It’s the annual “budget season” in Albany right now, and advocates, lobbyists, and others are crowding the halls of the State Capitol and the Legislative Office Building to plead their cause and the money needed for the programs they care about. As part of our statewide coalition Health Care for All New York (HCFANY), we too are working the shoe leather and bending the ears of legistors and their staff. Our key priorities include:

1.  Expanding and preserving health coverage options for immigrants. Of those who are still uninsured across our state, immigrants are the largest group. While many have benefited from the Affordable Care Act (ACA), others remain without any options other than Emergency Medicaid. Also, some low-income immigrants who qualify for Medicaid because they have Temporary Protected Status (TPS) or Deferred Action for Childhood Arrivals (DACA) status may lose it because of anti-immigrant moves by the Trump administration.

What NY can do: Open up the state’s very successful (and public) Essential Plan to low-income immigrants who don’t otherwise qualify for Medicaid. The state should continue Medicaid coverage for people who may lose their TPS or DACA status.

2.  Making coverage more affordable to buy and use. While the ACA has moderated health insurance premium growth significantly in New York, policies still remain expensive and deductibles and co-pays can be quite high depending on the metal-level plan one selects. When people move from public programs for the low-income into the private market, the financial shift can be quite dramatic and stressful, and many are living paycheck-to-paycheck.

What NY can do: Allow moderate-income people to “buy-in” to the Essential Plan at a modest premium price if they’d like. Also, augment existing federal premium assistance with additional funding to make premiums more affordable.

3.  Reaching out to the still-uninsured to help them enroll in coverage. Surprisingly, there are a significant number of people who already qualify for public programs and financial assistance, but for a variety of reasons they have not yet enrolled in coverage. They often are among the hardest to reach because the “live in the shadows.”

What NY can do: Provide modest funding to trusted, grassroots community groups to go out and locate the uninsured, answer their questions, allay their fears, help them understand their options, and get them to enrollers.

4.  Expanding consumer counselling and ombuds services. One of our state’s crown jewels resulting from the ACA is the Community Health Advocates (CHA) program. It is a statewide network of non-profit organizations which helps people and small employers who have all kinds of insurance. CHA helps them to use and solve problems with their coverage and accessing services, often saving them significant amounts of money and cutting through red-tape and hassles. As more people get enrolled in coverage and seek the care they need, demand for CHA’s free services is significantly increasing. (Find a CHA group near you at www.communityhealthadvcoacates.org or call their hotline at 888-614-5400.)

What NY can do: Increase funding for the program to help more people solve insurance issues and get and afford the care they need.

5.  Distributing indigent care funding in a fair and just manner. New York has always provided robust amounts of funding to hospitals to provide care to the uninsured and low-income people. However, those funds have often not been properly distributed to those facilities that actually care for large numbers of uninsured and Medicaid patients. Because of provisions in the ACA, the state has moved to (mostly) fix this problem, but a once-temporary transition period has been inordinately extended, and our safety net and public hospitals still do not get the full funding they deserve.

What NY can do: End the transition period, and fully support safety net and public hospitals.

One question that may likely come up as you promote one or more of these ideas is “how to pay for it?” As we indicated in our previous email, the overall answer is to raise the revenue needed by requiring those who’ve economically benefited so much in the last decade (or longer) to now pay their fair share of taxes. Our colleagues at the Fiscal Policy Institute have a menu of good ideas for the Governor and Legislature to choose from, and we can push them forward.  (See: www.fiscalpolicy.org.)

Among the key revenue options are:

• An “Ultra-Millionaires Tax” to create additional marginal tax rate tiers above current levels.
• A “Carried Interest Fairness Fee” to tax the incomes private equity and hedge fund managers at a rate equivalent to normal earned income.
• A “Pied-a-Terre” tax on unoccupied luxury apartments that merely serve as investment vehicles for real estate speculators.
• A “Stock Transfer Fairness Fee” on high volume sales of stocks.
• A “Stock Buy-Back Transfer Tax” on corporations who buy back their own stock from investors instead of using their excess profits and tax windfalls to create jobs, invest in research and development, or increase wages and benefits for their workers.

While all the issues discussed above may seem overwhelming, we urge you to take up those of them you feel comfortable and confident about, and reach out to your state legislators with your views on them. Some people will cover some of them, and others will do others, so that in the end, they all get raised and it’s all good. Thanks for taking on whatever you can do!

