While we haven’t seen all the fine print, HCFANY is delighted to report that this year’s budget deal includes important protections for New York’s health insurance consumers. The new budget deal includes:
- Co-premium assistance for people between 138-150% of poverty (people with children that are currently eligible for Family Health Plus ). Those who enroll in the Exchange with Silver-level plans will pay no premiums. This measure is NOT conditional on federal financial participation.
- Protection for people who currently have out-of-network coverage in the individual market. These consumers will have the option to pay for a Platinum-level plan on the Exchange with an out-of-network rider and be “risk pooled” with the rest of the State’s individual market.
- A requirement for SDOH to create a workgroup to study whether New York should adopt a Basic Health Plan
- Fair consumer protections on the State’s new Navigator program
- Funding for consumer assistance for New York’s health insurance consumers through Community Health Advocates
- Still waiting details on Medicaid budget, but it looks like most optional benefits have been saved….
A special thanks to everyone who added their names to our sign-on letter, called the Governor’s office, and worked hard to get these important consumer protections. These budget victories would not be possible without you!!!
Stay tuned for more on the budget!
Under the ACA, states are allowed the option of creating a Basic Health Plan (BHP) for low-income adults who earn too much to qualify for Medicaid. Ordinarily, if these folks don’t have employer-sponsored coverage then come 2014 they will be able to buy insurance through the Exchange with the help of federal tax credits. But, even with the tax credits this coverage may still be too expensive for them. The BHP then would act as a bridge between the free or low-cost Medicaid coverage and the higher priced options available on the Exchange.
Don’t be fooled by the name though – there is nothing “basic” about it. According to the ACA, BHP coverage must be as affordable and comprehensive as what these adults would have gotten on the Exchange. In New York, coverage would likely resemble that of the Family Health Plus program.
New York currently offers public coverage to low-income adults through its Family Health Plus program, the cost of which is split with the federal government. New York also pays for Medicaid coverage for low-income immigrants without help from the federal government. Through the BHP program, New York would be able to cover both of these groups and have the federal government pay for it all. This would save the state between $500 million and $1 billion per year.
Sounds great, right? Problem is, the federal government still hasn’t released guidance on this program, and isn’t planning on doing so anytime soon. Unfortunately, state policymakers won’t commit to the program until they are sure of all the details. So, until that happens, it is unlikely that New York will get any of the cost-savings and affordability protections that the BHP has to offer.
HCFANY has created a policy brief on this issue to explain it in detail, urge federal policymakers to release BHP guidance, and provide recommendations to state policymakers.
Click here to read HCFANY’s policy brief, titled “The Basic Health Program Option in the Affordable Care Act.”
A lot of folks think that 2014 is when the Affordable Care Act will really kick into effect, and yes, that is when the health insurance Exchanges will become fully operational. And yes, those are a big part of the ACA. But, they’re not the whole thing!
Many great things have already happened in the years since the law was implemented, including small business tax credits, a new coverage option for uninsured folks with pre-existing conditions, free preventive care, and allowing young people to stay on their parents’ plan until the age of 26.
And, 2013 will be no exception! There are more good things in store for us this year. Here is a roundup of some of what’s to come:
- More subsidies for seniors who hit the donut hole: Seniors who hit the Medicare Part D coverage gap will now get federal subsidies for brand-name prescriptions (in addition to the 50% manufacturer brand-name discount that went into effect in 2011).
- Improving Preventive Care: State Medicaid programs that offer free or low cost preventive services will get increased federal funding to do so. This means that low-income folks in many states will have better access to vaccinations, tests like colonoscopies and mammograms and routine screenings for high blood pressure, diabetes, and cholesterol.
- Increased Medicaid payments to doctors: On January 1st, Medicaid payments for primary care doctors were brought up to Medicare levels. In New York, this will mean an estimated increase of 156% in Medicaid payments to doctors and will help to ensure low-income New Yorkers have sufficient access to doctors. For more info on this, check out the Kaiser Family Foundation report titled, “How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees”
- CHIP funding will be extended: the ACA will authorize funding for the Children’s Health Insurance Program (CHIP) through 2015 (extended from 2013). In New York, this program is called Child Health Plus. This will allow roughly 400,000 kids in New York to keep their free or low-cost health insurance.
Of course, not all of the ACA changes happening in 2013 will be a clear-cut “goody.” 2013 will also see a number of tax changes, including an increase in Medicare taxes for higher income earners (in order to boost up the Medicare trust), an exise tax of 2.3% on the sale of medical devices, and changes to FSA limits. For a full list of changes, check out the Kaiser Family Foundation’s Implementation timeline.
Are you still feeling confused about the recent Supreme Court Decision on the Affordable Care Act (ACA)? Still wondering what this means for New York?
Well, you’re in luck! HCFANY will be hosting a webinar next Wednesday, July 25th at noon to update our members and fellow stakeholders on the Supreme Court decision. Join in to find out what the Court decided, what it means for New Yorkers, and to ask any questions you may have.
This webinar is free and open to anyone who wishes to join, but space is limited. RSVP today to reserve your spot!
After registering, you will receive a confirmation email containing information on how to join the webinar.
Hope you can make it!