BRAVO! Financial Supporters Make a Difference …and Make It All Possible.

We’d like to thank the following groups, unions, and individuals who financially supported us in various ways during 2015.  Their support made our work in 2015 possible, and lays a foundation for our work to come in 2016.  If you’d like to do so before the ball drops nearby in Times Square, please us the donate button here, or mail a check to 420 West 45th St., DC 1707, New York, NY 10009. 

MDs applauding

Annual Spring Dues Campaign

Groups and Unions:

  • Alliance for a Greater New York
  • *Center for Health Care Initiatives
  • *Center for Independence of the Disabled in NY
  • Children’s Defense Fund of NY
  • Citizen Action of New York
  • Commission on the Public’s Health System in NYC
  • Committee of Interns and Residents, SEIU Healthcare
  • *Communications Workers of America, District 1
  • *Communications Workers of America, Local 1102
  • Communications Workers of America, Local 1180
  • Community Health Care Association of New York
  • *Community Healthcare Network
  • DC 37 Retirees Association
  • District Council 37, AFSCME
  • Doctors’ Council, SEIU Healthcare
  • Federation of Protestant Welfare Agencies
  • Gay Men’s Health Crisis
  • *GuildNet/Lighthouse Guild
  • Healthcare Education Project, 1199SEIU/GNYHA
  • *Hudson Center for Health Equity and Quality
  • International Association of Stage and Theatrical Employees, Local 1
  • Long Island Coalition for a National Health Program
  • Make the Road New York
  • Medicare Rights Center
  • *New York Committees of Correspondence
  • *New York Gray Panthers
  • 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
  • *Primary Care Development Corp.
  • Physicians for a National Health Program, New York Metro Chapter
  • Planned Parenthood of New York City
  • Professional Staff Congress, CUNY
  • Public Health Solutions
  • *Ryan Center
  • *Social Service Employees Union, Local 371, DC 37
  • 1199 SEIU United Healthcare Workers East

(* new contributors from 2015)

Individuals:

  • Deborah Bell
  • Richard Bergman
  • Carmelita Blake
  • Francine Brewer
  • Gene Carroll
  • Jim Collins
  • Moira Dolan & David Mandelbaum
  • Anne and Sid Emerman
  • Shaurain Farber
  • Tim Foley & Susan Lee
  • Jay Gumbiner
  • Marica Hunte
  • John and Patricia Hyland
  • Nadia Jakoubek
  • Pauline Kuyler, MD
  • Lou and Sara Levitt
  • Jose Matta
  • R. Mayer
  • Cheryl Merzel, MD
  • Terry Mizrahi
  • Ethel Paley
  • Alec Pruchnicki, MD
  • Lois Steinberg
  • Katharine Wolpe

2015 Health Care Justice Leadership Annual Gala

Groups and Unions:

  • AARP New York
  • Alliance for a Greater New York
  • Associated Musicians of Greater New York, Local 802 AFM
  • Center for Independence of the Disabled in New York
  • Citizen Action of New York
  • Coalition of Asian-American Children and Families
  • Commission on the Public’s Health System
  • Committee of Interns and Residents
  • Communication Workers of America, Local 1180
  • Communications Workers of America, District 1
  • Communications Workers of America, Local 1102
  • Community Health Care Association of New York State
  • Community Healthcare Network
  • Community Service Society of New York
  • Consumers Union
  • Council of School Supervisors and Administrators, AFT Local 1
  • Doctor’s Council
  • Federation of Protestant Welfare Agencies
  • Freelancers’ Union
  • Gray Panthers, New York City Network
  • Greater NY Laborers-Employers Cooperation and Education Trust
  • GuildNet
  • Healthcare Education Project, 1199 SEIU-GNYHA
  • Housing Works
  • Hudson Center for Health Equity
  • International Cinematographers Guild, Local 600, IATSE
  • Medicare Rights Center
  • Municipal Hospital Employees, Local 420, DC 37
  • National Association of Social Workers, New York City Chapter
  • New York City Central Labor Council
  • New York Committee for Occupational Safety and Health
  • New York Immigration Coalition
  • New York State Nurses Association
  • New York Therapeutic Riding Center
  • Open Door Family Medical Centers
  • 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, AFT Local 2334
  • Raising Women’s Voices-NY
  • Ryan Community Health Center
  • 1199 SEIU United Healthcare Workers East
  • Social Service Employees Local 371, DC 37 AFSCME
  • Systonic Systems
  • Theatrical Stage Employees, Local One, IATSE
  • Transport Workers Union, Local 100
  • United Auto Workers, Region 9A
  • United Federation of Teachers, AFT Local 2
  • United University Professions

Individuals:

