Looking Back at 2014

As we close out 2014, we look back with pride to all of work of this past year and the role we played in fostering community-labor collaboration in the struggle for health care justice in New York, and comprehensive, quality, affordable health care for all New Yorkers.

clapping hands

First, we want to thank all those who supported us financially in 2014 – your donations made it ALL possible!

The following groups and individuals joined our “2014 Health Care for All Team” as part of our Annual Dues Campaign in the spring:

go team

Alliance for a Greater New York
Associated Musicians of Greater New York, Local 802, AFM
Children’s Defense Fund of New York
Citizen Action of New York
Committee of Interns and Residents, SEIU Healthcare
Communications Workers of America, Local 1180
Commission on the Public’s Health System in New York City
Community Health Care Association of New York State
Community Service Society of New York
DC 37 Retirees Association
District Council 37, AFSCME
Doctors’ Council, SEIU
Federation of Protestant Welfare Agencies
Gay Men’s Health Crisis
Goddard-Riverside Community Center
Greater NYC for Change
Healthcare Education Project (1199SEIU-GNYHA)
International Association of Stage and Theatrical Employees, Local 1
International Association of Stage and Theatrical Employees, Local 600
Long Island Coalition for a National Health Program
Make the Road New York
Medicare Rights Center
Municipal Hospital Employees, Local 420, DC 37 AFSCME
National Association of Social Workers, NYC Chapter
New York Immigration Coalition
New York State AFL-CIO
New York State Nurses Association
New York Statewide Senior Action Council
Open Door Family Medical Centers
Organization of Staff Analysts
Physicians for a National Health Program, New York Metro Chapter
Planned Parenthood of New York City
Professional Staff Congress, CUNY
Public Health Solutions
1199 SEIU United Healthcare Workers East
United Auto Workers, Region 9A
United Federation of Teachers

Robert Ambaras
Harold Allen
Ellis Arnstein, MD
Richard Bergman
Carmelita Blake, PhD
Francine Brewer
Anne and Sid Emerman
Shaurain Farber
Pat Fry
Nadia Jakoubek
Robert Lerner, MD
Jose Matta
Cheryl Merzel, MD
Terry Mizrahi
Ethel Paley
Ralph Palladino
Martin Petroff, JD
Alex Pruchnicki, MD
Adele Rogers
Clara Reiss
Mark Scherzer
Robert Spencer
Lois Steinberg
Myron and Janet Sussin
Marc Tallent, MD

We also want to thank all those groups and individuals who supported our 2014 Annual Gala Benefit on November 17:

20th Anniversary Champagne Toast

ACS Cancer Action Network
Alliance for a Greater NY
Assemblymember Richard Gottfried
Berlin Rosen
Business and Labor Coalition of New York
Center for Independence of the Disabled in New York
Children’s Defense Fund
Citizen Action of New York
Commission on the Public’s Health System
Committee of Interns and Residents, SEIU Healthcare
Communications Workers of America, Local 1180
Community Health Care Association of New York
Community Healthcare Network
Community Service Society
District Council 37 Retirees Association
Doctors’ Council, SEIU Healthcare
Federation of Protestant Welfare Agencies
Gay Men’s Health Crisis
Greater NY Hospital Association
Greater NY Laborer-Employers Cooperative & Education Trust
GuildNet/Lighthouse Guild
Healthcare Education Project (GNYHA-1199SEIU)
Hudson Health Plan, Hudson Center for Health Equity
Institute for Puerto Rican and Hispanic Elderly
Left Labor Project
Local 802, American Federation of Musicians
Make the Road New York
Municipal Hospital Workers, Local 420, DC 37
National Association of Social Workers, NYC Chapter
New York City Americans for Democratic Action
New York City Central Labor Council
New York Committee for Occupational Safety and Health
New York Immigration Coalition
New York Professional Nurses Union
New York State AFL-CIO
New York State Nurses Association
New York Therapeutic Riding Center
New Yorkers for Fiscal Fairness
Open Door Family Medical Center
Organization of Staff Analysts
Physicians for a National Health Program, NY Metro Chapter
Planned Parenthood of New York City
Primary Care Development Corporation
Professional Staff Congress, CUNY
Raising Women’s Voices – New York
Sarah Lawrence College, Health Advocacy Program
SEIU Healthcare
Senator Liz Krueger
Systonic Systems
TWU Local 100
United Auto Workers, Region 9A
United Federation of Teachers
1199 SEIU United Healthcare Workers East
United University Professionals

