Opportunities to Learn and Take Action

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.

The new 2018 census data numbers are out this this morning. 

The bad news is that uninsurance numbers increased across the country by 1.9 million in 2018, despite the positive economy. This was the first increase in uninsured since the Affordable Care Act was fully implemented in 2014. Here’s a New York Times article with more details.

BUT, there’s great news in New York, which was one of just three states in the country to have a decline in our uninsurance numbers, from 1,113,000 in 2017 to 1,041,000 in 2018 (our uninsurance rate declined from 5.7% to 5.4%). 

New York’s continued decline in uninsured residents is inextricably linked to its adoption of the high quality, affordable, Essential Plan, which saw an increase in enrollment from 665,000 in 2017 to 739,000 in 2018.  Other important factors include:

  • One-stop shopping: you can apply for the full spectrum of coverage, including Medicaid, Emergency Medicaid, Child Health Plus, the Essential Plan, Qualified Health Plans and tax credits, all through the same NY State of Health application
  • Robust Navigator funding of $27 million a year

Congratulations New Yorkers! And let’s keep up the good work!

The CDC released early results from its National Health Interview Survey and it echos some of the data we’ve already seen. In most states, fewer people have health insurance – but in New York, more people do! There wasn’t enough data to know whether or not the change was meaningful, but it matches what we know from other sources. And even holding steady is an achievement in an era where the Trump Administration is doing everything it can to sabotage health insurance programs.

This chart, from the CDC’s report, shows a small increase in the number of insured people – while it could be that we just stayed the same, we can be proud of that too given how many people in other states lost coverage.

For example, the NY State of Health released final numbers recently the last open enrollment. Over 4.7 million New Yorkers used the Marketplace to buy health insurance or enroll in public plans, the most ever! The increases happened in every single county of the State.

We’ve always argued that robust investment in our Marketplace and consumer-assistance programs pays off, but comparing outcomes here to those in other States shows just how important those investments are. Some States chose to use the federal Marketplace infrastructure when implementing the Affordable Care Act. New York chose to build its own, a harder task, but with the result that our Marketplace integrates all of our programs perfectly.

We didn’t foresee an Administration that would work so hard to hurt those Marketplaces, but the decision to create our own infrastructure has protected us from it. In those other States, funding for marketing and for consumer assistance programs is controlled by the federal government. Even the amount of time people have to enroll is controlled by the federal government. So now that we have an Administration that wants those Marketplaces to fail, they’ve cut funding for marketing and consumer assistance and drastically shortened the amount of time people have to enroll. New York has done just the opposite, and achieved the opposite result.

As we talked about last week, we still have a lot to do to get to universal coverage. People without health insurance in New York are disproportionately part of racial and ethnic minority communities. But as a state we have options, and now we have proof that State-level strategies can make a big difference.

On Tuesday we released an agenda for achieving racial justice in health care in New York. Today we’ll take a closer look at one factor that contributes to inequities in health care – white New Yorkers are more likely to have health insurance than others.

The most recent data on health coverage in the United States comes from the Census Bureau’s Small Area Health Insurance Estimates (SAHIE) for 2017. Right off the bat there are a couple missing pieces. The only racial and ethnic categories available for analysis are White alone, Black alone, and Hispanic (of any race). For one, what about people of Asian descent or who are mixed race? And second, people who say their ethnicity is Hispanic may have very different health care experiences depending on their race. We can’t pick up on something like that using this data-set.

We also can’t look at race and ethnicity at the county level, something that the SAHIE does provide for some other categories. It is especially challenging to get data by race and ethnicity at local government levels because in many counties of New York, the populations are too small to allow enough data points to meaningfully analyze trends.

Examining the available data shows some interesting differences in health insurance coverage depending on race and ethnicity. At every income category, people who said they were Hispanic are much more likely to be uninsured. Overall, about 9 percent of Hispanic people were uninsured, compared to 5.7 percent of people who reported their race as Black and only 3.5 percent of people who reported being White.

Looking at the data by income reveals some interesting differences:

Below 138% of the Federal Poverty Level:

People who reported their race as Black alone and White alone have almost the same likelihood of being uninsured (7.4 percent and 7.8 percent respectively). But for Hispanic (any race), the percent of uninsured at this level is shocking: 14.5 percent.

At this income, most New Yorkers are eligible for Medicaid. Some immigrants are eligible for the Essential Plan, which was created through the Affordable Care Act (ACA). The ACA excludes fewer immigrants from coverage than the Medicaid statute. That means New York was able to use the Essential Plan to cover many immigrants who would be income-eligible for Medicaid otherwise. But there are still many immigrants with very low-incomes who are not allowed to participate in public health programs because of their immigration status.

Between 138 and 400% of the Federal Poverty Level:

At this level there is more of a gap between the Black alone and the White alone categories: 8.2 percent of people who said their race was Black alone were uninsured, compared to 6.3 percent of people who said their race was White alone. People who said they are Hispanic were still uninsured at shockingly high rates: 14.5 percent.

At this income level, people move from eligibility for public coverage through Medicaid to public coverage for the Essential Plan and then into the private market. Essential Plan eligibility goes up to 200 percent of the federal poverty level. Above that, most uninsured New Yorkers can use the New York State of Health to purchase insurance and will be eligible for some level of premium subsidy. There are some glaring exceptions: depending on their type of immigration status, many immigrants are not allowed to purchase insurance on the New York State of Health, even if they use their own money and chose not to receive any assistance.

Above 400% of the Federal Poverty Level:

At this income level the gaps between Black alone and Hispanic (any race) close a bit, but the gaps between those categories and White alone increase. Only 2.2 percent of people who reported being White alone said they were uninsured. For Black alone 5 percent were uninsured and for Hispanic (any race) 6.5 percent were uninsured.

At this income New Yorkers are no longer eligible for any type of public coverage or premium assistance. Native-born New Yorkers and some immigrants can use the New York State of Health to shop for insurance and pay the full premium themselves.