Medicaid Matters, along with other leading health care consumer advocacy groups, has drafted a statement to advance key principles toward protecting Medicaid and reaching greater equity across New York’s health care system.
The statement is available for download here and is currently being circulated for endorsement.
The 2020-21 enacted state budget included a major provision to move the Medicaid pharmacy benefit from managed care to fee-for-service. Implementation of this provision is referred to as a “carve-out,” and it is a reversal of the “carve-in” implemented in 2011.
Medicaid Matters continues to investigate what, if any, front-end changes in consumer experience will occur when this transition takes place. Initial research indicates that various processes and payment happen on the back end with little known to the beneficiary. It will be incumbent on the state to implement extensive outreach efforts with appropriate notice to consumers upon implementation of this change.
The carve-out does, however, present tremendous fiscal hardship to safety-net providers that rely on the federal 340B prescription drug discount program, which will in turn threaten access to services provided to Medicaid beneficiaries. Established in 1992, the 340B program provides deep discounts on prescription drug purchasing in the form of rebates to federally-qualified health centers (FQHCs) and other safety-net providers. The savings are passed on to individuals through lower- or no-cost prescriptions. Many of the providers also use the funding to supplement typical health care services with transportation, housing supports, additional care management, and more.
FQHCs and other safety-net providers are woefully under-resourced, despite being the frontline providers that people turn to in their communities across the state. Also known as community health centers, FQHCs serve a vital function in the lives of thousands of New Yorkers who rely on them for trusted, comprehensive services. They rely on a patchwork of funding streams, the 340B program being a significant one. Many providers have developed, long-standing essential programs using 340B savings, something they would not be able to do with otherwise limited funds.
Until our system adequately funds the health care safety net, 340B funds must continue to flow to community health centers and other safety-net providers. The pharmacy carve-out should not be implemented without a clear path toward making sure providers that rely on 340B funding remain whole. Failure to do so will result in the loss of vital, trusted, comprehensive programs New Yorkers rely on for their health and well-being.
Download a PDF of the statement here.
New Data Finds Number of Uninsured Children In New York Decreased between 2016 and 2019, Bucking National Trend
Albany, NY (October 9, 2020) Analysis of newly released Census data shows New York is the only state that saw a significant decline in the number of uninsured children from 2016-2019 (pre-COVID-19). An estimated 101,000 New York children were uninsured last year, a significant decrease of about 10% since 2016, according to a new report released by the Georgetown University Center for Children and Families. New York’s experience bucks a national trend that left an estimated 726,000 more children without health coverage nationwide, since 2016, when our country achieved an historic low number of uninsured children.
“For decades, children’s health coverage had been a national success story that we could point to with pride, but the data nationally and across most states shows that the trend is now going in the wrong direction” said Georgetown University Center for Children and Families Executive Director Joan Alker.
New York is the only state to see a significant decline in the number of uninsured children from 2016-2019. The report also shows that in New York, the uninsured rate for Latino children, who can be of any race, was 2.3% in 2019 – four times lower than the national Latino child uninsured rate of 9.2%.
New York State has long been a leader when it comes to covering children. State leaders have worked with communities on a concerted effort to get and keep children enrolled in quality, affordable health coverage without discriminating based on where children were born.
“We’re proud of the progress New York has made and we’re intent on removing the remaining barriers to coverage so every single child in our state has health insurance and access to the care they need to grow and thrive,” said Kate Breslin, President and CEO of the Schuyler Center for Analysis and Advocacy. “Funding community-based efforts to reach families and enroll children, along with streamlining the paperwork involved, will ensure that children are continuously covered and can get access to care when they need it.”
“With Medicaid and Child Health Plus providing health insurance coverage for 35% of New York’s children under 19 and Medicaid covering nearly half of all births in the state, Medicaid matters immensely to the health of New York’s children and families. New York’s health leaders in and outside government have made covering kids a priority, including a focus on making information available in more languages and reducing the number of children who lose insurance during the year and must go through the process of re-enrolling,” according to Lara Kassel, the Coordinator of Medicaid Matters New York, the statewide coalition focused on making sure Medicaid works for the people it is designed to serve.