  • Alec Pruchnicki
  • Alice and Jon Fisher
  • Barbara Edmonds
  • Bob Ambaras
  • Carmelita Blake
  • Chris Verber
  • Nick Unger
  • Edwin Weber
  • Ester Lok
  • George Carter
  • Janet Sussin
  • Jim Perlstein
  • Joel Shufro
  • Kate Linker
  • Susan Moscou and Dan O’Connell
  • Kate Pfordresher
  • Lloyd Bishop
  • Marianne Kosits
  • Mark Seddun
  • Mary Tucker
  • Mike Rabinowitz
  • Moira Dolan
  • Paul Stein
  • Stanley Lave
  • Steve Oliver
  • Tom Shcherbenko

Health Care for All New York Subgrants

  • Community Service Society of New York (funding from the ACA Implementation Fund, and the Robert Wood Johnson Foundation)
  • Schuyler Center for Analysis and Advocacy (funding from the New York State Health Foundation)

Restore the American Promise Subgrant

Public Policy and Education Fund of New York (funding from Americans for Tax Fairness)

Grant Support for Our Internship Program

Anthony DeMarco Health Care for All of US Fund

Looking Back Over 2015, and Ahead to 2016

As this year draws to a close, we want to thank all those groups, unions, and individuals who partnered in and/or financially supported our work in 2015.  We couldn’t have done all we have without you!

people cheering

Some of our accomplishments this past year have included:

  • Passage of the “New York Health Act” universal health care bill by the State Assembly in May (by over a 2/3rds majority) – via the Campaign for New York Health
  • Advocating for New York to robustly maximize its options under the Affordable Care Act, including creating the exciting new “Essential Plan” that offers very low-cost coverage to the working poor – via Health Care for All New York
  • Educating uninsured New Yorkers about their new coverage options under the Affordable Care Act (nearly 3 million have signed up so far since 2 years ago.) – via Health Care for All New York
  • Securing dedicated funding from both New York State and New York City to enable community-based groups to reach out to uninsured people to get them enrolled in coverage and newly-insured people to help them learn how to use their coverage – via the People’s Budget Coalition for Public Health
  • Celebrating and calling attention to the 50th anniversary of Medicare and Medicaid as bedrock social programs for America and millions of New Yorkers over the decades – via No Bad Grand Bargain
  • Leading efforts statewide and here in New York City to protect federal funding for health care and related social programs by resisting austerity policies, advocating for tax fairness, and promoting general economic development – via Restore the American Promise
  • Contributing to new State and City government initiatives to improve access to services, improve the quality of care, promote population health, and make health care more affordable – via Health Care for All New York, Medicaid Matters New York, and the New York City Dept. of Health and Mental Hygiene
  • Production of 9 cable TV shows (check them out on our website here), and 28 segments for WBAI’s “Health Action” show, including 3 listener call-ins.

binoculars looking ahead

We will be continuing and building on all these efforts in 2016, and look forward to joining with you on them.  In particular, we will be working to inject these issues into the election year discourse, to educate voters about what’s at stake for state and national government policies, concerning both those enacted and desired. 

writing out a check

If your group or union, or yourself personally, have not yet had time to support our recent “Health Care Justice Leadership Annual Gala”, please take a moment now to do so, before the end of this year.  You can either send us a check (420 West 45th Street, DC 1707 AFSCME, New York, NY 10036), or contribute online via the donate button on this page.  Doing so will enable us to begin 2016 on strong footing.

Finally, please be sure follow everything we’re up to and the larger context of our work via our online platforms:  our blog and monthly calendar, our Facebook page, and our Twitter feed.

In closing, we wish everyone all the best for the coming new year.  By continuing to work together, we will advance the cause of universal health care, and the various health care justice efforts strategic to that goal.

New York Health Activists and Allies to Protest Pfizer’s “Corporate Inversion” Tax Dodge

On Friday, December 4th at 12 noon, members of No Bad Grand Bargain (NBGB), a citywide network of health and social justice activists who focus on federal budget issues, and Americans for Tax Fairness (ATF), a Washington, DC-based coalition of national organizations who advocate for politically-progressive tax reform policies, are gathering outside the World Headquarters of drugmaker Pfizer in midtown Manhattan for a press conference and protest in reaction to the firm’s recently announced merger with Irish drugmaker Allergan. 

pfizerlogo

“Pfizer’s Rx for America: Dodge U.S. Taxes, Stash Profits Overseas, Stick the Rest of Us with the Tab” will feature New York State Senator Liz Krueger, and speakers from ATF, UFT Retired Teachers Chapter, and Metro New York Health Care for All. The event will be held outside the company’s New York City office, located on the northwest corner of 42nd Street and 2nd Avenue.

 Sponsors of the event include Citizen Action of NY, Fiscal Policy Institute, Democracy for NYC, Doctors Council/SEIU Healthcare, Metro NY Health Care for All, MoveOn, NYS Alliance for Retired Americans, No Bad Grand Bargain, Restore the American Promise, UFT Retired Teachers Chapter.

