Several advocacy groups, along with NYC Health + Hospitals and labor unions, continue to push for redistribution of the Indigent Care Pool (ICP). Over $1 billion in Medicaid funds are allocated to hospitals across the state, and advocates believe the funding should be targeted to true safety-net hospitals.
Find linked here Medicaid Matters’ memo in support of the bill to redistribute ICP funds, along with a revised joint statement (linked here) endorsed by dozen of organizations in support of this effort.
Like our partners across all sectors, we are relieved after the verdict of Derek Chauvin, while also embracing the notion that true justice requires structural change. As health justice advocates, we will do our part to fight systemic racism. Our thoughts are with the family of George Floyd and the many families who have lost loved ones to racism.
Medicaid Matters New York and Health Care for All New York – the two major statewide health care consumer advocacy coalitions – applaud the State Legislature for several historic additions to the adopted state budget for 2021-22 related to funding for public schools and universities, rental and mortgage assistance, assistance to undocumented essential workers and small businesses, and taking some first steps toward restoring progressivity to the state’s tax system. Millions of low-income New Yorkers who rely on our state’s public health insurance programs will benefit from these improvements to the Governor’s initial set of budget proposals.
However, our State leaders failed to break ground in health care, which is disappointing in light of a decade of austerity budgets and the ongoing nature of the COVID-19 public health crisis. Medicaid Matters and HCFANY are specifically concerned about the following issues:
- The arbitrary Medicaid global spending cap was extended for another year. As a consequence, Medicaid continues to be approached with an austerity mindset. For ten years, Medicaid has suffered from unnecessary cuts, impacting access to services for low-income people, families, people with disabilities and communities.
- Public health insurance coverage was not expanded to low-income immigrants who have had COVID-19. Instead, those who are undocumented remain reliant solely on Emergency Medicaid for acute care and charity care programs for ongoing treatment. As a consequence, many will likely forego seeking necessary care, thereby prolonging illness and suffering, risking death, and incurring medical bills they cannot pay.
- The home care crisis and institutional bias remain unaddressed. Home care workers play a vital role in serving and protecting disabled New Yorkers and seniors living independently, a role that became even more critical and evident during the pandemic. However, New York’s failure to invest in home care has created a “worst in the nation” workforce crisis that prevents meaningful access to home care services for thousands of people and results in greater institutionalization.
- This is the first time in decades that New York State has adopted a discriminatory maternity coverage policy. Instead, only citizen and lawfully residing immigrant women will enroll in free (state-funded) Marketplace coverage after their Medicaid ends—continuing a system that allows for disruptions in care.
- No new initiatives were created to address inequities that are wide-spread throughout our state’s public health, health care, and health coverage systems, despite significant federal pandemic-related funds the state has received over the past year to address these disparities. The pandemic has revealed them clearly, and they can no longer be ignored.
On the positive side, we thank both the Governor and Legislature for these new initiatives:
- Eliminating all premiums in the state’s Essential Plan that provides insurance coverage to low-income people and families who are not eligible for Medicaid. This move will enable them to keep medical, dental, and vision coverage in place without financial barriers, an important step during the ongoing pandemic.
- Protecting the financial stability of community health centers and other safety net providers by delaying the implementation of the planned pharmacy carve-out from the state’s Medicaid Managed Care program.
We also acknowledge and appreciate restorations in funding cuts initially proposed by Governor Cuomo that made no sense given our ongoing pandemic:
- An across-the-board Medicaid rate cut that particularly threatened safety net hospitals that serve large numbers of Medicaid and uninsured patients.
- Elimination of Indigent Care Pool funding to public hospitals.
- Cuts to the state’s Vital Access Provider Assistance Program that keeps certain safety net and rural hospitals financially afloat.
- Additional cuts to Article VI public health funding to New York City.
- Allowing insurers to impose restrictions on the ability of doctors to prescribe certain drugs to Medicaid patients (elimination of the provision known as “prescriber prevails”).
- Another 25% cut to home care workforce recruitment and retention money that would have further harmed community-based long-term care.
