This weekend, the US Senate is taking up the new Inflation Reduction Act (IRA), moving it ahead under its special “budget reconciliation” process that will preclude any filibuster from opponents. After months of delays and painstaking negotiations, our own New York Senator Schumer, the Majority Leader, has closed the deal with his colleagues, and it’s likely to pass in the next few days. After that, it will be quickly taken up by the House of Representatives, which will consider via special proxy voting procedures since they have already recessed for their August summer break, and then go to President Biden for a signing ceremony.

We and our partners and allies in Health Care for America Now’s New York State Network have spent the last 18 months engaging with our state’s two senators and House delegation. Our goal has been to make sure that good stuff got into this bill and that bad stuff was kept out, and that sufficient savings were created and revenues raised in fair and just ways to pay for all the bill’s provisions.  

While we didn’t get everything we were all pushing for from the outset of our efforts, what has made it to the finish line for health care is all good, and lays out a foundation to build upon going forward. As is always the case in legislative advocacy, what didn’t make it this time, we take forward into coming election seasons and congressional sessions – our work continues and we fight on.

Here’s what the IRA does to improve health care:

• Requires Medicare to negotiate to lower prices for high-cost prescription drugs, including insulin.
• Creates rebate penalties on drug corporations when they raise their prices above the general inflation rate.
• Caps the amount of co-pays that people on Medicare Part D have to pay for medicines at $2,000/year.
• Caps the monthly co-pays for insulin to $35 per prescription.
• Makes all vaccines free for people on Medicare.
• Expands eligibility to Medicare Part D’s “Low Income Subsidy” (aka “Extra Help”) to more low-income people.
• Slows the annual growth of Medicare Part D premiums.
• Continues for three more years the expanded health insurance premium subsidies for people and families who buy their own coverage on the Affordable Care Act online marketplaces (here in New York: “New York State of Health”.)

The IRA’s tax fairness provisions include:

• Creating a minimum corporate tax of 15% on booked profits, as part of an international agreement among the G20 nations.
• Creating a new 1% excise tax on corporate stock buybacks that are used to inflate stock prices and dividends for shareholders and corporate CEOs.
• Providing more funds to the IRS to go after ultra-rich tax cheats who don’t pay their fair share or what they owe.

How New Yorkers can help get this bill over the finish line:

• Contact our two US Senators Schumer and Gillibrand to a) thank them for their leadership to get a final IRA deal negotiated with their colleagues, and b) get the job done over this weekend.
• Contact your own US Representative to urge they take up the IRA bill as soon as the Senate is done.
• Use phone, emails, and social media platforms to contact lawmakers and your own family, friends, and colleagues!

Many of the health care provisions in the IRA are historic. Because of everyday people pressure, Congress is finally poised to successfully take on and prevail over Big Pharma FOR THE FIRST TIME EVER!  Needless to say, the drug industry is fiercely opposed to IRA, and is pulling out all the stops to protect their long-running price-gouging and profiteering. They are openly voicing threats to exact revenge on supportive lawmakers going forward. We all know that we here in the US pay way more for the same drugs than patients do in any other country, and that the drug industry is far and away among the most profitable in the world and has rigged the system in their favor for years.

Similarly, Wall Street is strongly opposing the IRA’s tax fairness provisions that for the first time in decades starts to close special tax breaks and loopholes that allow large corporations and the ultra-rich to avoid paying any taxes — again, because of people power. This too is historic, and again begins to turn the political tide on an industry long all-powerful in Congress.

It’s been a long haul to get to this point where some good things are about to get done, and some long-entrenched industries successfully challenged. We couldn’t have made it without your support and taking action. The IRA’s goals and provisions are VERY popular with voters despite being opposed by the vested special interests.

It’s that time of year again! …when we all gather to celebrate the anniversaries of the “Big Three” of our nation’s bedrock and very popular social programs: Medicare and Medicaid (July 30), and Social Security (August 14.) These events that we organize annually are always very popular with our partners and supporters, and we invite all to be with us!