Robert Ambaras
Carmelita Blake
Anne Bove
Rachel Burd
Jim Collins
Moira Dolan
Barbara Edmonds
Alice and Jon Fisher
Shiela Geist
Marcia Hunte
Feygele Jacobs
William Jordan, MD
Pauline Kuyler, MD
Stanley Lave
Lou Levitt
Robert Lichterman
Jose Matta
Merle McEldowney
Terry Mizrahi
Susan Moscou and Dan O’Connell, MD
Steve Oliver
Ralph Palladino
Kate Pfordresher
Marcia Poston
Alec Pruchnicki, MD
Heather Roberson
Constancia Romilly
Margery Schab
Mark Scherzer
Margaret Segall
Sarah Sheffield
Jerry Shroder
Joel Shufro
Sid and Sandy Socolar
Diane Stein
Peter Steinglass, MD
Merry Tucker

We also want to thank the following funders for supporting our work in 2014:

  • ACA Implementation Fund (received via the Community Service Society)
  • New York State Health Foundation (received via the American Cancer Society)
  • Robert Wood Johnson Foundation (received via the Community Service Society)

Here’s just a sampling of how we put everyone’s financial support to work this past year:

working together sign

January:  Metro joins with Health Care for All New York leaders to visit the Capitol Hill offices of New York Congressmembers to inform them about the benefits of the Affordable Care Act (ACA) for New Yorkers, and the need for continued funding for the state’s ACA-authorized consumer assistance program which helps people solve their health insurance problems.

February:  Metro speaks at Labor Press’ “Union Health Care Summit” which assesses the impacts of the Affordable Care Act on trade unions and needed improvements.

March:  Metro and our allies in Health Care for All New York partner with the Dept. of Financial Services to successfully urge the Legislature to enact a landmark law to expand consumer rights and protections when they incur “surprise medical bills”.

April:  Metro and our partners in the Get Covered New York project wind up a 6-month effort that located and referred approximately 4,000 uninsured New York City residents to enrollers for the new Affordable Care Act plans.

May:  Metro and our partners in the People’s Budget Coalition for Public Health launch the “Access Health NYC” campaign to urge city officials to fund grassroots community outreach and education about how the uninsured can enroll in coverage, use that coverage, and access needed services.

June:  Metro and our partners in New Yorkers for Accessible Health Coverage undertake a legislative advocacy campaign to take on insurers and restore consumer choice in pharmacy access.

Aug.:  Metro and our partners in No Bad Grand Bargain and the New York State Alliance for Retired Americans hold a Social Security birthday party outside the New York City Regional Office of the Social Security Administration (SSA), in conjunction with Local 3369 of the American Federation of Government Employees, calling attention to harmful cutbacks in staff and in-person services, and closures of 7 local SSA offices across NYC since 2011.

Sept.:  Metro and Health Care for All New York partner with the Healthcare Education Project to convene seven well-attended Regional Outreach and Enrollment Summits across the state, including in Queens, Manhattan, the Hudson Valley, and on Long Island.

Oct.:  Metro facilitates planning session on “Community Benefits” at the annual meeting of the National Physicians Alliance, held in Yonkers.

Nov.:  Metro producing radio and cable TV programming on Medicare Open Enrollment for 2015 featuring experts from the Medicare Rights Center, to help people understand their options and choices, including a lively listener call-in on WBAI-FM.

Dec.:  Metro and our allies launch the Campaign for New York Health, to promote state legislation for a truly universal health care program in our state, and turn out hundreds at five public hearings across the state, including New York City.


…and we look forward to continuing our work with everyone in 2015.  Thanks again!

Campaign for New York Health Prepares for Assembly Hearing in NYC on Universal Health Care

On Tuesday December 16, the New York State Assembly Health Committee is holding a hearing in New York on the “New York Health Act” (A.5389-A/S.2078-A) to create a fully-public, truly-universal health care program in New York.  The Act is sponsored in the Assembly by Health Committee chair Richard Gottfried, who represents the west side of Manhattan, and in the State Senate by Sen. Bill Perkins, who represents Harlem.  The hearing will start at 10 a.m. and be held at New York University’s Global Center for Spiritual and Academic Life, 238 Thompson St., 5th fl. Grand Hall, in Greenwich Village.  People can sign-up to testify at this hearing or submit written testimony here.  Oral testimony will be limited to 5 minutes, and people with longer statements are urged to summarize their main points.


The NYC hearing is part of a series of hearings being held by the Assembly Health Committee across the state.  Hearings have already been held in Syracuse on Dec. 4, in Rochester on Dec. 8, and in Buffalo on Dec. 10.  Future hearings after the one in New York City will be held on Long Island (Mineola) on Dec. 17, and in Albany on Jan. 13.

