“Close the coverage gap” means something different to people with low income.
New York lawmakers must ensure this year’s budget goes beyond what institutions need to provide for the needs of the people who rely on Medicaid to keep them healthy and well.
Download this statement here.
During this year’s budget process, the phrase “close the coverage gap”* has been taken up by the hospital industry as a rallying cry for increased Medicaid rates to the tune of 10% for inpatient hospital reimbursements. The nursing home industry is pushing for an increase of as much as 20%. The budget agenda of these institutional providers has little to do with insurance coverage, as the budget request turned hashtag might suggest.
Medicaid Matters New York supports Medicaid reimbursement rate increases to meet the needs of the delivery system after years of unjustified flat funding and cuts. However, as important as all hospitals are to the local communities they serve, not all of them need a Medicaid increase.
Medicaid Matters New York believes that if hospitals and nursing homes are to receive increases in Medicaid funding, the Governor and the Legislature must:
- Direct the increase to hospitals that meet the statutory definition of “enhanced safety net hospital”;
- Provide commensurate increases to community-based safety-net providers, such as community health centers, community behavioral health centers, home care programs, and the like; and
- Ensure that nursing homes provide quality, dignified care and meet the state’s mandatory staffing levels.
In addition, this year’s Medicaid budget must go beyond the needs of institutions and provide for the needs of the people with low income and people with disabilities who are served by New York’s Medicaid program. To do this, this year’s budget must:
- Address New York’s remaining “coverage gap” by enacting Coverage4All to include all income-eligible New Yorkers in the move to expand the Essential Plan, regardless of immigration status;
- Eliminate or increase the asset limit for older people and people with disabilities;
- Repeal the restriction to home care services for people who need assistance with fewer than three activities of daily living (ADL); and
- Address the worst-in-the-nation home care workforce crisis by enacting FairPay4HomeCare.
We urge you to invest in people by expanding coverage and benefits and invest equitably in non-institutional care to ensure the health care system works for everyone in the communities where they live.
* Around the country, and among those who fight for people covered by Medicaid, the phrase “close the coverage gap” is used to refer to the call for Medicaid expansion in states that have yet to take up the Medicaid expansion offered by the Affordable Care Act. New York did that shortly after the ACA became law, providing affordable insurance coverage for over one million people with low income previously not eligible for the program.