Join us on Friday July 29 @ 11 a.m. when we’ll be holding a pandemic-safe celebration on the plaza out front of 780 Third Avenue in midtown Manhattan (@ 48^th St.), the office building where Senators Gillibrand and Schumer NYC offices are located. Members of their district office staffs will be joining us since both Senators will be down in DC finishing up work on several important bills before the recess for their August break.

Here are links to all the details:

• Action Network
• Facebook

During our event, we’ll be talking about:

• How everyday New Yorkers and our families benefit from these 3 programs.
• How we want Congress to protect these programs and address threats to them.
• How we want Congress to improve and expand these programs.

We’ll also be celebrating an exciting new, historic health care bill that is poised to be passed by Congress next week that will:

• Negotiate lower drug prices with #Big Pharma for Medicare (first time ever!)
• Limit how much drug corporations can raise their prices each year for Medicare (first time ever!)
• Cap annual out-of-pocket costs for Rx drugs for people on Medicare (first time ever!)
• Expand financial assistance to more low-income people for Rx drug co-pays.
• Lower annual increases for Medicare Part D drug coverage.
• Provide free vaccines for people on Medicare.
• Continue increased premium subsidies for people who buy Affordable Care Act health plans via the new online marketplaces. (Here in NY: “New York State of Health”)
• Here’s a full summary of this bill from Senator Schumer’s office.

We look forward to seeing everyone then! To keep everyone safe during the current COVID-19 omichron BA5 outbreak, please wear a face mask.

Here are some social media toolkits to use this Saturday morning (July 30), to help create some “trending buzz”:

• New York focus: All 3 programs, Medicaid only (from Medicaid Matters NY)
• National focus: Medicare & Medicaid, Medicaid only (both from Health Care for America Now)
• Medicare focus (from Physicians for a National Health Program)

Finally, late yesterday afternoon, Senator Schumer’s office announced agreement with Senator Machin and other Senate Majority members to add provisions to this bill related to tax reforms and climate change. All together, this combined new bill is known as the “Inflation Reduction Act.” We salute and thank Senator Schumer for his tenacious leadership in crafting this historic bill with his colleagues!

Good news! The US Senate is finally poised to move forward with its own legislative response to the Build Back Better bill passed by the House last fall. It will be much smaller in scope, and focus on key health care issues. The bill does not yet have a name or bill number.

The following provisions have been agreed upon so far:

• Empowering the federal government to negotiate lower drug prices with Big Pharma.
• Limiting how much drug corporations can raise drug prices each year to the general rate of inflation. (Typically, they raise their prices much more.)
• Capping out-of-pocket costs for Rx drugs for people on Medicare at $2,000 per year.
• Limiting how much Rx drug coverage goes up each year for people on Medicare.
• Free vaccines for people on Medicare.
• Keeping health insurance more affordable for people who buy their own coverage via Affordable Care Act (ACA) online marketplaces.

Many Senate Majority members and advocates are also pushing to add-in provisions to:

• Cap monthly co-pays for insulin to $35 per month per prescription
• Provide affordable health insurance to low-income people in states that have not yet expanded Medicaid to more low-income people and families under the ACA. (New York is not one of these states – we expanded our Medicaid program nearly a decade ago.)
• Expand Medicaid and the Child Health Insurance Program in various ways to help improve the health and well-being of new mothers and their babies, children, and adolescents.
• Free vaccines for all low-income people and families on public insurance programs.

Help is needed to get the insulin provisions included. Here’s what you can do:

• Organizations can sign-on to a letter to Senators that is being circulated by Patients for Affordable Drugs, AARP, and allies.
• Individuals can endorse and online petition that is being circulated by T1 International (a group of diabetes activists) and allies.

The final decisions about what ends up in a final package will come down to how much money is available overall, and the individual cost of this and that individual provision. What doesn’t make it in will remain to be pushed for later this fall after the elections as part of a federal budget deal, or next year by a new Congress. In either scenario, we will have our work cut out for us.