The Campaign for New York Health (CNYH), a multi-constituency coalition promoting the legislation, is advancing participation in these hearings, and holds press conferences in each city prior to the start of the hearing that feature the bill sponsors and other supportive public officials, doctors and nurses, labor leaders, patients with personal stories, health care activists, and local faith and community leaders, among others.  These press events have been garnering much local coverage in local and statewide media.  The press conference prior to the New York City hearing will take place at 9:30 a.m. at the hearing location.

CNYH is also holding “meet-and-greet” events in each community so that local activists and interested citizens can hear directly from the bill sponsors and CNYH representatives, engage in discussion, and have their questions about the bill answered.  The New York City meet-and-greet event will be held on the evening prior to the hearing, Mon. Dec. 15, from 6-8 p.m. at 220 Fifth Avenue, 5th fl., in Manhattan.  The public is welcome to attend.  RSVPs are requested in order to make adequate preparations for space and light refreshments, and can be made here.

CNYH’s website is where interested groups and individuals can sign up to get involved.

Metro Returns to Our Labor Roots

After a four-and-a-half-year hiatus, the Metro New York Health Care for All Campaign rejoined the family of District Council 1707 of AFSCME.  In late September, the community-labor health advocacy coalition moved into the union’s headquarters in the Hell’s Kitchen neighborhood of Manhattan.  Previously, Metro was based at the union’s former location in the Soho section of Manhattan from 2002-10.  It was from there that we lead the New York City Organizing Committee of Health Care for America Now, the large omnibus, multi-constituency campaign that pushed historic health care reform legislation through Congress during 2008-10, now known as the Affordable Care Act (ACA.)

 DC 1707

The union recently elected new leadership, comprised of Victoria Mitchell as Executive Director, and Lorraine Guest as President.  DC 1707 is comprised of six locals representing workers at non-profit agencies who provide human services via contracts with the City of New York:  day care centers, home care programs, social services, teaching and educational organizations, membership and fundraising groups, and Head Start programs, along with a retirees chapter.  We thank Ms. Mitchell and Ms. Guest for warmly welcoming us back.

Previously, Metro was based at the New York City office of Citizen Action of New York.  During our tenure there, we worked closely with Citizen Action and other groups involved in leading Health Care for All New York, a major state consumer health advocacy coalition, as the state implemented ACA.  To date, over 1.6 million New Yorkers have enrolled in new health insurance coverage plans created under the ACA, through the New York State of Health marketplace.  The vast majority of them were previously uninsured.  We greatly appreciate Citizen Action’s hospitality, and the generosity of their Executive Director Karen Scharff.  We look forward to continue working with them on new initiatives to expand coverage to those who have not yet benefited from the ACA, and to improve quality care and value in health care services.

Our new contact information is:

420 West 45th Street
New York, NY  10036

Phone:  646-527-6612
FAX:  212-925-0806 (include cover sheet)

Email:  metrohealth (at) igc (dot) org

2014 Health Care Justice Leadership Gala Announced

Each fall, the Metro New York Health Care for All Campaign sponsors the Annual Health Care Justice Leadership Gala.  The event salutes leadership in the fields of public service, trade unionism, and community advocacy, and features a special keynote speaker who frames the current moment in the struggle for health care justice in New York and America.

This year, the following groups and individuals will be recognized:

Assemblymember Annette Robinson, who has represented the Bedford-Stuyvesant area of Brooklyn since 2002.  She chairs the Banking Committee, and serves on the Aging, Children and Families, Housing, Small Business, Oversight, Analysis and Investigation, and Real Property Taxation Committees.  Previously, she served in the New York City Council.  In recent years, she has provided key leadership in bringing public officials in Brooklyn together to preserve Interfaith Medical Center, one of our city’s foremost community safety net hospitals, and to develop a creative solution for the Center’s future.


The Healthcare Education Project, a joint program of 1199 SEIU United Healthcare Workers East and the Greater New York Hospital Association.  Its mission is to protect and expand  access to quality, affordable healthcare for all New Yorkers through community education, advocacy, and coalition building.  Launched in the late 1990s, the Project works in partnership with individuals, healthcare providers, and civic and religious leaders in local neighborhoods across New York.  In recent years, they spearheaded Regional Enrollment Summits across New York State, in collaboration with Health Care for All New York, and undertook door-to-door canvasses in low-income communities to identify uninsured New Yorkers and direct them to in-person enrollers.

