By Richard N. Gottfried, Brad Hoylman, Gustavo Rivera and Linda B. Rosenthal
Many of New York’s health-care providers are in crisis. COVID-19 has increased the cost of providing care and cut their income because people are postponing care. This is on top of the fact that many health-care providers that rely on Medicaid have been on painful austerity budgets for years due to government cuts. Then, in April, Gov. Cuomo’s state budget slashed Medicaid even more.
As if that was not enough, one little-noticed action in the budget changes how Medicaid pays for prescription drugs. It will financially cripple our most vulnerable safety net providers and leave their patients without care.
Here’s the story. The vast majority of Medicaid recipients are required to get their coverage, including prescription drugs, from a Medicaid managed care plan. Each managed care plan does its own price negotiating with drug manufacturers. A small number get their Medicaid coverage directly from the state, without a managed care plan, and the state pays directly for their drugs, through its “preferred drug program.”
This year’s state budget “carves out” all prescription drugs from Medicaid managed care coverage and requires all Medicaid patients to get their prescription drugs directly through the state.
Like many small business owners, local baker and trained chef Samantha Hamilton had to figure out how to keep her home-based business, The Sugar Shack Bakery, alive during a…
In many ways, this is a good idea. The state will be negotiating drug prices for a much bigger group of patients than any one managed care plan. This will mean lower prices. And the preferred drug program gives patients and their doctors more choice of drugs than managed care plans do. For years, we’ve advocated getting Medicaid managed care plans out of the picture for drugs. (The NY Health Act, our single-payer bill, would get all insurance companies out of the whole picture for all of us, but that’s for another article.)
However, there is a serious problem in this plan. Community health centers, HIV providers, sexual health clinics, many rural hospitals and other safety net providers currently participate in a federal program called 340B, which allows them to purchase prescription drugs at a significantly reduced price. These providers rely on their 340B savings to “stretch” their Medicaid funding to pay for health care for the people they serve. The catch is, under federal law, this only works for drugs purchased under Medicaid managed care.
340B was created in 1992 by Congress “to stretch scarce…resources as far as possible, reaching more eligible patients and providing more comprehensive services.” It guarantees dramatically lower drug prices for the providers that are covered. In New York, these providers are all non-profit groups.
The money trail is complicated (like almost everything involving prescription drugs), but the bottom line is: If New York State shifts Medicaid drug coverage away from managed care, the way it was done in the budget, these non-profit safety-net providers will lose hundreds of millions of dollars they now use for patient care.
If this change goes ahead, the state and the federal government will pocket the savings. The benefit will no longer help the safety net providers the 340B program was created to help. How the Cuomo administration will use the money is anybody’s guess.
We believe it’s possible to change the new carve-out law to protect the 340B providers and HIV health plans. But it will take time for the Health Department, legislators, health-care providers and HIV plans to develop, evaluate and implement a successful carve-out that does not diminish access and quality for programs and the vulnerable people they serve.
That is why we’ve introduced a bill to have the carve-out go ahead for the bulk of Medicaid, but to delay it for three years specifically for 340B providers. The Legislature and the governor have to pass this bill before the full carve-out goes into effect on April 1, 2021. Otherwise, vulnerable health-care providers that serve vulnerable New Yorkers will suffer serious financial harm, and many will not survive.
Gottfried, chair of the Assembly Health Committee, represents parts of the West Side and Midtown Manhattan. Rivera, chair of the state Senate Committee on Health, represents parts of the Northwest Bronx. Hoylman represents parts of Manhattan in the state Senate. Rosenthal, chair of the Assembly Committee on Alcoholism and Drug Abuse, represents the Upper West Side and parts of Hell’s Kitchen.
It’s unclear whether the Legislature or even the governor, who must approve the changes as part of the state budget, have the stomach to cut spending to medical facilities grappling with an expected wave of COVID-19 patients and a potential health catastrophe, as well as rolling back Medicaid services to patients.
“It’s never a good time to cut health care, especially when the only rationale is to fit into an artificial limit. It’s even more wrong in the midst of a growing epidemic,” said Assembly Health Committee Chairman Richard Gottfried (D-Manhattan).
