 million of New York’s children, seniors, individuals with disabilities and low-income families rely on Medicaid to meet their fundamental healthcare needs. Now – more than ever – we must #ProtectMedicaid to fight #COVID19 and say #NoMedicaidCuts. @CarlHeastie @AndreaSCousins

Thank you for taking action!  During this unprecedented time, ALL New Yorkers need Medicaid’s protections more than ever. Stay healthy and stay strong! 

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.