The Coalition to Transform Interfaith, a community-labor-faith collaboration to protect and expand health care in Bedford-Stuyvesant, one of our city’s low-income communities with many uninsured.  To date, they have successfully kept Interfaith Medical Center in operation, and are now spearheading an innovative effort to re-establish the Center’s viability into the future.  They are striving to reorganize Interfaith as a “co-operative” jointly operated by the staff, patients, and community leaders.

This year’s Gala will be held on Monday evening, November 17 at District Council 1707 of AFSCME, 420 West 45th Street (bet. 9th & 10th Aves.) in Manhattan.  An informal reception will begin at 6 p.m., followed by the presentation of the awards.  The keynote speaker will be James Knickman, President and CEO of the New York State Health Foundation.

 The Gala is a fundraiser for the Metro New York Health Care for All Campaign.  The suggested contribution for individuals is $75, although all are welcome whatever they can donate.

Organizations and unions can support the Gala by joining the Host Committee, placing an announcement in the Commemorative Journal, or reserving groups of tickets.  Contact us directly for more information on these options.  The deadline for commitments for the Host Committee and placing journal announcements is Friday, November 7.


Health Professionals, Unions, and Advocates to Join Forces for Historic Climate Change March in New York City

On Sunday, Sept. 21, the streets of Manhattan will be filled with tens of thousands of people participating in the People’s Climate March, and health care justice advocates will be there too!  The march is being held in advance of a special United Nations session on Climate Change that will immediately precede the organization’s annual meeting of its General Assembly.  Organizers are hoping that the march will be on the magnitude of the 2003 march against war in Iraq and the anti-nuclear march of 1981, each of which drew very large crowds (in the hundreds of thousands.)

planet earth and hands photo

The march will be organized in six sections, each with its own “theme”.  The health contingent will be at the head of the second section, whose theme is “We Can Build the Future.”  We’ll be directly following the trade union contingent, and right behind the major health care unions such as 1199 SEIU United Healthcare Workers East, the New York State Nurses Association, and others.  The section will form up along Central Park West above Columbus Circle from W. 66 to 72nd Streets.  Participants will be able to enter from W. 72nd St., and are urged to arrive between 10-11 a.m., as the march will step off starting around 11:30.  Large crowds are expected, so people are urged to arrive early.  When you enter the section, walk toward the front to find the health groups.

Prior to the march, a special press conference focusing on climate change and health will be held at 9:30 a.m. outside Roosevelt Hospital, located at 59th St. and 10th Avenue in Manhattan.  Those scheduled to speak include Oliver Fein, MD (Professor, Weill Medical College, Cornell Univ.), Erica Frank, MD, Professor, University of British Columbia), Robert Gould, MD (President, Physicians for Social Responsibility), Corey Johnson (Chair, NYC Council Health Committee), Judy Sheridan-Gonzalez, RN (President, NYS Nurses Assoc.), Susan Spieler, PhD (Director of Continuing Education, Training Institute for Mental Health), and Catherine Thomasson, MD (Exec. Dir., Physicians for Social Responsibility).

Some of the groups involved in organizing the health contingent include (in alpha order) ACT UP/New York, Alliance of Nurses for a Healthy Environment, Climate 911, Healthcare Now NYC, International Transformational Resilience Coalition, NYS Nurses Association, Metro NY Health Care for All Campaign, Physicians for a National Health Program, Physicians for Social Responsibility, Psychologists for Social Responsibility, and the U.S. Climate and Health Alliance, among others.

Full information on the Public Health contingent can be found here.

General information on the march overall can be found here.

“Regional Enrollment Summits” Announced Across New York for this Fall

During the first open enrollment period for new health insurance plans available under the Affordable Care Act nearly 1 million New Yorkers signed up for coverage, and over 80% of them were previously uninsured.  That’s great news, and a good advance on lowering New York’s number of uninsured (previously, 2.5 million in 2013.)  For a full report on New York’s success, click here.

color crowd crop

The next open enrollment period begins on this coming November 15th and runs until February 15th.  It will be our next opportunity to sign-up those who are still-uninsured for coverage.  To help everyone get ready for it, advocates and our allies have joined forces to plan a series of “Regional Enrollment Summits” across the state, to bring all stakeholders together to assess what happened previously, and plan for the coming fall and winter.

These events will bring together community leaders and stakeholders to review the first year of outreach and enrollment for health insurance coverage available through New York State of Health, our state’s new health insurance marketplace. Health advocacy groups, navigators, community groups, health care facilities, unions, health plans, and small business representatives are all encouraged to attend.