Pfizer’s merger with Allergan is a “corporate inversion” whereby Pfizer technically becomes an Irish-based company, thereby escaping paying U.S. corporate taxes, yet all-the-while maintaining its full U.S.-based operations and New York City headquarters. Such inversions are a strategy being increasingly employed by large U.S. firms to dodge taxes.  Pfizer is one of the world’s largest and most profitable drug companies, in an industry that has one of the highest profit margins worldwide.

ATF Pfizer rpt cover

Tax dodging is nothing new for Pfizer.  It hasn’t paid its full taxes in years by using a variety of business schemes.  Meanwhile, it rakes in millions in profits by charging sky-high prices for its products, which forces up health insurance rates and rips-off Medicare, Medicaid, and other government programs.  ATF recently released a report on the company titled “Pfizer’s Tax Dodging Rx: Stash Profits Offshore”, detailing a decade of nefarious tax activities by the company.

Many large corporations engage in a slew of scams to dodge U.S. taxes, and Pfizer is one of the worst offenders.  When these companies don’t pay their fair share of taxes, the federal government doesn’t have enough money to pay for vital social and health care programs that many New Yorkers rely on to get by.

However, there IS some good news!

The “Stop Corporate Inversions Act” (S.198, H.R.415) in Congress will make it hard for large profitable companies like Pfizer to desert America for offshore tax havens, and will make large U.S. subsidiaries of small foreign parent firms pay its taxes if it is still managed and controlled from within the United States.

Schumer pic

New York’s Sen. Charles Schumer can champion this bill and push it through by the end of this year IF he makes it a priority.  There is a politically-viable “tax extenders” bill that Congress is likely to take up before it recesses for this year, and this new bill could be attached to it for easier passage.  Sen. Schumer is the #3 Democratic leader in the Senate, and sits on the powerful Finance Committee. It is anticipated that he is likely to become Democratic leader in the Senate in 2017, and depending on how the 2016 elections go, will either be the chamber’s majority or minority leader.

NBGB is the local organizing affiliate of the statewide Restore the American Promise (RAP) campaign.  NBGB, RAP, and ATF are together urging New Yorkers to contact both Senators Schumer and Gillibrand and their local members of Congress about the Stop Corporate Inversions Act within the next week.  Congress is aiming for a December 11th recess, although it’s possible the may not finish up all their work for 2015 until sometime during the following week.  In any case, there’s not much time.

Pfizer’s merger will not be completed until approved by the company’s stockholders at their annual meeting in the spring, so if this bill is enacted before then, it will make the firm’s proposed inversion much more difficult, if not impossible.  Last year, drugstore chain Walgreens proposed an inversion, but it was stopped after much public outcry, so it is possible to stop them.

New York Universal Health Care Advocates to Gather for Annual “Health Care Justice Leadership Awards” Gala

On Tuesday evening, December 8th, health care activists and advocates from across the New York City region will come together for this year’s Health Care Justice Leadership Awards. The event recognizes the exemplary efforts of selected individuals and groups in three key areas of politics, trade unionism, and community activism. The event will be held at District Council 1707 of AFSCME, located at 420 West 45th Street in Manhattan.

20th Anniversary Champagne Toast

This year’s distinguished honorees are:

Official Portrait

U.S. Senator Kirsten Gillibrand (D-NY) for political leadership in championing renewal of the James Zagroda 9-11 Health and Compensation Act (S. 928), and the Family and Medical Leave Act (S. 768.) In addition, she has been a leader on issues of women’s health care in the military and on college campuses, and working to protect public and safety net hospitals and community health centers from funding cuts for care for the indigent and uninsured.

PSC logo

• The Retirees Chapter of the Professional Staff Congress (AFT Local 2334) for trade union leadership for their various efforts to highlight the need to protect and improve our nation’s social safety net vital to retirees and their families: Social Security, Medicare and health benefits, pensions, and general welfare. A key initiative is their Safety Net Working Group that has organized university-wide public forums, given presentations to PSC campus chapters and trade unionists and educators statewide, and published the popular education booklet, Defending the Safety Net: A Call to Action. They’ve been a key leader and resource for championing these issues within the NYC Alliance for Retired Americans, and No Bad Grand Bargain, a citywide network of activists that focus on federal budget issues as they affect social safety net and health care programs.

AH NYC logo

• People’s Budget Coalition for Public Health for community leadership for their successful two-year campaign to secure $1 million in City Council funding for the new “Access Health NYC” initiative. Its purpose is to fund local grassroots entities that serve hard-to-reach and marginalized populations across New York City, such as racial and ethnic minorities, immigrants, LGBT people, and people with disabilities. The project’s goals is to enroll the uninsured in health insurance coverage, help them to use their coverage, and direct them to safety net providers for services.

J Malin

The keynote speaker for the gala will be Joan Malin, President and CEO of Planned Parenthood of New York City.

