Only two weeks and six session days left to go! That’s it for getting some good health care stuff done before the New York State Legislature adjourns for this year in early June. Here’s one more set of bills being put forward with regard to reproductive health care rights.

Earlier this month, a draft opinion in the Dobbs v. Jackson Women’s Health Organization case now before the US Supreme Court was leaked to the media. Its content signaled that the Court is poised to negate a constitutional right to abortion affirmed in their 1973 Roe v. Wade ruling. A final, official decision is due out by the end of next month.  

Since this leak, some state governments –including New York– are moving to enact laws to protect this and other rights that are threatened by the language of the draft. The good news is that three years ago, New York codified the rights affirmed by Roe v. Wade into state law.  
However, there’s more that can be done, and here’s what’s emerging in the State Legislature:

Equality Amendment (S.9707, Krueger) — An amendment to Article 1 of the State Constitution to a) assure that that equal rights may not be denied on account of race, color, ethnicity, national origin, disability, and sex including pregnancy and pregnancy outcomes, sexual orientation, gender identity, and gender expression, b) bar discrimination in both intent and impact by government entities, as well as barring discrimination in both intent and impact by entities in the provision of public accommodations, employment, or personnel practices, and c) protect the validity of efforts to prevent or dismantle structural forms of inequality and discrimination on the basis of a protected characteristic.

Reproductive Freedom and Equity Fund Act (S.9078/A.10148, Cleare/Gonzalez-Rojas) —  A bill to create a grant program to ensure access to abortion care in the state by providing funding to abortion providers and non-profit organizations whose primary function is to facilitate access to abortion care, particularly for those traveling from another state.

Freedom from Interference with Reproductive and Endocrine Health Advocacy and Travel Exercise (“FIRE HATE”) Act (S.9039/A.10094, Biaggi/Burdick) – This bill establishes a cause of action for unlawful interference with protected rights, to protect the rights of individuals seeking abortion care or gender-affirming care in New York.

Protection for Abortion Providers (S.9070A/A.9678A, Kaplan/Rosenthal) – A bill to Prohibit professional misconduct charges against health care practitioners on the basis that such health care practitioner, acting within their scope of practice, performed, recommended or provided reproductive health care services for a patient who resides in a state wherein such reproductive health services are illegal.

Role of New York Law Enforcement (S.8778/A.9615, Krueger/Lavine) – A bill to prohibit law enforcement from cooperating with out-of-state investigations related to the provision of lawful abortions.

Role of New York Courts (S.8779/A.9613, Krueger/Lavine) — A bill to prohibit New York courts and county clerks from issuing subpoenas in connection with out-of-state abortion proceedings.

It’s possible that several of these bills will be combined into a package to be considered as a whole. The legislative process with regard to them is fluid, so we urge people to be in contact with local reproductive rights advocacy groups to stay informed about developments and advocacy efforts.

Only six session days left to go! That’s it for getting some good health care stuff done before the New York State Legislature adjourns for this year in early June. Here’s one more set of bills being put forward to help more (if not all) New Yorkers get guaranteed health care:

Bills to Expand Insurance Coverage:

Continuous Medicaid for Infants and Toddlers (S.8438/A.9294, Rivera/Gottfried) – This bill will automatically extend Medicaid coverage to all eligible young children through the first three years of life. Currently, such coverage ends after only one year, at which point their family must either recertify for Medicaid or shift to another form of insurance coverage. Research shows that the first 1,000 days of a child’s life are very important to their physical, mental, social, and emotional development, and having health coverage in place during that period significantly advances those goals. In the Senate, this bill has passed through the Health Committee and is now before the Finance Committee. In the Assembly, It has passed through the Health Committee and is now before the Ways and Means Committee.

Universal Health Care (New York Health Act, S.1572A/A.880A, Rivera/Gottfried) – This bill will create a publicly-funded, publicly-administered health insurance program covering all New York residents and workers. It is similar to Medicare-for-All bills in Congress. The bill is currently in Health Committee in the Senate, and has passed through both the Health and Codes Committees in the Assembly and is now is in the Ways and Means Committee.

The campaign in support of the first bill above is being jointly led by our colleagues in Medicaid and various child health and welfare advocacy groups. The Campaign for New York Health is leading advocacy efforts to advance the New York Health Act, and we sit on its Steering Committee.

