NPA New York Local Action Network cosponsored an event on December 2nd with multiple organizations** entitled “Health Reform: The Battles Ahead in Albany and Washington.” Those who attended were fortunate to hear from New York experts Dr. John McDonough (Distinguished Fellow in Public Health at Hunter College); Mark Hannay (Director of Metro New York Health Care for All); Kinda Serafi (Senior Health Policy Associate at the Children’s Defense Fund); NPA’s Dr. Bill Jordan (NPA board member and co-chair of health policy for the Public Health Association of New York), Jenny Rejeske (Director of Health Advocacy for the New York Immigration Coalition), and Lois Uttley (Director of the Mergerwatch Project, co-founder of Raising Women’s Voices for the Health Care We Need, and Board Member of PHANYC).
1) Affordable and available coverage through creation of an insurance exchange and subsidies
2) Reforms of Medicaid and CHIP (Child Health Insurance Program) to increase the number of people eligible by changing income requirements and covering single adults
3) Delivery system reforms to lower the rate of spending increase throughout the system
4) Prevention and wellness initiatives to improve access to preventive care by eliminating cost-sharing for most preventive services and creating a national program to promote wellness & prevention
5) Workforce initiatives to improve access to primary care
6) Eliminating fraud and abuse
7) Improving access to generic versions of certain expensive medicines
8) New affordable private voluntary disability insurance
9) Attain revenues by increasing taxes on the most wealthy (with an income over $200,000 for individuals, $250,000 for families) and on unearned income, as well as taxes on indoor tanning salons
He also explained how the reforms enacted would not only pay for themselves, but would end up saving billions of dollars by decreasing costs of health delivery, decreasing costs of taking care of the uninsured nationwide, and reforming the way Medicare and Medicaid work to make them more efficient.
Kinda Serafi discussed the advantages of this law for many people who currently are uninsured. One of the challenges will be to make application for these programs accessible for all. Currently, Medicaid applications can be so long and daunting, or stigmatizing, that many New Yorkers who qualify do not apply. On implementation, the best case scenario would be to create a system accessible to everyone, by phone, mail, internet, or in person, that could help individuals and families determine what plans they’re eligible for, how much they will cost, and other details. Although this would require an extensive overhaul of the Medicaid eligibility system, which is currently quite antiquated, but would be well worth the investment.
Dr. Bill Jordan spoke about the challenges posed to the health care workforce by this law. As it is, there aren’t enough primary care doctors to meet demand. When millions more people flow into the system with their new health coverage, we need to make sure there are enough doctors to care for them. To help with this, the PPACA increases loan repayment for primary care providers, redistributes residency training slots to favor primary care sites and rural, underserved areas, and also redirects training funds to increase the supply of general surgeons.
Jenny Rejeske discussed the impact of the law on immigrants. As a group, many immigrants have much to gain from this law. Some immigrants, those who are undocumented, are left behind. The majority of immigrants will benefit as the most are here with legal status, either as residents or as naturalized citizens. The key will be to ensure that those eligible for Medicaid and other subsidies are aware that these programs are available to them. In addition, we need to ensure that undocumented immigrants are connected to the health care services available to them, including patient financial assistance at all hospitals that accept federal funds, as well as community health centers and HHC clinics and hospitals for those living in New York City.
Lois Uttley finished up by talking about women’s health. In terms of women’s health, there are great gains for most women, in that maternity care will be a mandated service starting in 2014, and preventive services must be provided without a deductible for new insurance plans starting this year (meaning mammograms, pap smears, and STI testing are now free to all women regardless of which insurance plan they use). The negative for women will be the restrictions on abortion coverage for all new insurances bought through the exchange, as well as a likely similar effect even on those who have insurance now. The law states that each state has the right to limit, prohibit, or restrict coverage abortion in all insurances sold on the exchange (14 states have already taken advantage of this). Even where abortion coverage is allowed, participants in those plans have to write 2 separate checks to the company, one to cover abortion and one for everything else.
Attendance at the event was impressive at 115. Audience members asked important questions to clarify the impact of the law on immigrants and children, as well as the future structure of the health care system.
Thanks to all the co-sponsors, panel members, and attendees!
**Co-sponsors of this event were: Long Island University School of Health Professions, AARP-NY, PHANYC, Children's Defense Fund-NY, Community Service Society, Committee for Interns and Residents - SEIU, Health Care for All New York, Health Care Leaders of New York, New York Immigration Coalition, National Organization for Women - New York State, and Raising Women's Voices for the Health Care We Need