Both our US Senators from New York (Charles Schumer and Kirsten Gillibrand) support all these ideas, as do many members of our state’s congressional delegation (all Democrats.)  The Senate is expected to vote on its bill during the first week of August, and the House will vote on it very soon thereafter. President Biden is then expected to quickly sign it.  

All that noted, we can take nothing for granted.  We urge you to contact both Senators Schumer and Gillibrand and your own member of Congress to urge that they move ahead to get this bill done before their August recess, since it’s now been well over a year that lawmakers have been working on it.

We want to acknowledge and thank all our partners and allies in Health Care for America Now’s New York State Network that we coordinate, for all our hard work together over many months to get us to this point. We couldn’t have done it without all of you. People power DOES matter.

While this final bill will not do everything we all want and need it to do to help everyday people in a whole lot of ways, it will nonetheless be historic in finally successfully taking on Big Pharma’s voracious profiteering and unconscionable price-gouging over many years.

Finally, all the ideas mentioned above are all VERY popular. There is no reason for any lawmaker or candidate for office to hesitate to embrace them. They are winning issues with voters across the political spectrum. We urge you to push for them during the coming election season.

Join us in midtown Manhattan this Fri. June 10th at 12 noon as we join with health and social justice activists worldwide to collectively to demand that the US and European countries “end COVID monopolies” and “vaccinate and treat the world now!”  Our event is one of many Global Days of Actions organized by the People’s Vaccine Alliance during early June. They are being held prior to the the upcoming annual Ministerial Conference of the World Trade Organization (WTO) that begins on Sun. June 12 in Geneva.  The issue of the WTO adopting a comprehensive response to the COVID-19 (and future) pandemics will be one of the top agenda items.

Here in NYC, we and our allies who lead the #EndVaccineApartheidNYC campaign will be gathering for “Earth to Europe and the US: End COVID Monopolies Now!” We’ll be marching to the UN Missions of Switzerland, European Union, United Kingdom, Germany, and US, to call them out for not taking the necessary steps to stop the COVID-19 pandemic and save millions of lives, and deliver a letter of demands to each country’s UN Ambassador.

Schedule of event components:

• 12 noon — Gather in Grand Central Plaza, 622 Third Ave. (NW corner of East 40th St.)
• 12:05 — Swiss Mission to UN, 633 Third Ave. (NE corner of East 40th St.)
• 12:15 — European Union Mission to UN, 666 Third Ave. (NW corner of East 42nd St.)
• 12:30 — United Kingdom Mission to the UN, 885 2nd Ave. (NW cor. East 47th St.)
• 12:45 — Germany Mission to the UN, 871 1st Ave. (SW cor. East 49th St.)
• 12:55 — US Mission to the UN, 799 First Ave. (SW cor. 45th St.)

Since the fall of 2020, these five Western nations have stood in the way of efforts at the WTO to temporarily waive international intellectual property rights so that COVID-19 tests, treatments, and vaccines can be immediately mass produced and used everywhere around the world, particularly in the Global South. As a result, millions get sick and many die, the pandemic keeps spreading, and new viral variants emerge that threaten all of us everywhere.  Instead of protect everyday people everywhere, these countries are protecting #BigPharma’s pandemic profiteering.  Over 120 nations are supporting a proposal from India and South Africa for the WTO to adopt a comprehensive “TRIPS waiver” to end the global pandemic as quickly as possible.

Here is the Action Network event and Facebook event to share.

List of participating organizations [list in formation]:

• Center for Popular Democracy and CPD Action
• Health Global Access Project (HealthGAP)
• Housing Works
• Metro New York Health Care for All
• New York Trade Justice Coalition
• Physicians for a National Health Program, NY Metro Chapter
• Public Citizen Global Trade Watch
• Rise and Resist
• Showing Up for Racial Justice NYC

Contrary to the wishes of many, the COVID-19 pandemic is not yet over, and there’s still important work to do to put it and its consequences firmly behind us. June is going to be a crucial month for Congress to get some important pandemic bills done before summer arrives in July when much attention will shift from lawmaking to election campaigning.  