The gala is a fundraiser for Metro New York Health Care for All, a citywide coalition of community groups, trade unions, professional association, faith organizations, and concerned individuals that advocate for a universal health care program in New York and across America.

The event’s proceeds will support our activities for 2016, including:
Promoting the New York Health Act for a universal health care program
Improving implementation of the Affordable Care Act in New York, including expanding coverage options for all immigrants, improving provider networks, and promoting the new Essential Plan that provides very low-cost coverage for the working poor.
Advocating for improvements to existing national social insurance programs such as Medicare and Social Security that will strengthen their benefits while also saving money.
• Producing original media programming for WBAI/Pacifica radio, and local public access cable TV.
Representing health advocates on various city and state advisory bodies
• Providing leadership to various local, state, and national coalitions and groups, such as Campaign for New York Health, Medicaid Matters New York, New Yorkers for Accessible Health Coverage, No Bad Grand Bargain, Physicians for a National Health Program, Restore the American Promise, and Universal Health Care Action Network.

Groups and unions can financially support the event by either:
• Joining the Host Committee
• Placing an announcement in the commemorative journal
• Purchasing groups of tickets
Parties interested in these options can contact 646-527-6612 for further information.

The suggested contributions for individuals is $75. Donations can be made at the door, sent by mail (to: Metro NY Health Care for All, 420 W. 45th St., New York, NY 10036), or by clicking the donate button above.

NY Health Advocates & Allies Scramble to Protect Consumers as Regulators Shut Down Health Insurance Co-op “Health Republic”

ATTENTION HEALTH REPUBLIC MEMBERS in New York!

The company is closing down for business as of Nov. 30, and members’ health insurance coverage through them will end as of that date. Current Health Republic policyholders will need to enroll in a new plan by Nov. 15 in order to have coverage in place for December. This action is being taken under order of federal and state regulators because their reserve funds are inadequate to pay claims going forward.

tossed lifesaver

For information on what to do (and FAST!) and where to get help with it, here’s where to check:  http://hcfany.org/alert-health-republic-to-end-coverage-on-november-30-2015/.  Current members are urged to reach out to enrollment assistors (Navigators, Brokers, Application Counselors) for help with this effort.  Community Health Advocates (www.communityhealthadvocates.org) is the state’s largest navigator network of non-profits across the state, and a good resource.

Health Republic was a new type of insurer authorized under the Affordable Care Act: a non-profit “health insurance co-op” operated by and for its members. During Congress’ crafting of the ACA in 2009-10, it was the alternative to the concept of a “public option” health plan that conservative Democrats could live with. The co-op idea was put forward by then-Sen. Byron Dorgan (D-ND), and ended up in the bill so that Senate Democrats could secure his vote for the ACA.

Several states went ahead with setting up these co-ops, and New York’s Health Republic was by far the largest, with over 200,000 members. Its establishment was spearheaded by the Freelancers’ Union, and they initially offered among the most affordable plans on “New York State of Health”, the state’s official health insurance marketplace created under the ACA.

After the mid-term elections of 2010, as Congress crafted federal budget deals during 2011-13, they raided the ACA’s co-op fund in order to pay for other things and reduce the overall budget deficit, and also because of general hostility to the ACA. Consequently, the monies these co-ops were expecting to help them get established was drastically slashed, and many of them have since experienced financial crises and had to close. In addition, the commercial insurance industry has worked to undercut them so as to lessen competition in the new health insurance marketplaces created under the ACA.

Health Republic is not the only co-op plan to go under because of this situation. At least 8 have now closed down, stranding over 500,000 people who enrolled in them, and some others are expected to follow. That said, there are some which, so far, are doing OK and are financially stable, for example in Connecticut.

The radio and TV program “Democracy Now featured a segment on this whole situation:  http://www.democracynow.org/2015/11/3/the_co_ops_collapse_how_gop

Advocates Express Relief Over Federal Budget Deal; Health Care Programs Largely Unscathed

Earlier this week, the Obama administration and Congressional leaders from both sides of the aisle came to an overall federal budget framework covering the next 2 years (known as the “Bipartisan Budget Act” or BBA.)  While in the end it still embodies an overall approach of austerity politics, it is MUCH less bad than many had feared, and also has some good provisions.

handshake

In sum, the on-again-off-again across-the-board budget sequester enacted as part of the Budget Control Act of 2011 (BCA) is temporarily suspended for the next 2 years, and new funding is provided to largely restore previous sequester cuts to slightly less than 2010 levels.  These cuts have seriously adversely affected a variety of “discretionary domestic” social programs such as meals-on-wheels, Head Start, etc.

Social insurance programs such as Social Security, Medicare, and Medicaid, are largely held harmless except for:

  • Modest changes to eligibility rules for Soc. Sec. disability (physician sign-off now required in all states.)
  • Closing of some loopholes around Soc. Sec. survivor and spousal benefits that are often exploited by the wealthy beneficiaries.
  • Continues current 2% provider cut under Medicare enacted under BCA.

