2021 Priorities to Reach Greater Equity and Protect Medicaid Consumers

Feb 9, 2021 | Policy & Budget Agenda

To reach greater equity and protect the Medicaid safety net and the people who rely on it, New York State must:

  • Keep Medicaid budgeting within the process set in the State Constitution to allow for full legislative and public discourse; if stakeholder bodies are seated to make recommendations on Medicaid, it is incumbent on the state to ensure substantial representation of people who are served by the Medicaid program;
  • Eliminate the Medicaid global spending cap in favor of adopting a Medicaid budget that realistically spends what is necessary to provide the program New Yorkers need;
  • Avoid across-the-board cuts (should cuts become necessary) as they disproportionately decimate programs, services, and community-based providers that low-income communities and communities of color rely on;
  • Streamline and simplify Medicaid eligibility and enrollment policy and procedures to ensure people entitled to coverage and current enrollees obtain and retain Medicaid coverage as easily as possible; retain simplified procedures put in place during the economic downturn caused by the COVID-19 pandemic;
  • Protect and enhance the ability of people to obtain and retain home- and community-based long-term services and supports, which provide for higher satisfaction, lower cost, and abide by the right to live in the most-integrated setting;
  • Enhance data collection and reporting to drill further down and capture the reality of what is happening in marginalized communities, and disaggregate data;
  • Execute health equity assessments on proposed budget initiatives and policy changes to demonstrate how specific proposals would impact on communities of color;
  • Ensure access to meaningful care coordination and needed services for all managed care enrollees; promote greater consumer input by enhancing existing satisfaction surveys and providing other opportunities for engagement; strengthen oversight of managed care organizations and revisit ways they should be held accountable for consumer experience, positive health outcomes, and overall well-being;
  • Instill greater transparency in all Medicaid spending to increase accountability and ensure public funds are spent as they are intended and in ways that serve low-income New Yorkers;
  • Enhance oversight of state contracts with large companies that do the work of administering the Medicaid program; impose restrictions on their ability to cut corners;
  • Invest in and ease access to programs and services that address social determinants of health, such as food insecurity, access to child care, housing, and more.

The intent of the Medicaid program is to provide coverage and access to low-income people and people with disabilities.  New York’s comprehensive and inclusive Medicaid program makes health care more affordable, enabling families and individuals to meet their health care needs and improve their quality of life.  It also provides access to long-term services and supports, promoting independence and dignity for people with disabilities and older adults. 

The Medicaid program has played a critical role as New Yorkers face the Coronavirus pandemic.  Medicaid enrollment has grown by hundreds of thousands of people, providing vital health insurance coverage when people across the state lost their jobs and struggled to make ends meet.  Medicaid has remained a lifeline to health care and other needed services as the pandemic surged to disastrous proportions in New York.  Unfortunately, the austerity agenda set forth by the administration has resulted in decisions to contain cost in areas that directly impact on access to human services and various non-Medicaid services.

The pandemic has brought back to light the structural racism and oppression that perpetuates poor health for people who, by no fault of their own, are more exposed and less protected from the virus.  This susceptibility is directly related to numerous factors, including living conditions, income inequality, and lack of access to quality care and services.  Thanks to Medicaid, however, many New Yorkers have been able to access health care at a time when they need it most. 

The COVID-19 public health crisis and associated economic downturn present us with an opportunity to do better.  Investing in Medicaid is an investment in New York’s future, and a properly funded Medicaid program is how New York State will build a better future for millions of people.  State leaders must reject the notion that budget austerity will help us reach the outcomes we seek.  Revenue options must be enacted to reach greater budget equity, asking wealthy New Yorkers to make small sacrifices to benefit the greater good.  With or without new federal relief, our state faces an unsustainable fiscal situation, and our state coffers must no longer be balanced on the backs of people who rely on Medicaid and other social service programs.

Medicaid Matters urges state policymakers to maintain New York’s unwavering commitment to the Medicaid program and thoughtfully address the budget crisis by preserving its strengths.  New York must show the nation that in challenging times, we stand by our families, children, older adults and people with disabilities.

Download our 2021 priorities here.

Response to the Governor’s proposed 2021-22 budget can be downloaded here.