Federal uncertainty keeps New York’s health care agenda in limbo

Health care legislation in Albany during the 2018 session will be largely affected by decisions made in Washington. State Sen. Kemp Hannon, chairman of the Senate Health Committee, said the state Legislature would be “very careful” and will be “watching what happens” in Congress this year when deliberating health care issues.

Last week, U.S. Senate Republicans launched another effort to dismantle the Affordable Care Act by including a measure in their sweeping tax reform proposal to eliminate the requirement that Americans buy health insurance or face a fine.

Additionally, the Children’s Health Insurance Program, which gives federal aid to provide medical coverage for low-income children, expired on Oct. 1. Nearly 700,000 children in New York state were enrolled in CHIP as of last year, according to Medicaid data.

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New York has been further affected by the decrease in federal funding for disproportionate share hospital payments, where additional aid is given to public hospitals to cover their expenses for uninsured patients. Funding for this program was also reduced on Oct. 1, with cuts put in place by the Affordable Care Act. This led to a showdown in October between Gov. Andrew Cuomo and New York City Mayor Bill de Blasio, when the Cuomo administration initially refused to pass through the hospital payments to the New York City Health + Hospitals Corp., and then later agreed to release $360 million, blaming the decrease in federal funding.

A bill has been passed in the House of Representatives to refinance CHIP for five years, fund community health centers for two years and delay the reduction in disproportionate share payments. However, it’s likely to face resistance in the U.S. Senate, as it defunds certain portions of the Affordable Care Act to finance the renewal of these health care measures. Meanwhile, New Yorkers who rely on this federal funding are left in limbo.

“We have to take a look at what actually comes out of Congress,” Hannon said about what the state Senate can do in response to this uncertainty. He does not believe that the state Senate will have to create legislation to compensate for the loss of CHIP and other federally funded programs, saying that it is more likely that lawmakers will come up with a solution in Washington.

Some state lawmakers believe that instituting state single-payer health care is the best option for providing coverage to New Yorkers in the face of uncertainty from Washington. Assemblyman Richard Gottfried has repeatedly introduced the New York Health plan, a bill to provide single-payer care, which has passed the Assembly but failed in the state Senate.

“The savings that we can achieve with a single-payer system are about the only way we can survive the assaults we expect from Washington,” Gottfried told City & State in a recent interview.

Although Gottfried and Hannon have worked together to call for a renewal of CHIP, the state senator said that the plan for single-payer health care will not be examined in the next legislative session.

“Their proposal can’t be done without explicit authorization from Washington,” Hannon said. The New York Health plan does note that “waivers and other approvals” are needed to create a state health care system. Instead of addressing this measure, Hannon said that his committee would “look at the way we deliver health care services,” but declined to say what possible solutions they would consider.

AGENCY FOCUS: New York State Department of Health

BILLS OF HEALTH

Opioid abuse

Beyond addressing federal health care issues, Hannon mentioned several other priorities for the state Senate Health Committee next year. He discussed the work of the state Senate Task Force on Lyme and Tick-Borne Diseases as well as the Task Force on Heroin and Opioid Addiction. Hannon said the state Senate will strive to pass legislation on the opioid crisis, after it approved bills in the 2017 session to address the criminal aspect of the crisis, which were rejected by the Assembly. “It still is the major concern in every neighborhood in the state, from Niagara to Riverhead, so we're going to continue our emphasis on that,” he said about the opioid crisis. Between statewide issues and possible federal changes, health care will be an important part of the docket for the 2018 legislative session.

Safe Staffing (S3330/A1532)

The bill sets specific nurse-to-patient ratios in an effort to improve care in all kinds of health care settings. This remains a top priority for state Senate Labor Committee chairwoman Marisol Alcantara – a one-time labor organizer for the New York State Nurses Association – although it will have to pass the Health Committee. When asked for his priorities, Hannon did not mention safe staffing.