[NYAPRS Enews] NYS Advocates Urge Leaders to Back House Health Care Reform Medicaid Formula

[Harvey Rosenthal]

NYAPRS Note: This letter comes from a broad NYS coalition of statewide
and regional health care advocacy groups (including NYAPRS) urging
Congressional leaders to protect New York State's Medicaid system by
backing the House rather than the harmful Senate health care reform bill
Medicaid formulae. Note Governor Paterson's comments to this point
issued yesterday after news of the Senate healthcare agreement. 

 

Honorable Harry Reid, Majority Leader

United States Senate 

528 Hart Senate Office Building

Washington, DC 20510 

 

Honorable Nancy E. Pelosi, Office of the Speaker 

US House of Representatives

H-232 US Capitol

Washington DC  20515

 

December 18, 2009

 

RE: Ensuring Equitable Federal Funding for State Medicaid Programs in
Final HCR

 

 

Dear Speaker Pelosi and Majority Leader Reid,

 

As organizations committed to ensuring all Americans have access to the
healthcare coverage they need and deserve, we applaud your ongoing
efforts to pass national healthcare reform legislation.  We are certain
your work will transform the lives of millions of Americans, and we
thank you for your leadership and perseverance in this endeavor.  

 

We offer our strong support for your decision to accomplish a national
expansion of health insurance coverage for millions of Americans.   

 

Over the last two years, New York State leaders have worked tirelessly
to expand health insurance coverage to individuals and families who are
falling through the cracks due to New York's high cost of living coupled
with high insurance premiums. We are proud of the coverage expansions we
have enacted.  We are writing today to ask for your assistance in
protecting the gains New York has made in expanding coverage for our
most vulnerable citizens. 

 

We wish to bring to your attention that, as currently written, the
Senate Patient Protection and Affordable Care Act (H.R. 3590) penalizes
New York State by denying it desperately needed federal matching dollars
to expand coverage to uninsured New Yorkers simply because New York
provided Medicaid coverage to low income adults and children before it
was required to do so by federal law.  

 

At present, the Senate Bill provides for enhanced FMAP only to the
extent that a state does not cover adults up to 133 percent of the
federal poverty level (FPL). Therefore, under the Senate plan, New York
would only receive the enhanced FMAP for single adults between 100 and
133 percent of the FPL - less than 100,000 people out of the more than
five million low-income New Yorkers eligible for Medicaid.  The Senate
Bill will mean close to $1 billion annually in added costs for New York
State as hundreds of thousands of uninsured New Yorkers enroll in
Medicaid as a result of reform.

 

By contrast, the House Affordable Health Care for America Act (H.R.
3962) effectively provides enhanced FMAP for individuals with incomes up
to 150% of the FPL who are not currently eligible under a state Medicaid
plan.  Under the House Bill, New York would receive an enhanced FMAP for
all single adults and for parents from 85% to 150% of the FPL. 

 

The House bill provides for a far more equitable distribution of federal
matching funds. We are at a loss to understand why the federal
government should pay barely half of the costs of covering single adults
in New York State and an average of 91% in virtually every other state
in the nation. 

 

Federal health care reform should not advance on the backs of New York
taxpayers. Not only is this unfair, but it puts in jeopardy our
healthcare system. New York needs a national healthcare reform bill that
treats all states fairly: one that does not leave behind those states
that have already made significant coverage expansions. 

 

We are also deeply concerned about the provisions in the Senate health
care bill that would reduce Medicaid and Medicare Disproportionate Share
funds.  There will continue to be low-income individuals without health
coverage for whom cost sharing will be well beyond their means.  In New
York the uninsured, underinsured and Medicaid beneficiaries account for
more than a third of the population.  New York's public hospitals are
the leading providers of health care to low-income uninsured residents
and, in some communities, the single largest provider of primary care.
Significant reductions in DSH funds will weaken New York's health care
safety net and undermine the service delivery goals we all seek to
achieve.

         

The Senate bill reduces DSH funding by more than twice as much as the
House bill.  At minimum, the total level of DSH reductions should be
what the House bill proposes.