It’s that time of year again in Albany: “Budget Season”. Since health care is always one of the biggest items in the annual state budget, there’s always a lot of specifics to pay attention to and advocacy to do.

But first, it’s time to “change the game!” for the overall budget process so that we’re no longer at the mercy of powerful special interests, and no longer fighting over the leftover crumbs when it comes to the health care needs of everyday New Yorkers.

What needs to happen now, and what’s in play:

#1: Creating “Fair Elections” – Our coalition was founded 26 years ago to foster community and labor coalition in New York to fight for universal health care. The reality is that we would have achieved our goal YEARS AGO were it not for the inordinate influence of the vested special interest and big donor money in our political process. NOTHING would make more of a difference to advance our cause than combating, rebalancing, and ending that influence, BY FAR. If we want universal health care, we have to have major campaign finance reform — it’s that simple.

In his budget proposals released in mid-January, Gov. Cuomo called for a) drastically limiting the amount of election campaign donations that corporations and large donors can contribute to any candidate, and b) the creation of a “small donor matching” system of public financing of elections. You can read more all about it here: www.fairelectionsny.org. We’re proud to be part of the Fair Elections for New York campaign, and serving as a liaison to the broader health advocacy community about it.

A Fair Elections system has been in place here in New York City for two decades now, and it has dramatically transformed our city government in terms of who gets elected and what issues are taken up and acted upon. We now have a government that is much more reflective of the residents of our city, and that focuses on the needs of everyday New Yorkers when it comes to health care and so many other of our shared concerns. We can now do the same statewide in our elections for Governor, Attorney General, Comptroller, State Senate, and State Assembly.

#2: Creating “Shared Prosperity” – For nearly a decade now, Governors Paterson and Cuomo and the State Legislature have intentionally limited spending in and the annual growth of the state budget. While this may have made some fiscal sense in the immediate wake of the Financial Crisis of 2008 and the subsequent Great Recession of 2009-10, things have clearly changed in our state’s economy since then so that such strategies are no longer needed, yet they continue to be invoked by Gov. Cuomo year after year. New York can now easily afford to raise more and sufficient revenue and spend more on many public programs to benefit everyday people struggling to get by, particularly for those who are still suffering from the ramifications of the Great Recession. Further, the economic growth and assistance that has occurred over the past decade has been VERY skewed toward the already-very-well-off, so our tax and spending priorities now need to be significantly recalibrated to assist people and communities in need, and raise enough money to do so.

Accordingly, the “New Hope for New York Budget Principles” campaign was launched late last fall to lead the charge for our state government to change direction with regard to overall budget policy and take a new, more socially-just path. It is being jointly led by the New York State Council of Churches, the Fiscal Policy Institute, and Strong Economy for All, and many public interest groups and faith communities have joined in to support it. You can read more about this campaign and join in its efforts here: https://bit.ly/2SJ8knj   We are proud to be participating in this campaign to help provide leadership and guidance to it as concerns health care issues such as coverage for all immigrants and universal health care.

Unfortunately, Gov. Cuomo continues to adhere to his budget austerity approach, and says he does not want to ask the ultra-wealthy to pay their fair share of taxes in order for the state to have enough money to meet the health and human service and other needs of struggling people, families, and communities which exist in every corner of our state. He claims the rich will up and leave the state, despite the fact of evidence to the contrary throughout this decade since the state instituted a “millionaires tax: on upper-income people. You can reach more all about that here: www.fiscalpolicy.org.

What’s happening now, and what you can do:

Right now, each house of the State Legislature is crafting their one-house budget bills which they will be releasing and voting on next week. These bills reflect changes each house wants to accept, change, or delete from what the Governor has proposed. We need to make sure that each of their bills contains provisions to a) create a “Fair Elections” program (so that we can move forward toward a universal health care program), and b) adopt a “Shared Prosperity” budget framework that promotes just economic recovery and growth to meet the broad range of human and community needs, including health care.

We urge New Yorkers to reach out to your State Senators and Assemblymembers now about these matters, and to share these ideas with friends, family, neighbors, and colleagues. Make a call, send an email, do a tweet! The state budget process will wrap-up by the end of this month, so NOW is the time to act.