At this point in the legislative process, for either of these bills to move to the floor in either chamber for a debate and vote, each chamber’s Rules Committee will have to call up the bill directly. Whether or not they do so is based on the wishes of the leadership and/or strong support within the majority party’s conference membership. Again, we urge you to contact your own legislators about them. Strong public support is necessary at this point.

It’s now just seven session days to go! That’s it for getting some good health care stuff done before the New York State Legislature adjourns for this year in early June. Here’s another set of bills poised to move ahead to passage:

Improving Hospital and Community Relations

For more than two decades under several governors, scores of hospitals across New York State have been allowed and urged to merge, downsize, or outright close as new large hospital systems have been created as part of regional restructuring to improve financial stability of individual facilities systems as these networks seek to expand market share.  As a result, local communities have had their health care system destabilized, and they are left with fewer services or none at all.  The current COVID-19 pandemic has revealed the drawbacks of consolidations and closures for all to see.  Again, a universal health care program with proper health planning would have prevented various adverse outcomes, and made sure that communities have access to the services they need, particularly during a public health crisis.

Absent that however, there are some steps that New York lawmakers are taking to begin to reassert a proper role for communities in what happens to their hospitals as our health care system consolidates. These bills include:

Local Input for Community Healthcare Act (S.3131A/A.2251A, Kavanaugh/Simon) – As crazy as it seems, under current New York law, when a hospital closes or dramatically downsizes core services, no government approval or advance notice is required, and a public hearing in the affected community is only required within 30 days AFTER it happens! This bill flips the dynamic around so that:

• Closure of facilities or key services must be announced in advance.
• The State Dept. of Health plays an active role in approving, overseeing, and managing a closure.
• The local affected community has meaningful opportunities for input into the process overseen by the State.

This bill also applies to closures of maternity units and emergency departments, as well as a full-out shut down. This bill has already passed through the Assembly, and has passed through all relevant committees in the Senate and is ready for a floor vote.

Improved Transparency of Available Services (S.5400/A.6334, Hinchey/Rozic) – Often when patients are seeking personally-sensitive services from hospital systems such as reproductive health care, end-of-life care, or gender-affirming care, they suddenly discover that it may not be available from their local facility because of non-medical, policy-based exclusions made by the facility’s operators. This bill helps patients navigate such situations by:

• Requiring hospitals to publish what services they choose to exclude.
• Requiring hospitals to comply with existing state and federal law as to what services they provide. in a manner that is non-discriminatory against particular classes of patients.
• Requiring insurers to make such information available about their provider networks prior to someone enrolling in one of their health plans.
• Requiring the State to research and publish a report on the statewide scope of this problem by facility and hospital network.

We urge you to contact your State Legislators to express your opinions about either of the above bills if you support them, since the clock is ticking.

A few years ago, Community Catalyst, a Boston-based health policy organization that works with state-based health advocacy coalitions, helped to form the Community Voices for Health System Accountability project here in New York, in partnership with Health Care for All New York and Medicaid Matters New York. Its purpose is to foster a better, more meaningful role for community residents, leaders, and advocates with regard to their local hospitals and health care facilities, and to strengthen New York’s oversight of these institutions. We have participated in this project since then.

Eight legislative session days to go! That’s it for getting some good health care stuff done before New York State lawmakers adjourn for this year in early June. Here’s one set of bills poised to move ahead to passage:

#EndPatientMedicalDebt:

In recent years, medical debt that simply cannot be paid off by patients has emerged as one of the top concerns for health care consumers, and politicians nationwide are starting to sit up and take notice. Of course, comprehensive solutions (such as universal health care!) are needed to fully resolve the problem, but unfortunately that approach will take more time to develop a head of political steam both in Congress and the State Legislature. In the meantime, there are some steps New York lawmakers are taking to help alleviate the crisis:

Ending Wage Garnishments and Liens on Primary Homes (S.6522/A.7363, Rivera/Gottfried) – All hospitals in New York are legally non-profit charities, yet a small handful of large, well-resourced hospital networks can and do sue patients for outstanding debt, despite the fact that the State provides hospitals with a total of more than $1 billion/year to compensate for indigent care. When a hospital successfully sues a patient, as part of the judgement they can ask the Court to place liens on property and garnish workers’ wages, a practice advocates consider cruel and counterproductive. This bill would prohibit such practices. The good news is that it has passed through both chambers and will soon be sent on to Governor Hochul for her consideration to sign or veto.