Here’s what needs to get over the finish line:

Continuing to Stop the Pandemic – Since March 2020, Congress has passed 6 bills to address the pandemic in various ways. Shockingly, the last round of funding authorized in March 2021 under the American Rescue Plan Act (ARPA) was not renewed by Congress this past March 2022 as part of a broad federal budget bill. Since then, much US funding for global programs has ceased, and domestic programs to pay for vaccines, testing, and treatment have begun to expire. The House did pass a stand-alone bill to restore such funding prior to their Easter-Passover break in mid-April.

However, the Senate has been gridlocked since then, for several reasons. One is political-ideological: the desire by the Republican Minority for the pandemic to be over-and-done-with as a public health crisis and shifting into a manageable “endemic” phase, regardless of reality. (Infection rates are going up again nationwide as we experience a new, fifth wave.) In addition, they want to use yet-to-be spent pandemic funding already made available to states under previous bills rather than appropriate new amounts, something many governors and Senate and House Majority members object to.  

Another unrelated but complicating factor concerns whether to continue or revoke use of Title 42 of the Public Health Service Act, a provision that allows federal immigration authorities to prohibit people from entering the US if they pose a public health threat. Early on in the pandemic, the Trump administration cynically and opportunistically invoked it as a general immigration control (vs. public health) measure, particularly with regard to people seeking asylum at the southern border. Now, the Centers for Disease Control believes that use of Title 42 is not necessary to protect public health since the pandemic is already widespread across the US. However, the Senate Republican Majority is seeking to attach a rider to a new pandemic funding bill that would keep Title 42 restrictions in place by law (vs. Executive Order, as is currently the case), again as a general immigration measure, which is a misuse of current public health law.

Recovering from the Pandemic – Last fall, the House passed the Build Back Better Act, a comprehensive bill to foster longer-term economic and social recovery from the pandemic. (Previous bills were primarily focused to provide immediate response and relief.) Since then, the Senate has been gridlocked over how to respond to the House bill. The Senate Majority has been working to craft a “budget reconciliation” bill that will likely be narrower in scope and ambition, with a focus on lowering Rx drug prices and out-of-pocket costs (see details below), responding to climate change, rebalancing our economy and tax system by raising taxes on large corporations and the ultra-rich, and paying down some of the accrued national debt. We are all awaiting and hoping for an agreement to be announced and legislative action taken very soon.

What’s already agreed upon to lower prescription drug prices and out-of-pocket costs as part of a new Senate bill:

• Directing Medicare to negotiate prices with drug corporations.
• Limiting how much drug corporations can raise drug prices each year to the rate of general inflation.
• Capping the total amount of co-pays for people on Medicare to $2,000 per year.
• Capping monthly co-pays for insulin to $35 per prescription.

Health advocates are also pushing for the inclusion of these health care measures as part of it:

• Extension of health insurance premium subsidies for Affordable Care Act (ACA) health plans that were expanded under ARPA.
• Continuing funding to states for home and community-based long-term care services that were expanded under ARPA.
• Creation of a new “work-around” health insurance program for low-income people who live in the 12 states that have not yet expanded Medicaid under the ACA and consequently remain unnecessarily uninsured. (New York is not in this category.)
• Making funding for the State Child Health Insurance Program permanent.
• Providing funding to states to address disparities in maternal-child health morbidity and mortality.

We urge you to reach out our two US Senators from New York, Charles Schumer and Kirsten Gillibrand about these issues. Both are supportive of all of them, and are pushing to bring them to fruition. They deserve our thanks, and encouragement to keep working for a final deal. Here’s how to contact them:

• Sen. Schumer – by email;  by phone
• Sen. Gillibrand – by email; by phone

Please also contact them on social media.

One additional and important note: As you contact both our Senators, it is important to stress that final deals are needed this month. Given the congressional calendar for this year and the impending mid-term elections this fall, it is vital that progress be made on these issues as quickly as possible, before the July 4^th recess week. After then, it will be very challenging to make progress on them.

