New Report Calls for a Pro-Consumer Health System That Protects New York Consumers from Health Insurer Abuses

by | Jan 20, 2011 | Press Releases

Citizen Action Blasts New York Congressional Representatives Who Voted With Health Insurers to Repeal Federal Health Reform

Albany, NY – Citizen Action of New York, which led the fight for passage of federal health reform in New York State, released today a major new report which establishes a roadmap for state implementation to build a “pro-consumer” health system in the state. The recommendations in the report will protect consumers from the well-publicized health insurer abuses that led to passage of the federal health care reform law.  Citizen Action also blasted the 8 New York Republican House members, including Capital District Congressman Chris Gibson (R-20), who yesterday voted to repeal the federal health care law that was signed by the President in March.

“What the Governor and Legislature do in 2011 will determine whether the new federal health care law meets its promise of holding health insurers accountable and providing New Yorkers with quality, affordable health care coverage,” said Karen Scharff, Citizen Action Executive Director. “This year, in his first year as Governor, Andrew Cuomo has the opportunity to achieve the passage of legislation that will serve as a national model for a pro-consumer health care system – a system that protects consumers against the well-known insurer abuses that led to the new health care reform law, including the denial of coverage for medically necessary care and the wrongful dropping of coverage. We need a pro-consumer health system in New York, and that means aggressive enforcement, strong consumer assistance, clear consumer information, affordable rates, and reducing health care disparities based on race and ethnicity.”

“The new federal health care law was a response to a health care system that consistently put profits over people,” added Scharff. “Governor Cuomo and the Legislature have to reverse the equation in 2011 and put health care consumers before health insurer profits.”

The new report: A new Pro-Consumer Health Care System: Enforcing the New Federal Health Care Law in New York State, was written by the Public Policy and Education Fund of New York (PPEF). The report makes numerous recommendations for the state implementation of the new federal law in New York State. The recommendations cover five major areas: 1) consumer-oriented governance; 2) consumer assistance; 3) affordable health insurance rates; 4) consumer rights; and 5) reduction of racial and ethnic disparities in health care. Among the report’s major recommendations are:

  • strong consumer representation on the governing board of the New York exchange, the health insurance “marketplace” that must be created by the state by 2014;
  • aggressive consumer enforcement through a significant increase in penalties that may be recovered by the State Insurance Department against health insurers that violate the new federal law, a state exhange that can exclude health plans that sell lower quality products, and a strong role in enforcement by new Attorney General Eric Schneiderman;
  • a permanent independent consumer assistance office to coordinate community-based organizations across the state to assist consumers with disputes with health insurers, enroll consumers in health insurance, and help consumers select health insurance plans;
  • reform of the health insurance rate regulation system that was reinstituted in New York in 2010 to allow consumers to meaningfully participate in rate proceedings;
  • expansion of consumer rights by allowing consumers harmed by serious violations of health insurance laws to recover their damages in court (known as a “private right of action”); and
  • reduction of health care disparities based on race, ethnicity and other factors by designating a single state entity to oversee collection of disparities data and to make this information available to the public at no charge through the Internet.

The full PPEF report is available at: http://ppefny.org/hcreport2011.

The U.S. House of Representatives voted yesterday 245 to 189 to repeal the federal health care law, called the Patient Protection and Affordable Care Act (PPACA). The New York Congressional delegation voted along party lines, with all Republicans voting for repeal and all Democrats voting against repeal. The vote yesterday was totally symbolic, since Senate Democratic Majority Leader Harry Reid has already said the Senate is not taking up health care reform (where it would fail anyway due to a Democratic majority), and President Obama has said he would veto any repeal legislation.

“With a national unemployment rate still over 9%, Chris Gibson should be working in his first month in office on creating jobs in New York rather than paying back the health insurance companies and other big corporations that funded his campaign,” said Chris Scoville, a Capital District organizer for Citizen Action.  “It is simply beyond me why Chris Gibson would vote to repeal a law that would stop insurance companies from denying coverage to thousands of New Yorkers, give more people health insurance coverage, and provide tax credits for numerous New York small business owners who want to provide health coverage for themselves and their employees.”

“The federal health care law left much of the responsibility for implementation to the states,” said Bob Cohen, Esq., Policy Director of the Public Policy and Education Fund, and the report author. “In order to ensure that consumers have adequate protections against the outrageous practices that led Congress to pass health reform last year, we need Governor Cuomo and the State Legislature to establish a strong system this year to strengthen the regulation of health insurers in New York, including a pro-active health insurance exchange with strong consumer representation.”

Citizen Action of New York (https://citizenactionny.org) is a membership organization that advocates for social, racial, economic and environmental justice. Citizen Action and its education and research arm, PPEF both are leaders of Health Care for All New York, a large consumer-focused health care coalition, which has issued standards for the health insurance exchange that must be established in the state under the new federal law.

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