Regulating “Facility Fees” (S.2521A/A.3470B, Rivera/Gottfried) – These new charges are something that many hospitals and medical practices are now tacking onto patients’ bills as a “resort charge” for just walking in the door seeking care. (Yet another way to pad their bottom line by sticking it to patients.) Sometimes these fees can be quite substantial depending on the overall amount of a bill. This legislation would a) prevent health care providers from charging these fees for preventive care, and b) require them to notify patients in advance when one is to be charged so that it doesn’t come as a surprise later on. The bill has advanced out of all relevant Committees in both chambers, and is ready for a floor vote.

Modernizing and Standardizing Hospital Financial Assistance Programs (S.7625/A.8441, Rivera/Gottfried) – All hospitals in New York are required by law to offer financial assistance programs to lower-income patients in the form of discount prices for in-patient services, and installment plans to pay down bills over time. However, there is little uniformity in learning about and applying for them, so many patients who could qualify never sign-up and get stuck with sky-high bills instead. This legislation would a) make the financial assistance process transparent and uniform across all facilities, b) streamline the application process without requiring lots of red tape and paperwork, and c) raise the income eligibility level to conform with those of the federal Affordable Care Act. This bill has passed out of all relevant committees in the Senate and is ready for a floor vote, and is now before the Ways and Means Committee in the Assembly after having passed out of the Health Committee.

We urge you to contact your state legislators about these bills since the clock is ticking.

With funding from the New York State Health Foundation, Health Care for All New York, a statewide coalition we help to lead, has been spearheading this multi-year campaign on patient medical debt, and we are proud to be part of the core team for it. In recent years, our campaign has passed bills to:

• Lower the annual interest rate hospitals can charge (if they choose) on outstanding bills to from 9% to 2%.
• Lower the statute of limitation for lawsuits from 6 to 2 years.
• Expand New York’s Surprise Medical Bills Law to cover all emergency room services at in-network rates.

The New York State budget process has spilled over into this week (past its April 1^st deadline), and is due to wrap-up in the next couple of days. There are still some key health care issues on the table that need one final push, and we urge everyone to contact lawmakers about them.

Here are the outstanding health care issues advocates are supporting:

• Public health insurance eligibility for ALL low-income New Yorkers regardless of immigration status (“Coverage for All”)
• A living wage for health care workers who provide home and community-based long-term care (“Fair Pay for Home Care”)
• Standardizing Medicaid eligibility criteria so that low-income people on Medicare qualify for Medicaid just like everybody else (“Medicare-Medicaid Equality”)
• Fair distribution of Indigent Care Pool funds to only those hospitals deemed “Enhanced Safety Net Providers”, as required by federal law.
• Higher Medicaid rates for health care providers to restore cuts from previous years and provide a long-delayed raise in general.

Here’s how to contact key State leaders to express your opinion on one or more of the above:

• Governor Kathy Hochul: 518-474-8390
• Senate Majority Leader Andrea Stewart-Cousins: 518-455-2585
• Assembly Speaker Carl Heastie: 518-455-3791

Some background on the State-of-Play:

Coverage for All – At the very last minute, Governor Hochul and her Division of the Budget have suddenly asserted that the cost of this provision is much higher than a reputable independent study from the Citizen’s Budget Commission and the Community Service Society of New York, yet she has provided no documentation to back up the claim. Unfortunately, many Albany observers note that Governor Hochul is not supportive of including all immigrants in various proposals to help lower-income people.

Fair Pay for Home Care – Governor Hochul and her Division of the Budget originally proposed that home care workers be provided with one-shot bonuses to attract and retain them as part of the long-term care workforce. The Legislature prefers instead to provide these workers with a permanent pay raise. New York’s current home care workforce is woefully inadequate, to the point where thousands of frail and disabled New Yorkers have been approved for such services but there is literally no one ready to provide the care because the salaries are too low to draw and keep people in the profession.

Medicare-Medicaid Equality – Over the past decade, all of New York’s public health insurance programs have significantly raised their income eligibility levels and eliminated asset tests as part of their applications. However, the State has yet to do either for low-income people on Medicare who need Medicaid to augment the services Medicare does not cover (vision, dental, hearing, and long-term care) that everybody else on Medicaid routinely receives.