Finally, it’s also helpful to check-in with your U.S. Representative to thank them for what they’ve already done, and to encourage them to keep working with the Senate to get these additional bills completed. Here’s how to get in touch with them.

Only two weeks and six session days left to go! That’s it for getting some good health care stuff done before the New York State Legislature adjourns for this year in early June. Here’s one more set of bills being put forward with regard to reproductive health care rights.

Earlier this month, a draft opinion in the Dobbs v. Jackson Women’s Health Organization case now before the US Supreme Court was leaked to the media. Its content signaled that the Court is poised to negate a constitutional right to abortion affirmed in their 1973 Roe v. Wade ruling. A final, official decision is due out by the end of next month.  

Since this leak, some state governments –including New York– are moving to enact laws to protect this and other rights that are threatened by the language of the draft. The good news is that three years ago, New York codified the rights affirmed by Roe v. Wade into state law.  
However, there’s more that can be done, and here’s what’s emerging in the State Legislature:

Equality Amendment (S.9707, Krueger) — An amendment to Article 1 of the State Constitution to a) assure that that equal rights may not be denied on account of race, color, ethnicity, national origin, disability, and sex including pregnancy and pregnancy outcomes, sexual orientation, gender identity, and gender expression, b) bar discrimination in both intent and impact by government entities, as well as barring discrimination in both intent and impact by entities in the provision of public accommodations, employment, or personnel practices, and c) protect the validity of efforts to prevent or dismantle structural forms of inequality and discrimination on the basis of a protected characteristic.

Reproductive Freedom and Equity Fund Act (S.9078/A.10148, Cleare/Gonzalez-Rojas) —  A bill to create a grant program to ensure access to abortion care in the state by providing funding to abortion providers and non-profit organizations whose primary function is to facilitate access to abortion care, particularly for those traveling from another state.

Freedom from Interference with Reproductive and Endocrine Health Advocacy and Travel Exercise (“FIRE HATE”) Act (S.9039/A.10094, Biaggi/Burdick) – This bill establishes a cause of action for unlawful interference with protected rights, to protect the rights of individuals seeking abortion care or gender-affirming care in New York.

Protection for Abortion Providers (S.9070A/A.9678A, Kaplan/Rosenthal) – A bill to Prohibit professional misconduct charges against health care practitioners on the basis that such health care practitioner, acting within their scope of practice, performed, recommended or provided reproductive health care services for a patient who resides in a state wherein such reproductive health services are illegal.

Role of New York Law Enforcement (S.8778/A.9615, Krueger/Lavine) – A bill to prohibit law enforcement from cooperating with out-of-state investigations related to the provision of lawful abortions.

Role of New York Courts (S.8779/A.9613, Krueger/Lavine) — A bill to prohibit New York courts and county clerks from issuing subpoenas in connection with out-of-state abortion proceedings.

It’s possible that several of these bills will be combined into a package to be considered as a whole. The legislative process with regard to them is fluid, so we urge people to be in contact with local reproductive rights advocacy groups to stay informed about developments and advocacy efforts.

Only six session days left to go! That’s it for getting some good health care stuff done before the New York State Legislature adjourns for this year in early June. Here’s one more set of bills being put forward to help more (if not all) New Yorkers get guaranteed health care:

Bills to Expand Insurance Coverage:

Continuous Medicaid for Infants and Toddlers (S.8438/A.9294, Rivera/Gottfried) – This bill will automatically extend Medicaid coverage to all eligible young children through the first three years of life. Currently, such coverage ends after only one year, at which point their family must either recertify for Medicaid or shift to another form of insurance coverage. Research shows that the first 1,000 days of a child’s life are very important to their physical, mental, social, and emotional development, and having health coverage in place during that period significantly advances those goals. In the Senate, this bill has passed through the Health Committee and is now before the Finance Committee. In the Assembly, It has passed through the Health Committee and is now before the Ways and Means Committee.