(Albany, NY) State Senator Gustavo Rivera, Assembly Member Richard Gottfried, advocates, and health care provider associations gathered today to call on the Legislature to pass the “Beyond the Fourth Trimester” bill, S.7147-A/A.9156 which would extend postpartum coverage for mothers from 60 days to one year after giving birth. The bill recently passed both houses’ Health Committees and has the support of physicians, midwives, hospitals, and advocates for improving reproductive health and reducing health care racial disparities.
Assemblyman Richard Gottfried and state Sen. Gustavo Rivera, who lead the health committees in the state Legislature, both expressed disappointment that NYC Health + Hospitals, the city’s public hospitals system, was left out especially given that New York City is expected to be hit particularly hard under the governor’s proposal to shift Medicaid costs onto localities.
“As they say, ‘if you’re not at the table, you’re on the menu,’” Gottried said in a statement. A week earlier, he and Rivera had criticized the governor and his administration for not providing updates about the selection for the team.
Several new laws – on birth certificates, cash bail, “pre-registering” to vote, farmworkers’ rights, and boating safety, among others – are taking effect beginning in 2020.
And an increase in the minimum wage began on December 31, with hourly minimums rising to $15 an hour in New York City, $13 on Long Island and in Westchester County, and $11.80 in the rest of the state.
ALBANY — Skeptical lawmakers skewered state health officials Wednesday as they sought details on Gov. Cuomo’s plan to tackle New York’s projected $6 billion Medicaid-induced budget deficit.
“It is a little bit concerning, scratch that, a lot, very concerning that you are coming to a public hearing on Jan. 29 and you’re telling us that by April 1 we have to just accept something that’s put together by a magical crew of folks,” Sen. Gustavo Rivera (D-Bronx), the chairman of his chamber’s health committee, said as he peppered state Health Department commissioner Howard Zucker and state Medicaid Director Donna Frescatore with questions about the proposal.
ALBANY, NY (WSKG) – A lack of information on how Governor Andrew Cuomo plans to cut billions out of state-funded health care programs led to some tense moments at a legislative budget hearing Wednesday.
Cuomo, in his budget address, said he will convene a commission to decide how to cut $2.5 billion in Medicaid spending to help close a $6 billion budget gap without harming recipients.
But that commission, known as the Medicaid Redesign Team, won’t report back until sometime in March, potentially just weeks or even days before the state budget is due, leaving the Legislature little time to analyze the proposals.
Cuomo said the MRT panel should hold counties “harmless” in its plan and that Medicaid recipients should not see benefits affected. What’s that leave? Real cuts to providers? Tax hikes on private insurance plans? New ways to reduce waste or fraud?
“I’m incredibly concerned that the governor’s office has yet to release the necessary details we need to assess the potential impact on our localities’ Medicaid share,” said Sen. Gustavo Rivera, a Bronx Democrat who heads the Senate health committee. He said Cuomo’s fiscal overview suggests New York City – and “particularly residents of my district” – will feel end up seeing actual Medicaid cuts.
Gottfried, the Manhattan lawmaker, is even more pointed. “It’s hard to believe that it isn’t a sham,’’ he said of the MRT route. He thinks it’s quite possible Cuomo’s budget team already has specific plans that will be rubber stamped by the MRT. Gottfried served on the 2011 MRT, and he eventually praised the end product.
The governor, in his Jan. 8 address, called the current situation “unsustainable” and referenced the state’s Medicaid Redesign Team, or MRT, which he created in 2011.
Assembly Health Committee Chairman Richard N. Gottfried (D) called the MRT largely a “sham.”
Many of the problems the state is experiencing came from changes made by the redesign, like moving toward managed care plans, he said. “I believe that the only responsible answer to this increase in Medicaid spending is on the tax side of the ledger.”
Several new laws – on birth certificates, cash bail, “pre-registering” to vote, farmworkers’ rights, and boating safety, among others – are taking effect beginning in 2020.
And
an increase in the minimum wage began on December 31, with hourly minimums
rising to $15 an hour in New York City, $13 on Long Island and in Westchester County,
and $11.80 in the rest of the state.
I
was proud to have been an Assembly cosponsor of a bill (sponsored by Assembly
Member David Weprin and Senator Andrew Lanza) that allows persons who were adopted unrestricted access to their birth
certificates once they turn eighteen.
Previously, adoptees could only get access by petitioning a court, and
even then only with the consent of both biological parents. The law, which was strongly supported by many
adoptees seeking potentially life-saving information on their family medical
history, takes effect on January 15.