In our area, two summits will be held in New York City and one on Long Island.  (There may also be one added in the Lower Hudson Valley – watch for further details.)  If your organization or union is focusing on outreach to uninsured New Yorkers and/or helping them to enroll in coverage, we invite you to attend one of them.

Here’s the details about the NYC are summits:

  • Mon. Sept. 22, 10 a.m. to 1 p.m. – Long Island Summit; at 1199SEIU, 100 Duffy Avenue, Suite 3W, in Hicksville (adjacent to the LIRR train station); registration Luis.Valenzuela@1199funds.org (by Sept. 18)
  • Tues. Sept. 30, 10:30 a.m. to 2 p.m. – Brooklyn-Queens-Staten Island Summit; at York College, Faculty Dining Room, 94-20 Guy R. Brewer Boulevard (south of Archer Ave.), in Jamaica; registration Marcelle.Dinnall@1199funds.org (by Sept. 28)

The agenda for the summits will include:

  • Presentation by “New York State  of Health”, our state’s online health insurance marketplace
  • Panel discussion by groups doing public outreach and enrollment activities
  • Discussion groups to plan share best practices and lessons learned, and plan for the future.

Additional summits across our state include:

  • Fri. Sept. 12, 10:30 a.m. to 2 p.m. – Capital District Summit; at 1199SEIU, 155 Washington Ave., in Albany; registration saracouchwalden@gmail.com
  • Tues. Sep. 30, 1 to 4:30 p.m. – Central New York Summit; at Southern Tier Independence Center, 135 E. Frederick St, in Binghamton; register sarah.lourdes.lister@gmail.com
  • Thurs. Oct. 2, 9 a.m. to 12 noon – Western New York Summit; at 1199SEIU, 2421 Main Street, in Buffalo; register hepbuffalo@gmail.com

Sponsoring groups for the summits include Citizen Action of New York, Community Health Care Association of New York State, Community Service Society of New York, Healthcare Education Project of 1199SEIU/GNYHA, Health Care for All New York, and Raising Women’s Voices-New York.  Additional co-sponsors for each local summit will be solicited.

New Yorkers to Celebrate that “Social Security Works!”

This summer has marks the 49th anniversary of the enactment of Medicare and Medicaid, and the 79th anniversary of Social Security.  All of these programs are all of a piece, and together comprise the bedrock of our nation’s ever-evolving and expanding historic social contract, which most recently added the Affordable Care Act to its scope.  In terms of advocacy, when we support any one of these programs, we support them all, as they are intricately linked to each other, particularly in the minds of the public and voters.

Soc Sec card

With that in mind, health care advocates are joining with senior citizens, disability rights advocates, and union retirees to celebrate the 79th anniversary signing of the Social Security Act by President Franklin D. Roosevelt.  This coming Thursday, August 14, we’ll all be gathering that morning at 11 a.m. outside the NYC District office of the Social Security Administration (SSA), located in Jamaica, Queens, the busiest Social Security office in the country, located at 155-10 Jamaica Avenue (at Parsons Ave.)  (See our action alert invite here, with all the details.)

We’ll be talking about what Social Security means for New York.  About 3.5 million New Yorkers and their families receive benefits from Social Security, including 1.1 million in New York City.  Statewide, beneficiaries include 2.3 million retirees, 520,000 people with disabilities, 421,000 surviving spouses, and 258,000 children.  The program also pumps over $50 billion annually into New York’s economy, and together with Medicare, keeps 1.2 million New Yorkers out of poverty.  (You can read the latest report from Social Security Works about all the ways New Yorkers benefit from it.)

We’ll also be refuting some of the BIG LIES that opponents of government social programs like to tell.  Social Security is NOT going broke!  In fact, it is fully solvent for another 20 years.  Also, Social Security has not contributed one penny to the federal budget deficit.  It has its own Trust Fund that is funded by a dedicated tax from contributions taken out of every workers’ paycheck.

We’ll be calling on Congress to rectify the crisis of recent local Social Security office closures and in-person service cutbacks resulting from budget cuts.  Since 2011, seven local Social Security Administration offices across New York City have been closed because of budget cutbacks, including in Astoria, Chinatown, East New York, Glendale, Midtown Manhattan, South Bronx, and Williamsburg.  Meanwhile, the number of people on Social Security will double in the next 20 years.  In addition, the Social Security Administration is shifting some services solely to online modalities, creating barriers to necessary services for New Yorkers who are not internet literate or do not have regular internet access.  New York’s Senator Charles Schumer has recently introduced a bill to address this problem (S.2742), and a similar bill (H.R.3997) has been introduced in the House by Rep. Brian Higgins of Buffalo.