 

We appeal to you today with one voice, and as one state seeking your
leadership on this critical issue.  We ask you to ensure that the
healthcare reform bill that moves to the conference negotiation process
guarantees New York equitable treatment.  We must not abandon our most
vulnerable citizens now. 

 

Sincerely,

 

1199 SEIU United Healthcare Workers

BALCONY - Business and Labor Coalition of New York

Center for Independence of the Disabled, NY

Cerebral Palsy Associations of New York State

Citizen Action of New York

Citizens Committee for Children of New York 

Commission on the Public's Health System

Community Health Care Association of New York State (CHCANYS)  

Community Healthcare Network

Family Planning Advocates of New York State 

Greater New York Hospital Association (GNYHA)

Health Care For All New York Campaign

Healthcare Association of New York State (HANYS)

Housing Works

Legal Aid Society

Medicaid Matters - New York State 

Medical Society of the State of New York  

Mental Health Association of New York City 

Mental Health Association of New York State

             New Yorkers for Accessible Health Coverage

             New York Association of Alcoholism & Substance Abuse
Providers  

New York Association of Homes and Services for the Aging

New York Association of Psychiatric Rehabilitation Services

New York Chapter of the American College of Physicians Services, Inc.

New York City Health and Hospitals Corporation (HHC)

New York State Coalition for School-Based Health Centers

New York State Conference of Local Mental Hygiene Directors 

New York State Council for Community Behavioral Healthcare

New York State Nurses Association

New York StateWide Senior Action Council

The Alliance of Long Island Agencies, Inc.

The Coalition of Behavioral Health Agencies

The Coalition of New York State Health Plans

The Community Service Society of New York

The New York State Academy of Family Physicians

PHI, Health Care for Health Care Workers

Primary Care Development Corporation

United Neighborhood Houses

YAI Network

 

cc:  Senator Charles Schumer

       Senator Kirsten E. Gillibrand

       Representative Charles B. Rangel

       Representative Gary Ackerman 

       Representative Michael A. Arcuri 

       Representative Timothy Bishop

       Representative Yvette D. Clarke

       Representative Joe Crowley

       Representative Eliot Engel 

       Representative John J. Hall

       Representative Brian Higgins

       Representative Maurice Hinchey  

       Representative Steve Israel 

       Representative Peter King 

       Representative Christopher J. Lee

       Representative Nita Lowey

       Representative Daniel Maffei

       Representative Eric Massa

       Representative Carolyn McCarthy

       Representative Michael McMahon

       Representative Gary Meeks

       Representative Scott Murphy

       Representative William Owens

       Representative Jose Serrano

       Representative Louise Slaughter

       Representative Paul Tonko

       Representative Edolphus Towns

       Representative Nydia Velazquez

       Representative Anthony Weiner

-----------

 

STATEMENT FROM GOVERNOR DAVID A. PATERSON


Governor David A. Paterson issued the following statement regarding the
Senate agreement on federal health care reform. 

"While I am pleased that today's announcement of a Senate agreement on
health care reform should benefit the 2.5 million uninsured New Yorkers,
I am deeply troubled that it worsens what was already an inequitable
situation for New York State.

"As Mayor Bloomberg and I pointed out earlier this month, the Senate's
bill already disproportionately burdened New York State and New York
City by increasing out Medicaid expenditures by nearly $1 billion
annually. Today's agreement addresses concerns of the only two states
that would have fared worse than New York - Massachusetts and Vermont -
by including state-specific provisions to provide both states with
additional assistance. New York received nothing. 

"In fact, the bill worsens an already bad situation by retroactively
taking away federal Medicaid assistance provided through the American
Recovery and Reinvestment Act. This may cost the State Financial Plan
between $300 and $400 million. 

"New York continues to send more money to Washington than its gets back.
In 2008, it was $55.6 billion more - a greater disparity than any other
state. At the same time, New York still faces a projected deficit of $7
to $9 billion for the 2010-2011 fiscal year, and a four-year gap of $44
billion. Any additional burden is simply untenable.

"While I fully support the federal health care reform, it should be done
in a way that treats states equitably, and I urge our Delegation to
insist on changes to treat New York fairly during the Conference
Committee process."

 

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