DEFENDING CRIMINAL JUSTICE REFORMS: On Dec. 10, I joined advocates and elected officials to defend pre-sentencing reforms like eliminating the cash bail requirement for most non-violent crimes.
DEFENDING CRIMINAL JUSTICE REFORMS: On Dec. 10, I
joined advocates and elected officials to defend pre-sentencing reforms like
eliminating the cash bail requirement for most non-violent crimes.
Important changes are also taking place affecting cash bail and streamlining pre-trial procedure. Beginning on January 1, persons charged with most misdemeanors and Class E felonies will no longer be released from jail while awaiting trial, which will help end the criminalization of poverty that imprisons those not yet convicted simply because they can’t afford bail.
Several reforms to speed up trials and streamline the discovery process also took effect on January 1.
Also taking effect on January 1 was a new
law allowing 16- and 17-year-olds to “pre-register” to vote by completing a
voter registration form that will make them automatically eligible to vote once
they turn 18, making New York the 14th state to allowing pre-registration for
persons beginning at age 16.
Farmworkers have more rights under Farm
Labor Fair Practices Act that took effect on January 1, aligning them with
those already guaranteed other workers in New York: an eight-hour workday, with
one mandatory rest day each week for farmworkers, as well as overtime pay set
at time and a half. The law makes it
illegal for an employer to “lock out” farm workers over pay disputes or for
seeking to unionize.
Starting
January 1, New Yorkers born in 1993 or
later will now be required to take a safety course before operating a motorboat
or jet ski. “Brianna’s Law” – named
after Brianna Lieneck, an 11-year-old killed in a boat crash off Long Island in
2005 – will require every motor boat or jet ski operator to take a course and obtain
a boating safety license before operating a motorized vessel on New York waterways,
by expanding the age group every year until all motorboat or jet ski operators
are included in 2025.
Five Tin Pan Alley
Buildings Are Designated Landmarks
In a big win for the local community and for preservationists, on
December 10 the New York City Landmarks
Preservation Commission (LPC) voted to designate five buildings in New York
City’s fabled Tin Pan Alley as New York City landmarks. We had been
fighting for years to get Tin Pan Alley, the block of West 28th Street between
Broadway and Sixth Avenue, designated. It became famous
in the late 1800s for its association with
American popular music. Dozens of music
publishers and songwriters, including Duke Ellington, George Gershwin, Irving
Berlin, and Cole Porter worked out of offices in a row of Italianate townhouses
on 28th Street, writing classic songs like “God Bless America” and “Take Me Out
to the Ballgame.”
The
most recent testimony I wrote in 2019 and submitted to the LPC along with New
York City Council Speaker Corey Johnson urging it to designate five buildings
in Tin Pan Alley as landmarks: 47, 49, 51, 53 and 55 West 28th Street. The LPC’s action in December is the
culmination of a long and hard-fought battle to preserve this vital piece of
New York’s, and America’s, history.
Public Finance
Commission Issues Recommendations
New York badly needs to combat the impact
that big-money interests exert on State government – and I’ve been fighting to
change the system. It’s not a new cause
for
me
– I wrote New York’s first bill on public campaign financing.
To help address mega-donors’
out-sized influence on New York’s government, the Governor and legislative
leaders agreed that New York State needed to create and implement a small-donor
matching system for elections for State offices. By
matching small donations with public funding,
voices of all New Yorkers are strengthened instead of being overwhelmed
by well-heeled special interests.
Unfortunately,
the Legislature and the Governor did not come to agreement on a campaign
finance reform program before the end of the legislative session in June. Instead, we created a “Public Financing
Commission” charged with approving a campaign finance reform package by December,
with Governor Cuomo promising that it would establish a campaign finance system
that would serve as a “model for the nation.” The recommendations it issued at the end of
November will become law unless the Legislature amends or repeals them.
The
commission process was highly questionable, with its members apparently getting
side-tracked by questions like whether to bar “fusion voting,” which allows
different political parties in New York to endorse the same candidate; and whether
to raise increase how many votes a “third
party” would need to receive
in order to be legally recognized with an official ballot line.