- Cuts to programs serving adult home residents.
While as a whole and on the surface it may appear that New York continues to meet the needs of those enrolled in our state’s public health insurance programs and the providers they rely on, the 2021-22 adopted budget fails to make needed investments to turn away from austerity politics, protect all immigrants, expand community-based long-term care, and promote health equity. A lack of harm must not be confused with a budget that provides for what New Yorkers need. We can do better, and we must.
You may download a PDF of this statement here.
Medicaid Matters New York – the statewide coalition representing the interests of people who are served by New York’s Medicaid program – is deeply disappointed the Medicaid Global Spending Cap has been extended in this year’s budget. The spending cap, which has been in place since 2011, is an arbitrary limit that was never designed to keep pace with essential program growth. The cap has perpetuated the notion that Medicaid growth is a problem that requires austerity, when in fact, a strong Medicaid program is a solution that allows people to have access to health care. Investment in Medicaid is an investment in the one in three New Yorkers who rely on the program for their health and wellbeing.
The cap was not designed to be responsive to increases in the number of people covered by the program or the cost of health care services, but to impose arbitrary controls on increased spending. Due to the economic downturn and job loss associated with the Coronavirus pandemic, over 820,000 people have newly-enrolled in Medicaid over the last twelve months. Under the spending restrictions of the cap, the Medicaid program cannot function as a true safety net for New Yorkers, one that ensures access to care for those who are ill, provides benefits to prevent illness and maintain wellness, and upholds the right of those needing long term care to do so in the least restrictive environment.
Medicaid cuts deemed necessary to keep spending below the cap disproportionately impact:
- People with disabilities and seniors who rely on community-based services and supports;
- Safety-net hospitals and community-based providers, like community health centers providing primary care and community mental health centers; and
- Historically under-resourced communities of color.
Medicaid Matters New York believes there are smarter ways to manage Medicaid spending that do not exclude or harm the very people who Medicaid is designed to serve. New York should “Scrap the Cap,” and Medicaid Matters will continue to strive for this change on behalf of the millions of New Yorkers served by Medicaid.
PDF of this statement may be found here.
Pandemic Enrollment Growth Highlights the Importance of Medicaid
Medicaid provides access to health care for many New Yorkers. The coronavirus pandemic, and the economic downturn resulting from the ensuing public health crisis, have highlighted the critical role that Medicaid plays in NY.
New York has always recognized the importance of Medicaid in helping New York guarantee health coverage to all New Yorkers. At the beginning of 2020, before the first COVID-19 case appeared in NY, over 6 million New Yorkers were covered by Medicaid. Due to the economic downturn and job loss associated with the pandemic, over 700,000 new enrollees turned to Medicaid between March and November of 2020. Medicaid ensured that they did not lose access to health care when they lost their employer health insurance. That is exactly how Medicaid should respond to economic downturns.
Even before the pandemic Medicaid provided coverage to one in four New Yorkers, including low-income New Yorkers, parents and children, individuals requiring long-term care services, both in the community and in nursing facilities, those with disabilities, including physical disabilities as well as mental health disabilities, individuals with substance use disorders, and people with intellectual/developmental disabilities.
This report includes county-specific information that highlights the important role that Medicaid plays across the entire state. Each page provides three pieces of information:
- the relative size of Medicaid within the county;
- the growth in Medicaid since the pandemic began;
- the contribution of the various Medicaid programs that are designed to meet the needs of specific populations.
We hope this information enhances your understanding of the importance of Medicaid in your community and for your constituents. Please reach out if you have any questions.
Download a PDF of the report here.
1. NYS Medicaid Enrollment Databook, https://www.health.ny.gov/health_care/medicaid/enrollment/historical/enrollment_trends.htm
2. Medicaid Managed Care Enrollment Reports, https://www.health.ny.gov/health_care/managed_care/reports/enrollment/monthly/
3. Child Health Plus Enrollment by Insurer, https://www.health.ny.gov/statistics/child_health_plus/enrollment/
Prepared by Mark King of GMHC and Denise Soffel