Universal Health Care (New York Health Act, S.1572A/A.880A, Rivera/Gottfried) – This bill will create a publicly-funded, publicly-administered health insurance program covering all New York residents and workers. It is similar to Medicare-for-All bills in Congress. The bill is currently in Health Committee in the Senate, and has passed through both the Health and Codes Committees in the Assembly and is now is in the Ways and Means Committee.

The campaign in support of the first bill above is being jointly led by our colleagues in Medicaid and various child health and welfare advocacy groups. The Campaign for New York Health is leading advocacy efforts to advance the New York Health Act, and we sit on its Steering Committee.

At this point in the legislative process, for either of these bills to move to the floor in either chamber for a debate and vote, each chamber’s Rules Committee will have to call up the bill directly. Whether or not they do so is based on the wishes of the leadership and/or strong support within the majority party’s conference membership. Again, we urge you to contact your own legislators about them. Strong public support is necessary at this point.

It’s now just seven session days to go! That’s it for getting some good health care stuff done before the New York State Legislature adjourns for this year in early June. Here’s another set of bills poised to move ahead to passage:

Improving Hospital and Community Relations

For more than two decades under several governors, scores of hospitals across New York State have been allowed and urged to merge, downsize, or outright close as new large hospital systems have been created as part of regional restructuring to improve financial stability of individual facilities systems as these networks seek to expand market share.  As a result, local communities have had their health care system destabilized, and they are left with fewer services or none at all.  The current COVID-19 pandemic has revealed the drawbacks of consolidations and closures for all to see.  Again, a universal health care program with proper health planning would have prevented various adverse outcomes, and made sure that communities have access to the services they need, particularly during a public health crisis.

Absent that however, there are some steps that New York lawmakers are taking to begin to reassert a proper role for communities in what happens to their hospitals as our health care system consolidates. These bills include:

Local Input for Community Healthcare Act (S.3131A/A.2251A, Kavanaugh/Simon) – As crazy as it seems, under current New York law, when a hospital closes or dramatically downsizes core services, no government approval or advance notice is required, and a public hearing in the affected community is only required within 30 days AFTER it happens! This bill flips the dynamic around so that:

• Closure of facilities or key services must be announced in advance.
• The State Dept. of Health plays an active role in approving, overseeing, and managing a closure.
• The local affected community has meaningful opportunities for input into the process overseen by the State.

This bill also applies to closures of maternity units and emergency departments, as well as a full-out shut down. This bill has already passed through the Assembly, and has passed through all relevant committees in the Senate and is ready for a floor vote.

Improved Transparency of Available Services (S.5400/A.6334, Hinchey/Rozic) – Often when patients are seeking personally-sensitive services from hospital systems such as reproductive health care, end-of-life care, or gender-affirming care, they suddenly discover that it may not be available from their local facility because of non-medical, policy-based exclusions made by the facility’s operators. This bill helps patients navigate such situations by:

• Requiring hospitals to publish what services they choose to exclude.
• Requiring hospitals to comply with existing state and federal law as to what services they provide. in a manner that is non-discriminatory against particular classes of patients.
• Requiring insurers to make such information available about their provider networks prior to someone enrolling in one of their health plans.
• Requiring the State to research and publish a report on the statewide scope of this problem by facility and hospital network.

We urge you to contact your State Legislators to express your opinions about either of the above bills if you support them, since the clock is ticking.

A few years ago, Community Catalyst, a Boston-based health policy organization that works with state-based health advocacy coalitions, helped to form the Community Voices for Health System Accountability project here in New York, in partnership with Health Care for All New York and Medicaid Matters New York. Its purpose is to foster a better, more meaningful role for community residents, leaders, and advocates with regard to their local hospitals and health care facilities, and to strengthen New York’s oversight of these institutions. We have participated in this project since then.