There is also good news on the social program front:

  • The impending funding crisis for the Soc. Sec. Disability Trust Fund has been put off for 7 years until 2022.
  • The impending large Medicare Part B premium increase for certain Medicare beneficiaries has been suspended for 1 year, along with an large increase in the Part B deductible (given the fact that there will be no Soc. Sec. COLA in 2016.)

Other good news in the deal:

  • The debt ceiling is raised “cleanly” (without any “pay-fors” or other policy riders.)
  • New funding for the IRS for audits of hedge funds and the like, to yield some new revenue.

Left untouched by the deal – these will all have to be dealt with separately in the future:

  • Reauthorization of the transportation trust fund.
  • Renewal or sunsetting of certain “tax extenders” and tax breaks for various industries and special interests.
  • Renewal of increases in the Earned Income Tax Credit and Child Tax Credit that were created under the American Recovery and Reinvestment Act of 2009 (ARRA, aka stimulus package.)
  • Comprehensive tax reform, including (but not limited to) the taxing of U.S.-based corporate profits booked off-shore.

What’s next for Congress:

  • Negotiating out and finalizing the appropriation bills necessary to keep the government funded.  The current “continuing resolution” expires on Dec. 11.  (N.B.: A government shut-down is still theoretically possible.)
  • Parceling out the sequester restorations among various domestic programs (see above.)
  • Dealing with one or more of the matters left untouched (see above.)

In sum, we want to thank everyone for all your advocacy efforts on these matters that you directed toward the Obama administration, Senators Schumer and Gillibrand, and members of the NY congressional delegation.  Because of your work, the White House and Democrats stood strong, and even some Republicans joined in:

  • against major entitlement changes and funding cuts
  • against resumption of further sequester cuts (it has been suspended for FY 2014-15), and for restorations of previous sequester cuts (enacted in FY 2013-14.)
  • for a clean increase in the debt ceiling
  • for solving impending crises in Soc. Sec. disability and Medicare Part B

In the end, this deal is as much a political as a policy one, designed to get all parties past next year’s elections and over into 2017 when there will be a new President and Congress, who will then have to revisit these matters all over again, along with other important related issues.  Elections will matter!

Finally, our work is far from done as there are still important outstanding matters yet to be addressed by Congress concerning tax fairness, economic recovery and prosperity, and military spending, any of which may or may not rise to the fore sooner or later.  They, along with our core concerns over health care and social programs and austerity spending, are all of a whole.  We may have a bit of breathing room now to turn from a largely defensive posture to go on the offensive to promote proactive ideas we want to see happen in these various issues areas that make up the whole.  These ideas will help to frame the political debates for next year’s elections when we all hope that candidates who agree with and support our positions prevail.  The future of the kind of nation and society we want to see realized hangs in the balance.

For a fuller analysis of this budget deal:

http://www.cbpp.org/press/statements/greenstein-budget-deal-though-imperfect-represents-significant-accomplishment-and

http://docs.house.gov/meetings/RU/RU00/CPRT-114-RU00-D001.pdf

Addendum (Oct. 29):

While this new agreement settled many things related to health care funding, other matters to repeal portions of the Affordable Care Act and discontinue funding for Planned Parenthood via a “budget reconciliation” process continues to move forward.  The House passed such a bill last week, and the Senate is scheduled to take it up before Dec. 11, perhaps as soon as mid-November.

Advocates Mobilize to Fight Against Steep Medicare Part B Premium Increase

Last week, the Social Security Administration announced that there would be no annual cost-of-living adjustment (“COLA”) for Social Security beneficiaries next year because the overall general inflation rate, based on the consumer price increase (“CPI”), has been negligible this year.  However, the rate of medical inflation is higher (historically, about 3 times the general rate), and most people on Social Security (the elderly and disabled) need more health care than the average working-age consumer.  The pressure on their monthly checks to cover medical out-of-pocket costs will increase next year regardless.  Half of all people on Medicare live on less than $24,000/yr.  This problem is nothing new, sad to say, but there is a simple policy solution: use a different COLA base formula (known as the “CPI-E”) that better reflects health care costs for seniors and people with disabilities.

medicare generic card

This coming year, there will also be an additional, very serious problem for a significant number of Medicare beneficiaries: a skyrocketing Part B premium, from the current ~$105/mo.in 2015, to nearly $160/mo in 2016, a whopping 52% increase.

Here’s the underlying dynamic:

About 70% of Medicare beneficiaries will experience no Part B premium increase next year because of a “hold harmless” provision of the Social Security Act that prevents such an increase when there is no annual increase in monthly Social Security benefit checks.  This is a good protection for them.  Had an increase been assessed on all beneficiaries across the board, the premium would have increased to $121 (an amount that is significant for those living on low and fixed incomes.)