There are also bills in Congress to improve and expand Social Security:

  • The “Strengthen Social Security Act” (S.567, H.R.3118), introduced by Sen. Tom Harkin and Rep. Linda Sanchez would raise the minimum base benefit, remove the cap on income subject to FICA taxes so that the wealthy pay their fair share just like the rest of us, and change the basis of the formula used to calculate the annual cost-of-living-adjustment (COLA) to more accurately reflect the spending needs of older people and people with disabilities, particularly when it comes to health care.  (You can read the ARA fact sheet here.)
  • The Retirement and Income Security Enhancement (RAISE) Act (S.2455), introduced by Senators Mark Begich and Patty Murray, would enhance Social Security benefits for widow(er)s and divorced spouses while extending benefit eligibility for children of retired, disabled, and deceased workers.  (You can read the ARA Fact Sheet here.)

We are collaborating on this event with the Alliance for Retired Americans (ARA), and Local 3369 of the American Federation of Government Employees (AFGE) which represents SSA workers at that office. AFGE’s “Save Our Social Security” campaign is encouraging their members to resist office closures and in-person service cutbacks.

Our event here in NYC will be part of several similar events taking place across New York State being organized by the Restore the American Promise (RAP) campaign.  Additional events will be taking place across the country, coordinated by ARA, AFGE, and Social Security Works.  We’ll be having party hats and cupcakes, and have invited some local members of Congress from the Queens too.  Please join us! 

Consumer Advocates Take on Big Insurance-PBM Alliance During Final Days of State Legislative Session

David v Goliath (Gebhard Fugel)

They’re at it again!  (Actually, do they ever stop?)

Three years ago, the State Legislature and Governor Cuomo enacted a law guaranteeing New Yorkers the right to receive our prescription drugs either by mail order delivery or from a local community pharmacy.  However, the insurance companies and their “pharmacy benefit manager” (PBM) pals have exploited a minor provision of that law to continue to deny consumers that right to choose.  Instead, insurers are forcing patients to use mail order only, especially for so-called “specialty drugs” (often arbitrary defined as anything costing more than $250 for a month’s supply.)  They’re also imposing onerous and ridiculous terms and conditions on community pharmacies in order to certify them as in-network.

Mail order works fine for many people.  It can be convenient and save money.  However, there can also be problems for people when packages don’t arrive on time, they get lost in the mail, they get left with neighbors (thereby violating patients’ privacy), or they get left on doorsteps and then are stolen, among other difficulties.  In such circumstances, patients then have to pay full cost for a replacement, which can often be hundreds or thousands of dollars.  In some cases, their health and well-being can be placed in jeopardy if they miss doses of maintenance drugs.

Many people prefer to use a local community pharmacy instead where they can pick up their medicines at a convenient time and not miss refills.  They also prefer to consult directly with a local professional pharmacist who has a record of all their medicines on file (often prescribed by different providers) to watch out for any complications and contraindications.  They prefer this option rather than have to deal with an often minimally-trained customer service agent at the end of a phone line far away who simply reads off a boilerplate script.

Why are insurers doing this?

Simple:  follow the money.  Many of the big PBMs are wholly-owned subsidiaries of insurance companies.  Others have sweetheart deals with them.  By denying us this right to choose, insurers and PBMs are cornering and gaming the market, and trying to put our local drugs stores out of business.

The good news:

There’s a bill in the State Legislature to restore our right to choose and eliminate insurers’ outrageous terms and conditions they want to impose on local drug stores.  This bill won’t drive up drug prices or insurance premiums at all, provided consumers use an in-network pharmacy.  There’s wide, bipartisan support for this bill, and it has already passed the Assembly unanimously.

The challenge:

The bill is now hung-up in the Senate because the chair of the Insurance Committee (Sen. James Seward of Oneonta) won’t let it out for a floor vote.  He’s parroting the industry’s specious claims that community pharmacists can’t be trusted to dispense specialty drugs (despite the fact that they’ve been handling them for years.)

How the Legislative Battle is Proceeding:

The insurance and PBM industry is running radio ads, putting up billboards, and placing ads in newspapers across the state, claiming that this bill will create a new “prescription drug tax”, raise insurance premiums, threaten patient safety, and undermine the mail-order drug business.  In particular, they are scaring seniors that their drug costs will go up.

