A 2020 Vision for New York’s Medicaid Program: Preserve Care and Protect Consumers

Medicaid Matters New York is the statewide coalition representing the interests of the over six-and-a-half million people who are served by New York’s Medicaid program and the community-based organizations and safety-net providers that serve them.  The mission of Medicaid Matters is to ensure those interests are included, understood, and met in any and all discussions on Medicaid in New York.

The intent of the Medicaid program is to provide coverage and access to low-income people and people with disabilities.  New York State has been a national leader in providing public health insurance coverage and promoting health care access.  Few states cover more people or provide as wide an array of community- and home-based services as New York.

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.  While there is room for improvement, and not all changes have been without harm, the State has made significant progress toward encouraging person-centered care and reducing costs through Medicaid redesign, once again proving to be a national leader.

While the State faces a Medicaid budget crisis, now is not the time to abandon its national leadership position in providing comprehensive health insurance to all who need it.  The rest of the nation is looking to see how New York will meet its financial constraints while preserving what has distinguished its Medicaid program from all others.  Medicaid Matters urges state policymakers to maintain its unwavering commitment to the Medicaid program and thoughtfully address the budget crisis by preserving its strengths.  New York must show the nation that in times of financial challenge, we stand by our families, children, seniors and people with disabilities.

Medicaid Matters identifies the following efforts as critically important to creating a program in 2020 that works for those who need it (including, but not limited to):

  • Protecting consumers from harm, such as loss of coverage or services as a result of potential Medicaid cuts;
  • Ensuring access to meaningful care coordination and needed services for all managed care enrollees;
  • Reaching greater equity in health outcomes by investing in culturally-competent, community-based, accessible care and services;
  • Rightsizing Medicaid reimbursement for facilities so safety-net providers are compensated for the services they provide; and
  • Ensuring that all Medicaid spending, including allocations made that are considered exempt from the global cap, be transparent. 

Medicaid Matters looks forward to continuing to partner with state officials in providing for the needs of the New Yorkers who rely on Medicaid for their health and well-being and ensuring New York’s Medicaid program continues to lead the nation.

Download our 2020 Vision document here.

Medicaid Matters released this statement regarding the Governor's Executive budget.

The Medicaid Matters Steering Committee put out this statement in response to the seating of a Medicaid Redesign Team.

The Medicaid Matters Coordinator, Lara Kassel, submitted testimony on January 29th at the Joint Legislative Budget Hearing on the Executive Budget on Health/Medicaid.

A flier was generated to provide “an alternate perspective” to the Legislature on Medicaid Matters coalition perspective on the Governor’s approach to Medicaid.

The Medicaid Matters Coordinator, Lara Kassel was interviewed on Capitol Pressroom on March 3, 2020.  Lara discussed Medicaid spending as Governor Cuomo's Medicaid Redesign Team works to find savings in the health care program’s spending.

The Medicaid Redesign Team (MRT II) established by Governor Cuomo in February 2020 opened an online portal for accepting Medicaid redesign proposals from the public.  Members of Medicaid Matters submitted dozens of proposals to the MRT II.  Medicaid Matters compiled the proposals submitted by several Medicaid Matters members, including the Medicaid Matters submission on reconsideration of the Medicaid global cap.

Medicaid Matters joined with other groups to draft a Statement of Principles on Medicaid and the Medicaid Redesign Team.  The statement calls for reconsidering the global cap, rejecting the Governor’s local share proposal, extending the MRT process to be more representative and better equipped to vet proposals, and raise revenue from ultra-wealthy New Yorkers.  Over 150 organizations signed on to the statement.

Despite its own directive to do harm, on March 19th, the Medicaid Redesign Team approved a package of Medicaid cuts that will significantly diminish access to services and supports.  Advocates issued a series of snapshots of people who will be directly impacted by the cuts.

The Protect Medicaid campaign, along with over 130 other organizations, issued a statement on the MRT package.

The final budget included much of what the Medicaid Redesign Team recommended. Advocates responded with a statement.

2019 Policy and Budget Priorities

Through payment and delivery system reform and other initiatives, New York State has made tremendous strides to improve its Medicaid program, while also reigning in spending.  However, these major initiatives have not been without harm to consumers and communities across the state.  State budget projections are uncertain; there are threats at the federal level to dramatically change the Medicaid program as we know it; and a single payer health system may be on the horizon.  New York must stay committed to protecting its Medicaid program, the people it serves and the providers that serve them.

Medicaid Matters New York presents a vision for what New York can achieve in 2019 in the interest of Medicaid consumers through the following policy and budget priorities:

Deliver on the promise of “Care Management for All.” Inherent in the mandatory enrollment of the people previously exempt or excluded from managed care is the promise that care management will improve care and outcomes while restraining Medicaid spending.  The state must do a better job of monitoring the managed care industry to ensure people and their rights are protected in the push to find efficiencies to the program.  MMNY remains most concerned about how the transition to managed care has impacted or will soon impact the most vulnerable New Yorkers, including people with behavioral health needs, children transitioning to new services, and people with intellectual/developmental disabilities transitioning to a managed care model. 

Guarantee home care and personal care for all who need it.  For too long, consumers and their advocates have faced tremendous barriers accessing home care and personal care through Managed Long Term Care.  In addition, the state has proposed changes to MLTC that are antithetical to the Olmstead decision and its own Olmstead plan.  The workforce shortage must be addressed to guarantee people will be able to live independently in their own homes.

Provide insurance coverage for New Yorkers who remain uninsured.  The State should allocate $542 million to create a state-funded Essential Plan for anyone up to 200% of the federal poverty level, for those individuals currently excluded because of their immigration status.  The State should also offer state-funded Medicaid coverage to immigrants who are losing their Temporary Protected Status (TPS) by enacting legislation proposed in 2018 (A10607, Solages/S7569-A, Hamilton).

Encourage CBO engagement in Value Based Payment to help address social determinants of health.  Because we know community-based organizations will be key in reaching the anticipated outcomes of delivery system and payment reform, the State has begun to implement specific requirements in VBP arrangements and has invested in regional planning efforts to encourage CBO collaboration and capacity to engage a value-based system.  These efforts must be continued and enhanced to ensure success and eventually promote health equity in communities across the state.

Protect and fund community-based providers and safety-net facilities that serve low-income, medically-underserved people in communities across the state.  Support for community-based primary care, behavioral health, substance use disorder and family planning providers ensures access to high-quality health care in the community and reduces reliance on more costly forms of care, such as hospital emergency rooms.  The State must provide community-based safety-net providers equitable access to needed capital dollars to expand and sustain their services and ensure they are adequately compensated for the care they provide to all New Yorkers, including the uninsured. 

Preserve and expand consumer assistance programs to ensure they can provide a full range of assistance and advocacy.  In the face of continued changes to the Medicaid program, the state must adequately fund consumer assistance programs to assist people in understanding and upholding their rights under various public programs, including Medicaid, and to advocate for these rights in all venues.  New York State has been a leader in supporting consumer assistance for low-income people and people who rely on Medicaid for their needed services.  However, funding levels are often inadequate.  The State can address this by increasing the state share of LTC Ombudsman Program funding by $3 million, and by committing state-only dollars for fair hearing representation through ICAN or the Community Health Advocates program.

MMNY 2019 Policy & Budget Agenda (PDF download)

MMNY submitted testimony on the 2019-2020 Executive Budget on Health and Medicaid to the Joint Legislative Fiscal Committees.  The testimony is available here.