However, because by law 25% of the total cost of the Medicare Part B program must be borne by beneficiaries in total, the remaining 30% of beneficiaries not protected by the hold-harmless provision must make up the entire difference, consequently having to pay for the entire cost of the increase for the program, which will go up because of the higher medical inflation rate.  This 30% will be comprised of new beneficiaries (who become eligible and enroll in 2016), people on Medicare who don’t receive Social Security benefits, Medicare beneficiaries who already pay higher, non-standard, income-related premiums because they have above-average incomes, and people who are on both Medicare and Medicaid.  (Fortunately, this latter category will not experience the increase directly because state Medicaid programs will cover it for them.)

Two bills have been introduced in Congress to mitigate this tremendous increase next year for the unlucky 30% who aren’t “held harmless” under current law when annual Social Security COLAs are not granted.  The “Protecting Medicare Beneficiaries Act” (S.2148) has been introduced by Sen. Ron Wyden (D-OR), the ranking member on the Senate Finance Committee, which has jurisdiction over Medicare.  In the House of Representatives, Rep. Dina Titus (D-CA) has introduced the “Medicare Premium Fairness Act” (H.R. 3696.)  Both would cancel the Part B premium increase for those beneficiaries not protected by the “hold harmless” provision, and cancel the increase on state Medicaid programs. Neither bill indicates how the additional cost would be paid for.  New York co-sponsors include Sen. Schumer on S.2148, and Reps. Carolyn Maloney, Sean-Patrick Maloney, Jerrold Nadler, and Charles Rangel on H.R. 3626.  Senior citizen, disability rights, and health care advocates are reaching out to Sen. Gillibrand and the remaining Congressmembers to talk about the importance of addressing this situation quickly, since there are only 2 months to go.

New York Health and Social Welfare Advocates Mobilize as Congress Focuses on Final Budget Negotiations

Autumn has arrived, and in Washington that means two things: budget deals, and election campaigns.  This year, there are no federal elections, so tax and spending measures claim the spotlight alone.

stacks of dollars

Congress passed a Joint Budget Resolution last spring which serves as an overall blueprint to guide specific committees of jurisdiction as they craft specific appropriations bills which (theoretically) adhere to it.  Their Resolution called for large cuts in spending on Medicare, Medicaid, and the Child Health Insurance Program (CHIP) over the next decade (along with implicit suggestions of block granting or imposition of “per capita caps” for the latter two programs), and outright repeal of the Affordable Care Act (ACA) per special “budget reconciliation” instructions (see below.)

While only a simple majority was needed for adopting their Resolution and the President played no role concerning it, this time around with appropriations bills in play, both the Senate Minority Democrats and the White House will need to be included in whatever is finally enacted.  In addition, the issue of funding for family planning services, particularly those provided through Planned Parenthood and/or state Medicaid programs, has since been added to the mix.  Technically, all appropriations bills were to have been enacted by October 1st when the federal government’s new fiscal year began.  However, as has often been the case in the past decade or more, this deadline was not met, and instead Congress enacted a “continuing resolution” (CR) to keep the government open and operating per the current budget for a limited period of time, this year until Dec. 11.

Outside of this regular budget matter, several other major actions that relate in various ways and in varying degrees will also need to be addressed and may likely end up as part of some “grand deal” by the end of this year.  They include whether or not to reinstitute and/or refashion an across-the-board sequester of funds (50% defense, 50% discretionary domestic), raising the debt ceiling, renewing and refunding the transportation trust fund, continuing certain temporary tax provisions that benefit large corporations and/or low-income families, creating incentives for multi-national corporations to “repatriate” their profits booked off-shore, and whether or not to actually invoke the budget reconciliation process per se or forego it.  In the end, the final decisions on all of these matters will be a function of both policy and political concerns, with an eye toward each party setting themselves up for next year’s elections when a new President and Congress will be chosen.

Overall, the Obama administration and Congressional Democrats are striving to cancel the budget sequester and minimize any general cuts to health care and social programs, except where rational savings can be achieved (e.g., lowering drug costs for public programs.)   While the Budget Control Act of 2011 (enacted as a result of that summer’s fight over raising the debt ceiling) created the sequester process, it has only been invoked occasionally since then, and has been suspended for the past 2 years.  Health care programs were largely exempted from it except for a 2% decrease in Medicare reimbursement rates to providers.

Congressional Republicans are seeking to reinstitute the sequester process in order to lower the overall deficit, and to rejigger its target areas to lessen the impact on defense spending and make up the difference via further cuts to domestic and social programs whose funding is discretionary (as opposed to mandatory.)  (Mandatory programs, termed “entitlements” in federal budget-speak, are programs like Social Security, Medicare, Medicaid, CHIP, SNAP, SSI, veterans’ benefits, etc.)  Should the sequester be reinstated, it is possible that Congress could revisit whether to institute new spending cuts in various health care programs in order to achieve overall deficit reduction target dollar amounts.

