Part and parcel of our budget advocacy on public health and health care is the simultaneous imperative to push for what will make our priorities a reality: actual dollar allocations. Doing so will require the State Legislature to turn away from Gov. Cuomo’s long-held insistence on cut-and-starve austerity politics. Now is their chance (and time!) to challenge him, and to lead our state in a new and different direction so that we can turn the corner on the pandemic and economic recession.

Unleashing Medicaid

Medicaid is currently the bedrock of our state’s health systems. It is simultaneously an insurance coverage program for over a third of our state’s residents, the financial foundation of our hospitals and health care safety net, and a vital public health program that helps to protect all of us. Unfortunately, for the past decade our state leaders have imposed an arbitrary global growth cap on Medicaid, regardless of any change in circumstances, enrollment growth, and demand for services. In effect, this policy has turned our Medicaid program into a de-facto block grant, something our state’s leaders have always vehemently (and correctly!) opposed when proposed at the federal level.

Over the past year, because of the pandemic and recession our Medicaid program has grown substantially and is now bursting at the seams. It’s trying to do what it’s supposed to do yet is severely hampered by the global cap mechanism. It’s time to turn away from austerity measures and scrap the cap. We must let Medicaid be Medicaid, and that will require substantial additional financial resources.

Raising the Money

The new “Invest in Our New York” campaign, of which we are a member, is promoting a package of six bills to make sure that there’s adequate state funding available to respond to a host of urgent needs that everyday New Yorkers have because of the ongoing COVID-19 pandemic and economic recession. Chief among these needs is a) restoration of a robust public health system that has been severely diminished over the past two decades, and b) strengthening and expanding of our health care safety net and public insurance programs. Both of these urgent priorities will require significant new funding from state coffers, regardless of what may come down from the federal government in the next pandemic relief bill now moving through Congress.

The Invest in Our New York Act is a package of six bills that will raise substantial new revenue by rolling back various special state tax breaks that have been given to large corporations and the ultra-wealthy over recent decades, so that they pay their fair share along with the rest of us. These new funds will be used to a) help out everyday people in this moment of crisis, and b) restore funding to state agencies and programs that have been starved for resources over the past decade. (Click here to learn more about the six bills, and then scroll down.)

The Invest in Our New York Act will restore progressivity to our state’s tax system by a) slightly raising what very rich people pay in wage and investment income taxes, and what large corporations pay on their profits, b) slightly raising taxes on large inheritances, c) slightly taxing overall personal wealth growth, and d) restoring a tiny sales tax on stock trades and other financial transactions that the state used to collect. Taken all together, estimates are that these bills could raise as much as $50 billion. Just imagine what we could do for public health and health care with just a portion of that!

Click here to get more involved in the Invest in Our New York campaign in various ways.

What YOU can do:

As you undertake your advocacy on health care issues, we urge you to also call for our state leaders to raise new revenues by ending special tax breaks given to those who already have the most income and wealth, so as to a) help the millions of everyday New Yorkers who desperately need help right now, and b) reverse a decade or more of austerity politics and foster broad prosperity instead. The Invest in Our New York Act offers a template, and there are also other legislative proposals from other quarters that put forth ideas in a similar vein. We need our state leaders to not just talk the talk (which many do robustly) but to also walk the walk, and get it done.

Each year, March is budget month for our state government in Albany. In addition, this year is unique because one year ago today the first COVID-19 case was announced in New York. Since then, over 1.6 million New Yorkers have been infected, including 725,000 in New York City, and over 47,000 state residents have died with over 29,000 in New York City.

Over the next few weeks, Governor Cuomo and the State Legislature will be negotiating out a spending and tax plan for our next fiscal year that begins on April 1st. Now is time to contact them to speak up for what New Yorkers need to a) improve our public health,  and b) expand access to health care. Both are matters that are so very important given the COVID-19 pandemic we are all coping with.

The state budget process begins in mid-January when the Governor releases his own proposals. Then the State Legislature holds a round of topic-specific public hearings on them ending by late February, and the Governor releases any 30-day amendments. During the first half of March, each chamber of the Legislature crafts and passes their own “one-house” budget packages, working off the Governor’s proposals. It is here that they support some of his proposals, reject others, and add new ideas of their own. Stakeholders –including advocates– pay a lot of attention at this time and work to get their own priorities included in them. Finally, during the latter part of the month, the Governor and legislative leaders hammer out an agreement based on what each has put forward.

Based on the analyses of various consumer and patient health advocacy groups, here’s what we are recommending to the Legislature about Gov. Cuomo’s proposals:

What the State Legislature should support:

• Getting rid of all premiums for medical coverage for people enrolled in the state’s “Essential Plan” (a special insurance program for low-income people and families who don’t qualify for Medicaid, up to about $1,100/mo. for an individual.)
• Increasing funds to consumer assistance programs run by non-profits that provide ombuds services to patients with using health insurance, getting access to health care, and resolving billing problems.
• Lowering the interest rates that hospitals can charge patients for overdue bills from (currently allowed) 9% to the federal Treasury rate (currently about 1.5%.)

What the State Legislature should reject:

• Continuing the Medicaid global cap for two more years.
• Denial of any indigent care pool funds to public hospital systems across the state (including in NYC, Westchester, Nassau, Erie, and SUNY systems in Suffolk, Brooklyn, and Syracuse.)
• Across-the-board Medicaid rate cuts to hospitals designated as “enhanced safety net providers” who treat large numbers of Medicaid and uninsured patients.
• “Article 6” basic public health funding cuts to New York City.
• Funding cuts to the “Vital Access Provider Assurance Program” which helps hospitals that are financially unstable.

What the State Legislature should add:

• Getting rid of any separate Essential Plan premiums for dental and vision coverage.
• Expanding the Essential Plan to cover all low-income immigrants, especially for those ongoing COVID-19 treatment outside of the hospital.
• More funding for community-based health insurance enrollment programs to help people who are uninsured because of the pandemic recession.
• More funding for the state’s Long-Term Care Ombuds Program that helps nursing home residents and their family members.
• Higher wages for workers who provide home and community-based long-term care services, and more funding for programs to recruit and train them.
• Replacement funds to community health centers who are inadvertently losing access to federal “340B Drug Pricing Program” subsidies because of recent changes to New York’s Medicaid Managed Care program.
• Repeal eligibility restrictions imposed last year for home and community-based services for people with moderate levels of disability. (They have not yet been implemented because of federal restrictions related to special Medicaid pandemic funding to states.)

What YOU can do:

• Contact Gov. Cuomo and your own State Senator and Assemblymember to express your opinions on any of the above ideas. Write, call, email, and reach to them via social media.
• Use your own social media accounts to let others know about what’s going on and how any of the above issues may be affecting you, your family, and/or your community.
• Keep up to date by following the activities and statements of Health Care for All New York and Medicaid Matters New York via their websites and social media accounts.
• Keep in touch with us by checking in regularly with our website and Facebook page.

PS — What about the New York Health Act?

This bill to create a fully-public universal health care program covering all New Yorkers is not on the table in this year’s state budget process. However, it will become an active priority for supporters during the second half of this year’s legislative session once the budget process is over. People can keep up to date with all that via the Campaign for New York Health.