Eight legislative session days to go! That’s it for getting some good health care stuff done before New York State lawmakers adjourn for this year in early June. Here’s one set of bills poised to move ahead to passage:

#EndPatientMedicalDebt:

In recent years, medical debt that simply cannot be paid off by patients has emerged as one of the top concerns for health care consumers, and politicians nationwide are starting to sit up and take notice. Of course, comprehensive solutions (such as universal health care!) are needed to fully resolve the problem, but unfortunately that approach will take more time to develop a head of political steam both in Congress and the State Legislature. In the meantime, there are some steps New York lawmakers are taking to help alleviate the crisis:

Ending Wage Garnishments and Liens on Primary Homes (S.6522/A.7363, Rivera/Gottfried) – All hospitals in New York are legally non-profit charities, yet a small handful of large, well-resourced hospital networks can and do sue patients for outstanding debt, despite the fact that the State provides hospitals with a total of more than $1 billion/year to compensate for indigent care. When a hospital successfully sues a patient, as part of the judgement they can ask the Court to place liens on property and garnish workers’ wages, a practice advocates consider cruel and counterproductive. This bill would prohibit such practices. The good news is that it has passed through both chambers and will soon be sent on to Governor Hochul for her consideration to sign or veto.

Regulating “Facility Fees” (S.2521A/A.3470B, Rivera/Gottfried) – These new charges are something that many hospitals and medical practices are now tacking onto patients’ bills as a “resort charge” for just walking in the door seeking care. (Yet another way to pad their bottom line by sticking it to patients.) Sometimes these fees can be quite substantial depending on the overall amount of a bill. This legislation would a) prevent health care providers from charging these fees for preventive care, and b) require them to notify patients in advance when one is to be charged so that it doesn’t come as a surprise later on. The bill has advanced out of all relevant Committees in both chambers, and is ready for a floor vote.

Modernizing and Standardizing Hospital Financial Assistance Programs (S.7625/A.8441, Rivera/Gottfried) – All hospitals in New York are required by law to offer financial assistance programs to lower-income patients in the form of discount prices for in-patient services, and installment plans to pay down bills over time. However, there is little uniformity in learning about and applying for them, so many patients who could qualify never sign-up and get stuck with sky-high bills instead. This legislation would a) make the financial assistance process transparent and uniform across all facilities, b) streamline the application process without requiring lots of red tape and paperwork, and c) raise the income eligibility level to conform with those of the federal Affordable Care Act. This bill has passed out of all relevant committees in the Senate and is ready for a floor vote, and is now before the Ways and Means Committee in the Assembly after having passed out of the Health Committee.

We urge you to contact your state legislators about these bills since the clock is ticking.

With funding from the New York State Health Foundation, Health Care for All New York, a statewide coalition we help to lead, has been spearheading this multi-year campaign on patient medical debt, and we are proud to be part of the core team for it. In recent years, our campaign has passed bills to:

• Lower the annual interest rate hospitals can charge (if they choose) on outstanding bills to from 9% to 2%.
• Lower the statute of limitation for lawsuits from 6 to 2 years.
• Expand New York’s Surprise Medical Bills Law to cover all emergency room services at in-network rates.

The New York State budget process has spilled over into this week (past its April 1^st deadline), and is due to wrap-up in the next couple of days. There are still some key health care issues on the table that need one final push, and we urge everyone to contact lawmakers about them.

Here are the outstanding health care issues advocates are supporting:

• Public health insurance eligibility for ALL low-income New Yorkers regardless of immigration status (“Coverage for All”)
• A living wage for health care workers who provide home and community-based long-term care (“Fair Pay for Home Care”)
• Standardizing Medicaid eligibility criteria so that low-income people on Medicare qualify for Medicaid just like everybody else (“Medicare-Medicaid Equality”)
• Fair distribution of Indigent Care Pool funds to only those hospitals deemed “Enhanced Safety Net Providers”, as required by federal law.
• Higher Medicaid rates for health care providers to restore cuts from previous years and provide a long-delayed raise in general.