In response, New Yorkers for Accessible Health Coverage (a statewide coalition of chronic illness and disability groups) has been joined by Gay Men’s Health Crisis, NYS Bleeding Disorders Coalition, the MS Society, Consumers’ Union, the Lupus Foundation, the Pharmacists Society of the State of NY, and the Coalition of Community and Chain Store Pharmacies.  Together, they are saying to state lawmakers, “Do it again, just like you did three years ago, but close the loophole this time.  Make sure New Yorkers maintain our right to choose how we get our medicines.”

The 2014 Legislative Session ends by this coming Friday, June 20.  Advocates are hoping that, given the broad support among rank-and-file Senators, Senate leadership will take the bill to the floor for a vote despite Senator Seward’s opposition.

What you can do: read our Action Alert here.

NYC Health Advocates Announce City Budget Agenda for 2014

Members of the People’s Budget Coalition for Public Health gathered for a press conference on the steps of City Hall on May 13th to respond to Mayor de Blasio’s recently-released budget for the city’s coming fiscal year and urge that the City Council build on it to address additional unmet needs of New Yorkers. They laid out broad priorities to guide the Mayor and Council as they now enter into negotiations, to be concluded by the end of June. PBC’s priorities include: community-based health planning, addressing health disparities, expanding the health care safety net, and investing in the city’s municipal hospital and public health system.

PBC Pr Conf 5-13-14 pic3


“The Executive Budget takes many steps in the right direction, but needs to do more to address the social determinants of health and disparities; and create a health care system rooted in our neighborhoods and communities,” said Anthony Feliciano, Director of the Commission on the Public’s Health System, “A successful health care system results from a prescription that includes access, quality, services, fairness, equity, and community. If one element is missing, the prescription does not work. Over the years, too many communities have been consistently left out of planning, or left with substandard care, or no care at all. Often the factors in determining those left behind are income, race, ethnicity, immigration status, disability status, gender identity, primary language, and sexual orientation. We know the Mayor and Council understand this reality, and urge them to support some of our health priorities to address these problems.”

“We commend Mayor de Blasio and Health Commissioner Mary Bassett for prioritizing public health activities aimed at communities that have the disproportionate share of physical and mental illness and premature death,” said Esther W. Y. Lok, Assistant Director of Policy, Advocacy and Research from the Federation of Protestant Welfare Agencies. “Engaging local residents, community and faith leaders, institutions, unions, and elected officials in the planning process is essential to the expansion of public health initiatives,”

As New York State implements the Affordable Care Act (ACA) and a recently-approved $8 billion dollar Medicaid Waiver, PBC members said it is critical that the City maintains and strengthens a public health care infrastructure that ensures continuous, high quality care delivery to those who are newly-insured as well as those left uninsured. Even with the leveling benefits of federal health reform, many New Yorkers and their communities continue to face disparities in access, distribution, and coordination of health resources.

The group called for the creation of a new “Access Health NYC” program, to provide city funding to community-based organizations to help connect uninsured people to new coverage options and/or access to services.

“While New York has done very well enrolling uninsured people into new coverage options available under the Affordable Care Act, we know there are still hundreds of thousands of uninsured across our city who still haven’t done so,” said Mark Hannay, Director of the Metro New York Health Care for All Campaign. “On-the-ground community-based organizations are the key to engaging hard-to-reach populations, and they need the resources to go out there and find the still uninsured, inform them about the law, and get them enrolled in coverage, all in culturally appropriate ways. Unfortunately, the state government chose not to fund community outreach programs, so this is an important gap that our city government can fill to make sure that all New Yorkers get health insurance.”

“Collaborative and culturally appropriate outreach services that connect people with care are very important”, said Suki Terada Ports, Vice President of the Japanese American Association of New York, “In an example of historic significance, Korean and Japanese not-for-profits worked together to enable people of Japanese ancestry to obtain health insurance. Korean Community Services stepped up to the plate to help educate and enroll limited English speaking people in New York and New Jersey because neither state had arranged for a Navigator who spoke Japanese.”

“We urge the administration to remember that the Affordable Care Act left health care reform incomplete for New York City’s undocumented residents,” said Jackie Vimo, Policy Director for the New York Immigration Coalition. “New York City immigrants and their families have options that they may not know about including services through NYC’s Health and Hospitals Corporation facilities, federally qualified health centers, and Emergency Medicaid. We look forward to working with the administration to educate immigrants in New York City about services and programs that are available to them and to crafting a durable policy solution to facilitate health care access for all New York City residents.”