Though the Commission did not act to
eliminate fusion voting outright, as has been feared, it did move to increase
the threshold for parties to obtain a position on the ballot, which puts their
long-term survival in jeopardy. Up until
now, “third” parties like the Working Families Party and Conservative Party had
to receive 50,000 votes in a gubernatorial election to maintain a ballot line
and thus field candidates in a range of elections across the state on that
ballot line over the course of the next four years. Under the Commission’s
rules, instead of qualifying in every four-year gubernatorial election, parties
will have to receive 2% of all votes cast or 130,000 votes, whichever is
higher, for either governor or president, meaning that parties would have to
requalify every two years with a significantly higher number of votes than are
currently required of them every four years.
(No other state in the country that allows fusion voting requires
“third” parties to qualify during presidential election years.)
The question of party qualification
should have never been a part of this commission. Third parties are an essential part of the electoral system in New
York, shining light on important issues that otherwise may not get the
attention they deserve. The proposed
thresholds for party qualification are unacceptable. We should be making it easier for third
parties to make it on the ballot, not harder.
That’s
why I have introduced legislation to undo the recommendations of the Public
Campaign Finance Commission relating to “third” parties. My bill would restore the provisions of the
Election Law relating to third parties.
I will be working with other
legislators to fix the problems created by the Commis-
sion’s
set of recommendations, ensure the
viability
of smaller political parties, and make the proposed matching campaign finance
system for New York State even stronger.
Looming State Budget
Shortfall Threatens Medicaid Funding
New
York’s budget gap for the coming year stands at an estimated $6.1 billion, with
much of that shortfall attributed to the State’s Medicaid program. In order to maintain a “global spending cap”
imposed by Governor Cuomo on Medicaid spending, his administration shifted more
than $1 billion in Medicaid payments into the next (2020) fiscal year.
Governor
Cuomo’s administration ascribes the Medicaid deficit to several factors,
including the effect of an increase in New York’s minimum wage on health care
providers, a phase-out of some federal funding, an aging population resulting
in greater demand for long-term care, and the rising cost of that long-term
care.
We can’t cut Medicaid spending to the bone
in order to comply with an artificially imposed spending cap without
jeopardizing the health of millions of New York families who depend on this
vital program. As Chair of the
Assembly Health Committee, I’ll be working to protect Medicaid patients by
providing it with additional revenue on high-income earners.
Assembly Task Force on Opiate Addiction
Across
our state, New Yorkers have been struggling to overcome an epidemic of opioid
abuse. To help address the crisis, the
NYS Assembly Majority has formed a “Task Force on Examining Socio-Economic Responses
to People with Substance Use Disorders.”
I was appointed to serve on the Task Force by Speaker Carl Heastie.
Opioid addiction does not discriminate, impacting
New Yorkers of all ages, races, and genders across the state. This Task Force will help guide the state’
response with the insight of stakeholders and experts in the field, as we work
to break down barriers preventing access to care and services.
The Task Force will
convene hearings to receive recommendations on how to address the opioid
epidemic, as well as learn about the impacts of substance use disorders on
those that suffer from the disorder,
on their support systems, and on their communities.
The
formation of the Task Force is not the first step that the Assembly has taken in
2019 to address the crisis; earlier this year, the Assembly and the State
Senate allocated $1 million for NYS substance abuse and rehabilitation service.
Tues., Jan. 7: Workshop on “Cultivate Hell’s Kitchen”
Do you live, work or
play in Hell’s Kitchen? Have ideas about
what the future of this neighborhood should look like? The “Cultivate HK” Town Hall series,
sponsored by the Clinton Housing Development Company (CHDC), is designed to
mobilize neighbors and advance a greener, more interconnected Hell’s Kitchen.
Join your neighbors at the second “Cultivate
HK Town Hall” on Tuesday, January 7 from 6:00 p.m. to 8:00 p.m. at 545 West
52nd Street (between Tenth & Eleventh Avenues) on the first floor.🎉
This
event is free and open to the public, and refreshments will be provided.
Mulchfest! Through Sat., Jan. 11, Recycle Christmas
Trees
From now through Saturday, January 11, you
can recycle your Christmas tree or wreath, courtesy of the New York City
Parks and Sanitation Departments.
Just
bring your tree to a Mulchfest location, and your tree will be turned into wood
chips that will be used to nourish trees and make New York City even greener. More than 28,000 trees were recycled last
year.
Help the City top that number in 2020!
