URGENT: New York’s Medicaid Program is Under Threat!

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.

A new rule proposed by the Trump Administration could result in drastic cuts to New York’s Essential Plan, which covers almost 800,000 people. The rule was published on April 2 and comments are due by 5PM today (comments can be posted electronically here). You can read HCFANY’s comments here.

The Essential Plan is an option for states that was created in the Affordable Care Act (in Section 1331, where it is called the Basic Health Program). The program provides an option for people with low-incomes who are not eligible for Medicaid. This could be because of income – for adults, Medicaid is only available in New York up to 138 percent of the federal poverty line. Or it could be because of immigration status. Many lawfully-present non-citizens are not allowed to enroll in Medicaid regardless of income. The Basic Health Program statute provided a way for states to cover those residents.

The program is available to people who earn up to 200 percent of the federal poverty level (about $25,000 for an individual). The federal government funds the program by calculating the amount of assistance (tax credits and cost-sharing reductions) those enrollees would have received if they purchased their own health insurance on the Marketplace. It would be difficult for people who earn less than $25,000 to afford those plans – so New York decided to take that funding and provide a public plan for them. The funding is only 95 percent of what those enrollees would have received, but administrative costs are lower in public plans than in private plans. New York knew it could provide robust coverage for less money, and the program has been wildly successful.

Republicans had targeted the cost-sharing reductions (payments to insurers to reduce enrollees deductibles and co-payments) long before the Trump Administration took office. They succeeded in a lawsuit that resulted in the de-funding of the cost-sharing reductions – in part because the Trump Administration refused to fight in court. So one of the Administration’s arguments is that the cost-sharing reduction part of the formula is now zero. The Administration’s other major argument is that more people than ever are enrolling in Bronze plans, which would mean the tax credit part of the formula should also be lower. Tax credit amounts are tied to silver-level plan premiums, so when silver-level premiums go up (as they did in response to the loss of CSR funding), the tax credits go up. If you use the tax credits to buy a Bronze plan and your tax credit is worth more than the plan’s premium, you save the government money (and give yourself less financial coverage).

There are lots of arguments against both of these ideas. First, individuals are still benefitting from the CSRs because insurers are required to give them to members by the ACA. The federal government may fail to fund those payments, but there is still a value attached. HCFANY argues in our comments that the Administration cannot stop taking account of that value without changing the ACA. And though it has tried, it has failed!

Another argument is that in New York very few people purchase Bronze plans. Bronze plans might look like a good deal because they have lower premiums. But they also have higher deductibles. In New York we have great consumer assistance programs that educate people about those trade-offs. The result is that before we had the Essential Plan, fewer than one percent of people in that income group choose Bronze! If the Administration was truly trying to adjust funding to account for people enrolled in Bronze plans and not just trying to give New York a big funding cut, the impact would be very, very small.

The proposed executive budget is shockingly silent on health coverage:

-Health insurance for immigrants left behind by the ACA:  $0

-State premium assistance for people who can’t afford coverage:  $0

-Funding to stabilize the high costs of NY’s individual market: $0.

Instead, the people get a “commission” of so-called experts. What can a commission tell us about health coverage that we don’t already know?  Here’s what we already know:  coverage reduces mortality; coverage reduces morbidity; coverage brings people out of poverty; coverage provides economic security to people.

Coverage matters. There are plenty of giveaways in this budget for the health care industry. But no investment to provide the health coverage that would make such a difference to so many New Yorkers. State leaders in California, Colorado, New Mexico, and Washington have taken big steps on coverage.  But not here in New York, where over a million people are uninsured and millions more are struggling to afford their insurance.

New York’s advocates, including HCFANY, have developed agendas over the years that would move New York towards universal coverage. Our most progressive advocates have proposed a bold single-payer plan.  New York could take several smaller steps that would immediately ease the financial burden of accessing health care in New York: (1) state premium subsidies for people who buy their own plans and have trouble affording them; or (2) a public option for people who want a cheaper alternative to private plans.

The most heartbreaking oversight in the budget is that it does nothing to help the 400,000 New Yorkers who are uninsured because of their immigration status. Again, there are simple steps that New York could take to help. Governor Cuomo could have proposed an expansion of Child Health Plus to young adult immigrants, as Governor Newsom did. He could have been bolder and expanded the Essential Plan to all low-income adults, regardless of status. If health care is a human right, why are there so many New Yorkers whose birthplace leaves them without health coverage?

State premium assistance, a public option, immigrant coverage: all would have been progressive achievements to crow about – something that would let HCFANY agree wholeheartedly with Governor Cuomo that New York is the “most progressive big state in the nation.”