As for (yet another) repeal attempt of the ACA, using the budget reconciliation process would allow the Senate to bypass its normal rules for procedural votes where 60 votes are needed for cloture to move forward, thereby allowing simply 51-vote majorities to rule.  However, this special process can only be used when the item under consideration is directly germane to spending, revenue raising, or deficit reduction, and related policy goals are of secondary concern.  It cannot be used in the opposite circumstance where major policy change is attempted via relatively minor financial concerns, and when any measure actually raises the budget deficit.

Given these parameters, the ACA provisions considered at risk would be:

  • the so-called individual and employer mandates (“responsibility’ provisions in ACA-speak)
  • the medical device tax
  • taxes on insurers’ windfall profits
  • funding for the (yet to be created) Medicare Independent Payment Advisory Board
  • the so-called “Cadillac” (excise) tax on employer-sponsored health plans with high actuarial values.

Left unaffected would be funding for:

  • new health benefit exchange marketplaces;
  • premium tax credits and cost-sharing reductions for low- and moderate-people who purchase private “qualified health plans”;
  • expansions of Medicaid in states that have done so.

(N.B.: Source for information here about the ACA and budget reconciliation is from http://healthaffairs.org/blog/2015/10/21/instructions-for-reconciling-tax-credits-basic-health-plan-funding-methodology-released/)

Should these actions be taken in total, the Congressional Budget Office has estimated that the number of uninsured would rise by 14-15 million (20% of whom would be children), premium costs would rise by 20%, and up to 25% of current family planning patients could lose access to services.  Should any or all of these changes and up in a budget bill that goes to the President, he is expected to veto them, so beyond policy considerations, Congressional leaders will also have to decide if they want to expend the time, energy, and political capital to pursue them since a successful veto override vote would likely be impossible.

Health care and social service advocates across New York State are mobilizing through the Restore the America Promise (RAP) campaign to:

  • engage members of the House Majority (in the 2nd, 11th, 19th, 21st, 22nd, 23rd, 24th, and 27th congressional districts) about the importance of health care and social safety net programs to their constituents;
  • engage members of the Congressional Progressive, Black, and Hispanic Caucuses, who have historically championed health care and social programs;
  • engage Senators Schumer and Gillibrand to defend these programs as important to our state overall.

The RAP campaign is a statewide effort jointly spearheaded by Citizen Action of New York, Hunger Action Network of New York State, New York State AFL-CIO, the New York State Alliance for Retired Americans, New Yorkers for Fiscal Fairness, and New York Statewide Senior Action Council.  Here in New York City, No Bad Grand Bargain, a network of labor and community activists, operates as the local affiliate for RAP, and we here at Metro New York Health Care for All coordinate its communications and convene its meetings.

Unexpectedly part of all this political stew is the unanticipated changes in House leadership now underway – how that all falls out and its impact on any final budget deal remains to be seen.  At its most extreme would be a federal government shutdown over family planning funding for Planned Parenthood.  However, speculation is that when all is said and done, a 2-year budget deal that’s not too far afield from the current status quo is likely to be negotiated, simply to get all parties past next year’s elections and into a new presidential administration and Congress when all these (and other) “major issues” will move back to the fore.  In sum, elections do matter.

(P.S.:  One other possible health care budget issue that’s suddenly emerged out of left field is fallout from a recently announced lack of any cost-of-living-adjustment (COLA) next year for Social Security beneficiaries.  As a consequence, Medicare Part B premiums will skyrocket for a limited number of Medicare beneficiaries.  A subsequent post to this blog will discuss that in more detail.)

New York Health Advocates and Stakeholder Allies Gather for 3rd Annual Round of Regional Health Insurance Summits

According to the U.S. Census, New York continues to do very well in lowering the number of uninsured.  The latest numbers released on Sept. 16 show that we’re down to 8.7%, a full 2% reduction during 2014 alone, the first year of the various new coverage options available under the Affordable Care Act.  Since these new options became available, over 2.5 million New Yorkers have enrolled in coverage through the state’s new health benefits exchange marketplace known as “New York State of Health” (NYSOH) as of this summer.  89% of them were previously uninsured.  90% of them report satisfaction with their coverage, according to a study by the New York State Health Foundation.

While this is all good news, there are plenty of “still uninsured” New Yorkers out there.  With that in mind, and in anticipation of the upcoming Open Enrollment Period which begins on November 1st, leaders of Health Care for All New York, the Healthcare Education Project, and the Community Healthcare Association of New York have joined forces once again to convene a series of 8 regional meetings across the state during this Sept. and Oct.  They are designed to bring all the various local stakeholders together to discuss how to keep building on the enrollment successes to date, and brief them on the new, low-cost “Essential Plan” for moderate-income people and families who don’t qualify for public programs because of their income.

