This week, New York lawmakers made an impressive push toward expanding health coverage for all New Yorkers in Senate and Assembly budget proposals. Still, the proposals leave some key populations behind.

In what would be a major win for immigrant justice advocates, both houses budgeted to expand health insurance to low-income immigrants. The Coverage4All proposal opens the State’s Essential Plan to everyone who meets income requirements — including thousands of New Yorkers currently excluded because of their immigration status.

The Assembly budget bill also extends Medicaid coverage for 12 months post-partum to all New Yorkers—including immigrants. New York currently provides Medicaid coverage during pregnancy and for 60-days postpartum, and the Executive Budget proposal extends this to one full year, but it excluded immigrants from the Medicaid for Pregnant Women program for the first time.  The Senate resolution, like the Assembly bill, would include immigrants, although its actual bill language appears to have an inconsistent drafting error and would exclude immigrants.  To ensure no New Yorker is left behind, Governor Hochul and the Senate should incorporate the Assembly’s language to make sure no one is left out of this important coverage expansion. 

The budget bills include other important coverage expansions for New Yorkers, including equalizing Medicaid eligibility for people over 65 and with disabilities. Currently, people in those groups face higher eligibility thresholds than others. The Executive Budget and both legislative budget bills change this so that both groups become eligible at 138% of the federal poverty level and without an asset test, just like other New Yorkers. The Assembly and the Executive Budget also both eliminate premiums for some children enrolled in the Children’s Health Insurance Program and expand their benefits. An estimated 60,000 children lose coverage for a month or longer every year because of problems paying the premium. Eliminating them will stop this.

Importantly, the Assembly and the Senate proposals would repeal the Medicaid global cap. The cap triggers automatic cuts after the program hits a certain spending level, meaning that the program gets hits with cuts when and where it is most needed. For example, the global cap led to safety-net hospitals being threatened with budget cuts during the height of the pandemic in 2020. Repealing the cap would allow Medicaid to grow with need instead of according to an arbitrary formula. Governor Hochul should include the Assembly and Senate’s proposal in the final State budget.

Finally, the Assembly increases funding for the Community Health Advocates (CHA) and both houses support the Executive Budget’s allocation for the Community Health Access to Addiction and Mental Healthcare Project (CHAMP). Both programs provide similar post-enrollment help, such as finding in-network providers, fighting billing errors, and appealing insurance denials. CHAMP specializes in providing these services to people who need medical care related to their mental health or substance use disorders.

Now that the Legislative budget bills have been introduced, HCFANY is looking forward to the next step in the budget process: reconciling them. Governor Hochul’s initial budget proposal included lots of great health care stuff—HCFANY has high hopes that she’ll consider the expansions on her original proposals that were included in the new budget bills. Stay tuned for updates on New York’s progress toward health care for all!