New York State’s budget included harmful changes to Medicaid – though many of those changes are delayed (see our joint statement with other Medicaid advocates here). The Medicaid cuts are going to be an on-going issue throughout the year. But outside the Medicaid budget, there were a few wins for consumers.
Full Funding for Consumer Assistance Programs
New York’s consumer assistance programs received full funding. These programs include the Community Health Advocates and the Community Health Access to Addiction and Mental Healthcare Program (CHAMP). Both programs provide free, independent help to make sure your health insurance works and that you can access care. Both are running full speed ahead despite social distancing – if you ever need help dealing with care denials or prior authorizations or even finding a doctor, give them a call! You can find more info about the Community Health Advocates here, and about CHAMP here.
Other good CHAMP news – the budget created a fund to make sure that people who need assistance getting mental healthcare or addiction help can get the services they need. The fund will be filled using fines against health plans that do not follow the rules about ensuring access to those services. New York has had parity laws for a long time that require plans to treat mental healthcare the same as other healthcare – the fund will help hold plans accountable while providing resources to people who need care.
Protecting Patients from Medical Debt
Two parts of the Patient Medical Debt Protection Act made it into the budget (learn more about medical debt in New York here). One reduces the statute of limitations for medical debt court cases from six years to three. After six years, most people don’t have the same insurance or the records they need to defend themselves against hospitals in court. The budget changes the law so that these cases must be filed sooner, giving defendants a better chance to defend themselves. The second change closes a loophole in the state’s surprise medical billing law – now emergency charges by either the hospital or individual providers will be covered by the law. That means fewer unanticipated and unfair bills.
Making Prescription Drugs More Affordable
There were two actions on prescription drugs in the final budget. First, the budget caps co-pays on insulin at $100 every 30 days. There’s a lot more the state could do on prescription drugs (see S6492/A8533) but this will be a big help to people with insurance who depend on insulin. The budget also creates a drug accountability board that will help the Commissioner of Health investigate prescription drug price gouging.
Fair Hospital Funding
Finally, the enacted budget ends the transition collar for the state’s indigent care pool. The transition collar was part of a system that short-changed safety net providers and rewarded hospitals that provide little or no financial assistance to patients. Advocates have worked for years to improve how indigent care pool funds are distributed – and won some improvements six years ago. When the funding formula changes happened, the state instituted a transition collar to slowly phase them in. But the transition was extended every year – until now. Without it, New York will finally fully implement the formula improvements and move closer to a fair system. You can learn more about the indigent care pool and its history here.