In
our Assembly district, drop-off sites are Central Park West and West 65th
Street and on East 14th Street between Broadway and Park Avenue South. Until Jan. 11, you can bring your tree to any
Mulchfest location. Find the complete listing online at https://www.nycgovparks.org/highlights/festivals/mulchfest.
Please
remember to remove all lights, ornaments, and netting before bringing the tree
to a Mulchfest site.
Weather
permitting, the NYC Department of Sanitation will also be conducting curbside
collections for mulching and recycling of Christmas trees from Monday, January
6 through Friday, January 17, 2020.
Mon., Jan. 20:
Deadline for Citizens Committee Grant Applications for Local Community Organizations
Do
you have an idea to improve our community?
The Citizens Committee for New York City is now accepting applications
from volunteer-led groups for its Neighborhood Grants program, which offers up
to $3,000 and project planning support for initiatives aimed at bringing neighbors
together and improving the quality of life in neighborhoods across the city. The
deadline to apply is January 20.
An organization does not have to be a registered 501(c)(3) to be able to
receive a grant from CCNYC!
Eligible
groups include block associations, tenant associations, PTAs, gardening groups,
cultural organizations and others.
Examples of projects considered for funding include turning a vacant lot
into a community garden or community composting site; facilitating workshops on
healthy cooking and eating; beautifying public spaces; arts and cultural programs;
youth fitness initiatives; and much more.
Organizations
can access the application for 2020 Neighborhood Grants online at www.citizensnyc.org/grants. For
more information about the application process or eligibility, contact Arif
Ullah, Director of Programs, at aullah@citizensnyc.org or (212) 822-9580.
Wed., Jan. 22:
Workshop on SCRIE & DRIE
SCRIE
and DRIE (Senior Citizen Rent Increase
Exemption and Disability Rent Increase
Exemption) help eligible New Yorkers stay in affordable apartments by freezing
their rent.
From
12:00 noon to 2:00 p.m. on Wed., Jan. 22, the New York City Mayor’s Public
Engagement Unit will host a workshop on the SCRIE and DRIE programs in conjunction
with the office of City Council Speaker Corey Johnson. The event will be held at Selis Manor, 135
West 23rd St. between Sixth and Seventh Avenues in Chelsea.
To apply for SCRIE or DRIE, you must be at least 62 years
old, or 18 with a qualifying disability; have a household income of $50,000 or
less; live in a rent-regulated apartment (either rent-stabilized,
rent-controlled, or a Single-Room-Occupancy hotel); and spend more than 1/3 of your income on rent.
To
complete an application, you must provide photo identification; 2018 tax returns
documenting the income of all household members; copies of your two most recent
leases; and, if applicable, a copy of an Social Security Disability award
letter or Veterans Administration disability or compensation notice of award
letter. Residents of NYHCA developments
or Section 8 housing are not eligible.
Fighting to Preserve
a Historic Fifth Avenue Building
On December 18, I spoke at a rally to
urge the NYC Landmarks Preservation Commission (LPC) to grant landmark designation
to the Demarest Building at 339 Fifth Avenue. An historic Beaux-Arts, iron-framed structure
with four-story-high arched windows located on 33rd Street across from the Empire
State Building, the Demarest was built in 1890 and originally housed a horse
carriage showroom as well as the first electrically operated elevator in the
world. It was designed by the architectural
firm of Renwick, Aspinwall & Russell, whose founder James Renwick also
created the plans for St. Patrick’s Cathedral and the Smithsonian Institution
in Washington, among many other famous buildings. Unfortunately, the Demarest is facing demolition
because its owner, Pi Capital Partners, has filed an application to construct a
new high-rise building.
I have
previously joined with community members and electing officials in unsuccessfully
urging the preservation of the Demarest and other historic buildings in the
area as part of a proposed expansion of the Madison Square North Historic District. Now, our effort to save the Demarest is assuming
new urgency in light of the imminent threat to its survival.
FIGHTING TO PRESERVE NEW YORK’S HISTORY: Last month, I joined members of the 29th Street Association and other elected officials to rally support for designating the Demarest Building on Fifth Avenue as a New York City landmark.
I represent Chelsea, Hell’s Kitchen, Midtown, and parts of Murray Hill and the Lincoln Center area in the State Assembly. I have been chair of the Assembly Health Committee since 1987. During off hours, I like to write Chinese calligraphy.