“We congratulate NYS on its leadership and commitment to provide health care coverage for all children,” said Elie Ward, Director of Policy for the NYS American Academy of Pediatrics. “Our work together over many years has created a true health care safety net for millions of children across the state. It is our hope that the significant gains we have made over the last several years are not jeopardized by the current budget challenges facing our state. We look forward to working with New York State to maintain the gains we have made for children’s access to quality health care and to extend vital health care services to those children who still do not have coverage.”
The Schuyler Center, together with the American Academy of Pediatrics in New York State, is urging the State to ensure continuous eligibility and enrollment for children from birth to age three so these youngest New Yorkers never lose precious time receiving the services they need for healthy development. Research shows children with health coverage are more likely to graduate from high school, attend college and grow up to be healthier and more productive adults.
This data is all pre-pandemic, so the reality today for families may be quite different. National data show worrying trends that primary, preventive, and mental health services have declined among children and while telehealth has filled some gaps, it has not offset the decline in services. Vaccinations and screenings – especially important for very young children – have declined, as have dental health services.
This is the 10th annual report on uninsured children published by the Georgetown University Center for Children and Families, an independent, nonpartisan policy and research center founded in 2005 with a mission to expand and improve high-quality, affordable coverage for America’s children and families. The report analyzes single-year estimates of summary data from the U.S. Census Bureau’s American Community Survey (ACS) from 2016 through 2019. For more information about the report, visit ccf.georgetown.edu
This press release was published by the Schuyler Center for Analysis and Advocacy. Founded in 1872, the Schuyler Center for Analysis and Advocacy is an independent, nonpartisan policy and advocacy organization focused on shaping New York State policy.
On October 7th, Medicaid Matters Coordinator, Lara Kassel, participated in a pre-Election Day health care policy discussion. Hosted by the Health Foundation for Western and Central New York, the League of Women Voters, and public media outlets, “Election 2020 and Your Health Care: What to Know Before You Vote” included a robust discussion with other top New York health care policy experts. Represented were the Community Service Society of New York, the Campaign for New York Health, the Empire Center for Public Policy, and Canisius College.
Video of the event is available here. The Medicaid Matters Coordinator’s presentation is at about minute 23 and 20 seconds.
New York State is at the epicenter of a global pandemic. Data has emerged that reflects what we have witnessed almost since the Coronavirus reached our doorstep: severe illness and death from the disease that results from Coronavirus, COVID-19, is significantly more prevalent in communities of color. Outside New York City, 14% of New Yorkers who have died from COVID-19 have been Hispanic and 18% have been Black, while they represent 12% and 9% of the population respectively. In New York City, 62% of fatalities have been suffered by Black and Hispanic residents, while they represent 51% of the New York City population.
The disproportionate impact of COVID-19 on communities of color reflects the pervasive health disparities which impact low-income communities, people of color, immigrants, people with disabilities, older adults, and LGBTQ people. This pandemic has brought back to light the structural racism and oppression that perpetuates poorer health outcomes for people who, by no fault of their own, are more exposed to and less protected from COVID-19. This susceptibility is directly related to numerous factors, including but not limited to: living conditions, income inequality, underlying health conditions, and lack of access to quality health care and community-based services.
Our state leaders face the enormous task of keeping the public safe, protecting frontline and essential workers, keeping our economy from ruin, and much more as the pandemic surges on. It is critically important, however, that New York State do everything possible to reach greater equity for all of its residents. To do that, state leaders must:
The devastation left behind by this Coronavirus will be felt for years to come. Medicaid Matters New York stands ready to partner with New York State to ensure New Yorkers receive required and urgent disaster and economic relief from the Federal government. While New York State has made efforts to address the tremendous shortfalls being re-exposed by this pandemic, there is so much more we can do. This time is our opportunity to build New York back better by righting the wrongs that have impacted New York’s Black and other minority communities for far too long. It is imperative our state policymakers do everything in their power to do just that.
Download this statement here.
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