Press & Sun Bulletin
1/5/12
Cara Matthews
ALBANY — Health care advocates said Thursday that Gov. Andrew Cuomo and lawmakers must move quickly this session — before the new fiscal year starts April 1 — to set up a health care exchange and capitalize on millions of dollars in federal funding.
The Health Care For All New York coalition released two reports Thursday detailing the benefits that have already taken effect under the 2010 Affordable Care Act and personal stories of people who have benefited from the law.
The law requires that all states have health exchanges — marketplaces where individuals and small businesses can buy insurance — operating by Jan. 1, 2014. The federal government will intervene and create exchanges in states that have not set up viable models by Jan. 1, 2013.
A negotiated bill passed the Democratic-led Assembly in 2011 but hit a snag at the last minute when some members of the Senate GOP majority balked at setting up what they call “Obamacare.” Senate leaders said members needed more time to review the proposal and get important questions answered.
Advocates said they are buoyed by the mention of creating the exchange in a book released in conjunction with Cuomo’s State of the State address Wednesday. The governor said legislation to set up an exchange must be passed now. It would cover more than a million New Yorkers, his State of the State policy book said.
“The $1.7 billion that taxpayers currently contribute to offset the cost of providing care to the uninsured will be significantly reduced. The increased federal Medicaid match that recognizes New York’s higher Medicaid eligibility levels will bring an additional $18 billion in funds to the state over 10 years,” the book said.
Nearly 16 percent of New Yorkers under 65 — 2.7 million people — are uninsured. Under an exchange, people who currently pay for individual coverage would see their cost drop by 66 percent, and small businesses would pay 22 percent less, the book said.
The exchange needs to be established as soon as possible, and no later than the April 1 start of the new fiscal year, Sherry Tomasky, legislative campaign director for the American Cancer Society of NY & NJ, said at a news conference Thursday.
The lack of action in 2011 put the state many months behind schedule, she said.
Members of the Health Care For All New York coalition said the legislation has to be more detailed this year. Last year’s bill left a lot of policy questions undecided, most of which are being analyzed by the state now.
“Some of the studying and deciding later is obsolete,” said Elisabeth Benjamin, vice president of health initiatives for the Community Service Society of New York. “The Legislature has to pull the trigger on a bunch of decisions and there’s no time.”
Leslie Moran, senior vice president of the Health Plan Association, said policymakers need to see the results of those studies before making decisions on the health care exchanges. Her group represents managed-care plans.
Senate Health Committee Chairman Kemp Hannon, R-Nassau County, said many questions remain about how a health care exchange would be set up in New York. The largest is how it would be paid for, he said.
Another issue is defining what has to be included as the essential benefit in the health insurance plans offered, a task that has been delegated to the states, he said.
Challenges to Affordable Care Act are making their way through the courts, and the case is expected ultimately to be addressed by the Supreme Court.
Benjamin Lawsky, superintendent of the state Department of Financial Services, said having state officials create a health exchange is a “no-brainer.”
“If we don’t set up a New York health exchange that we have designed and makes sense for the state of New York, we’re going to get a federal one run out of Washington,” Lawsky said.
The Health Care For All New York coalition’s report said millions of New Yorkers have benefited and are eligible to benefit from the federal law. Children can now stay on their parents’ insurance plans until they are 26; 2.6 million people no longer have co-payments or deductibles for preventive care; and there is now a prohibition on lifetime limits for insurance policies.
Between 800,000 and 1.2 million New Yorkers will become insured in 2014, said Bob Cohen, policy director of the Public Policy and Education Fund of New York, the education arm of Citizen Action New York.
The second report includes personal stories of families, small businesses, senior citizens and students who have benefited under the Affordable Care Act.
Pat Curry-Wilson of Binghamton, a retired nurse practitioner, hit the Medicare prescription drug coverage cap in the fall of 2010 and had to pay $300 out of her own pocket for medicines. She received a $250 rebate check from the federal government in February.
“That eased the burden, you’re darned right,” she says in the report.