Here’s how to contact key State leaders to express your opinion on one or more of the above:

• Governor Kathy Hochul: 518-474-8390
• Senate Majority Leader Andrea Stewart-Cousins: 518-455-2585
• Assembly Speaker Carl Heastie: 518-455-3791

Some background on the State-of-Play:

Coverage for All – At the very last minute, Governor Hochul and her Division of the Budget have suddenly asserted that the cost of this provision is much higher than a reputable independent study from the Citizen’s Budget Commission and the Community Service Society of New York, yet she has provided no documentation to back up the claim. Unfortunately, many Albany observers note that Governor Hochul is not supportive of including all immigrants in various proposals to help lower-income people.

Fair Pay for Home Care – Governor Hochul and her Division of the Budget originally proposed that home care workers be provided with one-shot bonuses to attract and retain them as part of the long-term care workforce. The Legislature prefers instead to provide these workers with a permanent pay raise. New York’s current home care workforce is woefully inadequate, to the point where thousands of frail and disabled New Yorkers have been approved for such services but there is literally no one ready to provide the care because the salaries are too low to draw and keep people in the profession.

Medicare-Medicaid Equality – Over the past decade, all of New York’s public health insurance programs have significantly raised their income eligibility levels and eliminated asset tests as part of their applications. However, the State has yet to do either for low-income people on Medicare who need Medicaid to augment the services Medicare does not cover (vision, dental, hearing, and long-term care) that everybody else on Medicaid routinely receives.

Governor Hochul initially proposed that the State standardize Medicaid eligibility criteria for all low-income people across the board, and the Legislature agreed. However, suddenly the Elder Law attorney lobby has flexed its political muscle to sew doubt with Governor Hochul and some legislators about eliminating an asset test. One of the major lines of business of these lawyers has been to assist middle and upper-income people on Medicare to restructure their finances so that they can then qualify for Medicaid coverage while also sheltering their assets. However, most low-income people on Medicare cannot afford these legal services. and they are denied Medicaid eligibility until they spend-down any modest assets they may have, thereby forcing themselves into poverty first.

Safety Net Hospital Support — For many years now, almost all hospitals across New York have received funding from the State’s billion dollar Indigent Care Pool that reimburses hospitals for services provided to uninsured and Medicaid patients. However, federal law requires that federal funds received for that pool must only go to those hospitals that provide care to large numbers of these patients. These hospitals are collectively known as Safety Net Providers. Unfortunately, New York has yet to update its distribution formula because of resistance from politically-influential hospital systems that would likely lose this funding. Neither Governor Hochul nor the Legislature have put this idea on the table in this year’s budget process.

Higher Medicaid Rates for Providers – Generally speaking, while nothing is locked down in the budget negotiations until everything is locked down, Gov. Hochul’s proposals on this issue seem on solid ground and the Legislature is in full support. So barring anything unusual happening at the last minute, they seem likely to be included. In addition, the health care provider community is strongly in support and they are usually very influential on health care issues in Albany.

Some larger factors at play:

• At the very last minute, after the public hearings were over and the Legislature’s one-house budget bills were passed, Gov. Hochul suddenly proposed a $600 million subsidy for a new football stadium in Buffalo, and also demanded major criminal justice reforms that technically have nothing to do with the budget per se. Both these ideas have fostered confusion and division in the Legislature.
• Advocates are demanding increased transparency, accountability, and justification for the State’s various regional economic development projects that over the years have generally utterly failed to meet their objectives, and they were often just shoveling billions of dollars to politically-connected businesses and institutions. This funding can be put to much better use to grow our state’s economy by increasing spending on long-underfunded health and social programs that help everyday New Yorkers.
• While the State currently projects a revenue surplus for the new fiscal year (estimates range from $6 to $10 billion), Gov. Hochul want to take a significant portion of that and put it in the State’s “rainy-day” reserve fund. However, many health and human service advocates are saying that “it’s raining now” for many lower-income everyday New Yorkers, particularly in the wake of the COVID-19 pandemic and its accompanying economic recession that many communities have yet to emerge from.