What the New Administration in Washington Means for Health Policy in New York
The election of Donald Trump and the current control of Congress are a serious threat to programs and policies that protect our health. Washington could make radical changes to Medicare, Medicaid, the Affordable Care Act, reproductive care, and other programs that could drastically undermine our right to health care, cost New York State billions of dollars a year in federal funds, and destabilize health care providers.
The first step in stopping or reversing these attacks is to clearly understand what's at stake and spread the word. There is hardly anything more rigged against working people than health care. The Trump agenda will make it worse. This is a time to redouble efforts in more progressive states like New York to create universal access to health care, with funding based fairly on ability to pay, through an "improved Medicare for all" system.
For years, congressional attacks on funding and programs have been defeated by the threat or use of presidential vetoes. Now we will have a president who may be leading the charge.
Under the Affordable Care Act (ACA), we get 90% federal matching money, instead of the usual 50%, for the "expanded" Medicaid population. ACA repeal would take away the additional funding and cost New York over $2 billion a year. ACA repeal would also eliminate federal funding for the new Essential Plan, blowing an additional $800 million hole in the State budget and potentially leaving 100,000 New Yorkers without health coverage.
President-elect Trump has vowed to eliminate funding for Planned Parenthood, and Vice President-elect Mike Pence is an anti-choice extremist who carried legislation doing just that. This is a major platform plank for their supporters and it's likely that Congress would eliminate federal support for family planning services. If President-elect Trump has his way, a new Supreme Court majority would not only overturn Roe v. Wade, but could go further and outlaw some or all abortion - overriding New York's law that protects legal abortion.
We will have a federal government committed to protecting corporate interests at the expense of just about anything else. Cuts in Medicare and privatizing it by turning it over to insurance companies could destabilize hospitals and other providers, shift costs to patients, and cut their access to care.
Federal laws and regulations that protect the rights of Medicaid recipients and nursing home residents could be gutted, and enforcement of remaining protections undermined by underfunding federal agencies like the Department of Health and Human Services or Centers for Medicare and Medicaid Services.
Efforts to control rising prescription drug prices could be stopped before they start, and pharmaceutical companies would likely face less oversight of drug quality or safety under the slogan of "lifting government restrictions and regulations."
When Trump and the Majority in Congress say "repeal and replace Obamacare," the agenda is eliminating financial help for low- and middle-income people who can't afford high premiums and deductibles, shifting more of the cost of health care from insurance companies to consumers, and eliminating consumer protections. They talk about letting insurance companies sell in any state, but insurance companies already can do that. What they really mean is making out-of-state insurance companies exempt from state consumer protection and financial solvency laws.
Gutting Environmental Protection Agency regulations to reduce carbon emissions will undo the progress we've made on environmental protection, clean energy, and environmental health. That means more asthma, more cancer-causing chemicals in our drinking water, and more disastrous storms and floods from global warming.
The new administration may try to trash state medical marijuana laws. Federal law does not allow selling marijuana for medical or recreational use. But for years, the federal government has officially looked the other way to allow states to have medical marijuana programs and even recreational marijuana laws. An administration driven by outdated "drug war" thinking could shut down programs that provide relief to patients in need in almost 30 states
Much of our State public health policy is driven by federal funding, laws, regulations, and oversight. We must protect the federal policies and programs New York depends on, and respond with appropriate changes to state law when needed.
Fighting for the Right Answer: The New York Health Act
Our health insurance-based system is a major contributor to economic inequality and lack of opportunity. The insurance company wants the same premium and imposes the same "cost sharing" whether you're a multi-millionaire CEO or the receptionist struggling to make ends meet. For a median-income household, the cost of insurance can be over a quarter of your income (whether paid by the worker directly or indirectly by your employer lowering your wages). And that's not counting possibly thousands of dollars in out-of-pocket costs.
It doesn't have to be that way.
The New York Health Act is my bill to provide complete universal health coverage (called "single payer" or "improved Medicare for all"), eliminate financial barriers to care, and let people go to the doctor and hospital of their choice. Instead of regressive premiums, deductibles, co-pays and out-of-network charges, it would be funded fairly through broad-based taxes based on ability to pay.
The Assembly passed the bill in 2015 and 2016 - helping to move it from being "a great idea that could never happen" to something really achievable. In 2017, we will continue to work to build public support so it can ultimately pass the Senate.
There is increased talk about the need for government to respond to the needs of working and middle class people and treat them with respect and fairness. Passing the New York Health Act is a key action we can take.
New York's Medical Marijuana Program Expands
Last month, the New York State Department of Health (DOH) announced a number of changes that will increase access to medical marijuana for New Yorkers who need it. Among these steps were adding chronic pain to a list of 10 qualifying conditions that also include cancer, AIDS, epilepsy, and multiple sclerosis; allowing companies that manufacture and sell medical marijuana (registered organizations) to wholesale their products to other registered organizations, which will expand the variety of products available across the state; and lifting the cap of five products ("brands") per registered organization, which will increase access for patients with rare or complex conditions.
These changes built on DOH's recent decision to allow physician assistants (PAs) and nurse practitioners (NPs) to certify patients for medical marijuana - good news for the thousands of New Yorkers who use PAs or NPs as their health care providers, and reflecting PAs' and NPs' long-recognized scope of practice.
As Chair of the Assembly Committee on Health and as the Assembly sponsor of the Compassionate Care Act of 2014 that first made the medical use of marijuana legal in New York, I had been urging the State to expand access to medical marijuana and applauded the recent changes to the State's regulations.
Were You Denied SCRIE or DRIE Benefit Renewal?
Several thousand people who were getting Senior Citizen Rent Increase Exemption (SCRIE) or Disability Rent Increase Exemption (DRIE) benefits were wrongly denied a renewal of the benefit. They will be getting letters from the City Department of Finance in early 2017 telling them how to get their benefits restored. If you or someone you know needs help applying for the renewal, call my Community Office at 212-807-7900 or email us at GottfriedR@nyassembly.gov.
My Community Office can help you find out if you are eligible for SCRIE or DRIE, and help you apply for the benefits and renewal of benefits.
Thanks to JASA for the legal action that got the City to do this.
Helping Those in Need
As we begin the new year, it's appropriate to think about the many New Yorkers who are struggling, including those facing food insecurity - not knowing where their next meal will come from or simply not having enough food to meet the nutritional needs of each family member.
Let's keep this in mind during the year ahead and think about how we can help the less fortunate. Federal and local hunger prevention programs and food banks help provide meals to millions of vulnerable individuals and families.
If you'd like to help by making a financial contribution, donating food, or volunteering, you can contact the Food Bank for New York City at (212) 566-7855 or http://www.foodbanknyc.org/. To donate food or water to a local food pantry or soup kitchen, you can use the Food Bank's website to learn how to contact an organization near you.
Apply for a Grant for Your Neighborhood Organization from the Citizens Committee for NYC
Every year, the Citizens Committee for New York City awards grants of up to $3,000 to community-based organizations seeking to improve the local quality of life.
Neighborhood organizations, public housing tenant associations, and groups working to improve public schools, are just some of the winners of past grants. The application deadline for grant applications is January 23, 2017.
For a grant application or to obtain more information, please contact Imani by phone at (212) 822-9567 or by email at firstname.lastname@example.org. Applications can also be found online by going online to http://www.citizensnyc.org/grants/neighborhood-grants
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