“We are grateful that the Mayor’s budget outlines progressive health measures. However, more needs to be done to address health inequities and disparities,” said Noilyn Abesamis-Mendoza, Health Policy Director for the Coalition for Asian American Children & Families. “Initiatives such as Access Health NYC would greatly expand health access and services to various communities in a culturally- and linguistically-competent manner, while improved community health planning will ensure that those on the receiving end of health programs have greater agency and self-determination of healthcare resources.

The group also called for budget provisions to grow public health care infrastructure from the communities it serves. They said New York’s health system must serve all New Yorkers; enabling everyone to receive high quality, accessible health care services in their own neighborhoods. PBC called for the Mayor and City Council to put forward a vision for public health that is rooted in community input, addresses health disparities facing New York’s more marginalized neighborhoods through the stabilization of the safety net, and further builds and expands the city’s current public health infrastructure and workforce.

“Being an individual who has worked in Federal, State, City and Privately-Funded Health and Human Services programs, it is glaringly obvious that there needs to be an even larger increase in local control over, and participation in, the decisions around health care resources and public health issues,” said Stephen Beasley, Program Coordinator for CAMBA/Greater Brooklyn Health Coalition.

“Thanks in large part to the inclusive approach of Mayor de Blasio toward our safety-net hospitals and the diligent work of healthcare advocates across the City, New York has the opportunity with this year’s budget to address health disparities that have long plagued struggling New Yorkers and focus on meaningful quality improvement measures that matter to our patients and communities,” said Dr. Matthews Hurley, Vice President of Doctors Council SEIU. “We are proud to stand with our partners in the People’s Budget Coalition and look forward to working with health care professionals, community members, patients and Mayor de Blasio to ensure New York City is the best provider of care to our loved ones.”

“New York Health” Advocates Converge on Albany to Promote Universal Health Care for New York

Over 200 members and allies of the “New York Health” campaign held their annual legislative advocacy day on May 6, to push for a vote on the bill in the Assembly before the end they adjourn in late June.  The bill, sponsored by Assembly Health Committee chair Richard Gottfried of the Chelsea-Hell’s Kitchen area (A. 5389A) and Senator Bill Perkins of Harlem (S. 2078A), has 72 co-sponsors in the Assembly and 18 co-sponsors in the Senate to date, and  61 organizations and trade unions have endorsed it.

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Participants in the advocacy day made over visits to 81 members of the Legislature to ask for support for the bill, and to answer questions legislators and their staff.  In particular, they pushed for Assemblymembers to sign-on to a letter to Assembly Speaker Sheldon Silver to bring the bill to the floor for a vote, and for those who’ve not yet endorsed the bill in either house to do so.

During the lunch hour, a rally was held in the park outside the Capitol that garnered significant media coverage.  In addition to Assemblymember Gottfried and Senator Perkins, speakers included Dr. Matthew Hurley from Doctors’ Council SEIU, Judy Sheridan-Gonzalez from the New York State Nurses Association, Michael Milligan, author and actor in “Mercy Killers”, a one-man show about health care in America that has toured nationally in numerous cities, and Helen Shaub from 1199 United Healthcare Workers East.

The New York Health proposal would create a fully public health insurance program covering all New York residents.  Everyone would be eligible to enroll, regardless of age, income, wealth, employment, or other status. The benefits would include comprehensive outpatient and inpatient medical care, primary and preventive care, prescription drugs, laboratory tests, rehabilitation, dentistry, vision care, and hearing care. Everyone would choose a primary care practitioner or other provider to provide care coordination who would help to get the care and follow-up the patient needs, referrals, and navigating the system.  However, there would be no “gatekeeper” obstacles to care.  Long-term-care coverage is not included at the start, but the bill requires that the Board develop a plan for it within five years of implementation.

Health coverage provided through the program would be publicly funded.  Health care would no longer be paid for by insurance companies charging premiums, deductibles and co-pays that are not set according to ability to pay. Instead, New York Health would be paid for by assessments based on ability to pay, through a progressively graduated state payroll tax (paid 80% by employers and 20% by employees, and 100% by self-employed) and a surcharge on other income and placed into a dedicated New York Health Trust Fund. The current federal funds now received by the state for Medicaid, Child Health Plus, and the Affordable Care Act could also be added in, along with Medicare funding.  A broadly representative Board of Trustees would advise the Commissioner of Health on the program.  The “local share” of Medicaid funding —a major burden on local property taxes— would be ended.

Health care providers, including those providing care coordination, would be paid in full by New York Health, with no co-pays or other charges to patients. The program would develop alternative payment methods to replace old-style fee-for-service (which rewards volume but not quality), and would negotiate rates with health care provider organizations and practitioners. (Fee-for-service would continue until new methods are phased in.)