Governor Hochul initially proposed that the State standardize Medicaid eligibility criteria for all low-income people across the board, and the Legislature agreed. However, suddenly the Elder Law attorney lobby has flexed its political muscle to sew doubt with Governor Hochul and some legislators about eliminating an asset test. One of the major lines of business of these lawyers has been to assist middle and upper-income people on Medicare to restructure their finances so that they can then qualify for Medicaid coverage while also sheltering their assets. However, most low-income people on Medicare cannot afford these legal services. and they are denied Medicaid eligibility until they spend-down any modest assets they may have, thereby forcing themselves into poverty first.

Safety Net Hospital Support — For many years now, almost all hospitals across New York have received funding from the State’s billion dollar Indigent Care Pool that reimburses hospitals for services provided to uninsured and Medicaid patients. However, federal law requires that federal funds received for that pool must only go to those hospitals that provide care to large numbers of these patients. These hospitals are collectively known as Safety Net Providers. Unfortunately, New York has yet to update its distribution formula because of resistance from politically-influential hospital systems that would likely lose this funding. Neither Governor Hochul nor the Legislature have put this idea on the table in this year’s budget process.

Higher Medicaid Rates for Providers – Generally speaking, while nothing is locked down in the budget negotiations until everything is locked down, Gov. Hochul’s proposals on this issue seem on solid ground and the Legislature is in full support. So barring anything unusual happening at the last minute, they seem likely to be included. In addition, the health care provider community is strongly in support and they are usually very influential on health care issues in Albany.

Some larger factors at play:

• At the very last minute, after the public hearings were over and the Legislature’s one-house budget bills were passed, Gov. Hochul suddenly proposed a $600 million subsidy for a new football stadium in Buffalo, and also demanded major criminal justice reforms that technically have nothing to do with the budget per se. Both these ideas have fostered confusion and division in the Legislature.
• Advocates are demanding increased transparency, accountability, and justification for the State’s various regional economic development projects that over the years have generally utterly failed to meet their objectives, and they were often just shoveling billions of dollars to politically-connected businesses and institutions. This funding can be put to much better use to grow our state’s economy by increasing spending on long-underfunded health and social programs that help everyday New Yorkers.
• While the State currently projects a revenue surplus for the new fiscal year (estimates range from $6 to $10 billion), Gov. Hochul want to take a significant portion of that and put it in the State’s “rainy-day” reserve fund. However, many health and human service advocates are saying that “it’s raining now” for many lower-income everyday New Yorkers, particularly in the wake of the COVID-19 pandemic and its accompanying economic recession that many communities have yet to emerge from.

One of the most exciting proposals on the table during the current state budget negotiations in Albany is “Coverage for All.”  It will open up New York’s special public insurance “Essential Plan” to all low-income New Yorkers regardless of their immigration status. This is nothing radical since we have long covered all children and adolescents in low-income families through Child Health Plus, and pregnant and post-partum women through Medicaid. If we’ve learned nothing from living through two years of pandemic, it’s crucial to make sure everyone is enrolled in health insurance in order to promote good public health.

As we head into the final week of budget negotiations, NOW is the time for ALL OF US to call our Governor Hochul and state legislators to make sure Coverage for All gets included in their final agreement.  The good news is that there’s strong support for it in both the State Senate and Assembly. However, so far Governor Hochul is not yet on board, so the Legislature must stand strong and fight for it.

We urge everyone to contact state lawmakers on this issue, by phone, email, and social media:

• Governor Hochul – 518-474-8390 (phone); online email form here; @GovKathyHochul (Twitter & Instagram); Facebook page here
• New York State Senators – Find contact info by Senator here
• New York State Assemblymembers – Find contact info by Assemblymember here

• Simple message to Governor Hochul: “Accept the Legislature’s Coverage for All proposal in the final budget deal.”
• Simple message to Legislators:  “Keep fighting for Coverage for All in the final budget deal.”

Several years ago, the Coverage for All campaign was established by Health Care for All New York to develop and push for proposals to provide health insurance to all immigrant New Yorkers, many of whom can have few public or private coverage options. We’re proud to be on its leadership team that is being led by the New York Immigration Coalition and Make the Road New York, and includes around 160 organizations. You can learn all about this campaign here.

About 1 million New Yorkers remain uninsured. Over 400,000 of them are immigrants who don’t qualify for public insurance programs or federal subsidies to purchase private coverage. Approximately 245,000 of them could become eligible for our Essential Plan if our state steps forward to do the right thing in this year’s budget. Other states like California and Illinois are already providing coverage to more immigrants, so it’s time for New York to join that esteemed club.