The first of these “Health Coverage Outreach and Enrollment Summits” was held for the Hudson Valley on Sept. 17 in Fishkill, attended by approximately 75 people.  The program began with a presentation from Danielle Holahan, Deputy Director for NYSOH, and Piper Allport, the organization’s Outreach Director.  They discussed the latest data and plans for the upcoming open enrollment period, with a spotlight on the Essential Plan and how they will be promoting it.  They were followed by a panel of stakeholders doing outreach and enrollment in the region including Maternal and Infant Services, Westchester Disabled on the Move, MVP Healthcare, Mount Vernon Neighborhood Health Center, and the Westchester Dept. of Health.  The panelists shared their experiences over the past two years, discussed lessons learned, and offered recommendations for the year ahead.  In the final hour, attendees broke up into smaller groups to discuss and brainstorm ideas for what could be done and how they might collaborate.

Upcoming summits will be held in the following regions:

  • NYC: Bronx-Manhattan – Fri. afternoon Sept. 25 in Manhattan
  • Long Island – Mon. morning Oct. 5 in Hicksville
  • NYC: Staten Island – Tues. morning Oct. 6
  • Central New York – Tues. afternoon Oct. 6 in Binghamton
  • Western New York – Thurs. morning Oct. 8 in Buffalo
  • Capital District – Thurs. afternoon Oct. 8 in Albany
  • NYC: Brooklyn-Queens – Wed. morning Oct. 21 in Brooklyn
Full details of times, locations, and how to register can be found at www.hcfany.org.  RSVPs are strongly encouraged so that organizers can plan for adequate space and refreshments.

New Yorkers Proclaim “Medicare and Medicaid: American as Apple Pie”

July 30th was a busy and heady day for New York City’s health care justice movement!   It started off with a wonderfully uplifting celebration of the 50th anniversary of Medicare and Medicaid that took place in the morning at the Professional Staff Congress Union Hall in lower Manhattan.  The place was packed.

BD card    M&M 50 cake

Celebrants were honored to be joined by HHS Region 2 Director Jackie Cornell-Bechelli and her Region 2 CMS Director Frank Winter, Rep. Nydia Velazquez (NY-7th CD, Brooklyn & Queens) , NYS Assembly Health Committee Chair Richard Gottfried (Manhattan), NYC Public Advocate Letitia James, and staff from Rep. Joe Crowley and the NYC Dept. for the Aging.  Thereafter, brief remarks were given by from Dr. Matthews Hurley (Doctors Council, SEIU), Dr. Hemant Sindhu (Committee of Interns and Residents, SEIU), Steve Toff (NY State Nurses Assoc.), Andrew Leonard (Children’s Defense Fund), Chris Widelo (AARP-NY), Audrey Iszard (NYS Alliance for Retired Americans), Mario Henry (NY Statewide Senior Action Council), Monnie Callan (1199 SEIU Retirees), and Vince Gaglione (UFT Retirees).  The formal program closed out with a panel of activists talking about what is needed now to “protect, improve, and expand” Medicare and Medicaid, including John Hyland (Professional Staff Congress), Krystal Scott (Medicare Rights Center), Heidi Siegfried (Center for Independence of the Disabled in NY), Dr. Oliver Fein (Physicians for a National Health Program), and Mark Hannay (Metro NY Health Care for All).  The event ended by sharing in apple pie, and a cake proclaiming “Hurray for Medicare and Medicaid at 50!”

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DG lectern pic

For the afternoon, a dozen or so attendees crossed over the harbor to join Staten Island trade unionists and activists at Staten Island Borough Hall for a press conference calling on the NYC Congressional delegation to protect, improve, and expand Medicare and Medicaid in the current budget fight.  Earlier this year, the Republican majority adopted a budget resolution to cut trillions from various health care programs over the next decade, rather than close corporate tax loopholes and giveaways, end wasteful military spending, and restore taxes on the wealthy.  After taking the obligatory photos for various communications purposes, just as the first speaker began the skies suddenly opened and it rained torrents for a good 10-15 min.  Despite umbrellas, all ended up soaked to the bone, yet maintained good spirits.

SI ferry SIBH 3

The salvation was that a handful then left for a scheduled meeting with the office of Rep. Dan Donovan, the newly-elected Congressmember from Staten Island, and the only member of the House Republican majority from NYC.  The group met with his District Director (Brendan Landry) and Constituent Services Director to express our concerns about ideas on the table in the budget negotiations that will severely impact Medicare and Medicaid.  The attendees took along a homemade apple pie (just out of the oven!) made by UFT retiree Teri Caliari, and a gigantic homemade Medicare birthday card signed by a doctors and nurses from two Staten Island hospitals.  Since Rep. Donovan’s staff were both new in their roles, participants spent much of the meeting informing them of the bad ideas congressional leaders were pushing and why they are not good for New York and New Yorkers.  They seemed engaged on the issues, enjoyed the pie, appreciated the card, and promised to convey our views to Rep. Donovan.

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