Tag Archives: Trumpcare

NYS Gov Cuomo Devises Healthcare Model to Counter TrumpCare (Hint: Pre-Existing Conditions, Contraception, Abortion Would be Covered)

Governor Andrew Cuomo has come up with a list of items that any health insurance company that wants to sell in New York State would have to include. Among them: rehabilitative and habilitative services and devices, such as durable medical equipment, medical supplies, prosthetic devices, hearing aids, chiropractic care, physical therapy, occupational therapy, speech therapy, and home health care © Karen Rubin/news-photos-features.com

 

By Karen Rubin, News & Photo Features

As the fate of Americans’ health care falls in the hands of 13 Republican Senators conferring in secret without input from Democrats let alone health care experts or patients, deciding how much of the “harsh” House plan they incorporate into their own bill, it may well fall to states to take matters into their own hands. Indeed, New York State may provide the model for health care, just as California has dictated pollution standards to the auto manufacturing industry, exceeding federal standards.

New York State Governor Andrew M. Cuomo has directed the New York State Department of Financial Services to promulgate new emergency regulations mandating health insurance providers do not discriminate against New Yorkers with preexisting conditions or based on age or gender, in addition to safeguarding the 10 categories of protections guaranteed by the Affordable Care Act. The new first-in-the-nation measures will ensure that essential health services are protected and covered for all New Yorkers regardless of efforts at the federal level to strip millions of Americans of their healthcare.

At the Governor’s direction, the Department of Health will ban all insurers who withdraw from offering Qualified Health Plans on the State Health Marketplace from future participation in any program that interacts with the marketplace, including Medicaid, Child Health Plus, and the Essential Plan. New York is home to one of the most robust health marketplaces in the country, and insurers who do not comply will lose access to such profitable programs. The Governor will also direct state agencies and authorities to ban insurers who withdraw from the State Health Marketplace from contracting with the state and to consider all available actions to protect New Yorker’s access to quality healthcare.

Furthermore, the administration finalized regulations that will ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles no matter federal action. The regulations also ensure all medically necessary abortion services are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles.

“We will not stand idly by as ultra-conservatives in Washington try to roll back the progress we have made to expand access quality, affordable health care, putting our most vulnerable New Yorkers at risk,” Governor Cuomo said. “As long as I am Governor, New Yorkers will not be subject to price discrimination based on age, gender, or pre-existing conditions, and essential health benefits will continue to be the rule, not the exception. These aggressive actions will make certain that no matter what happens in Congress, the people of New York will not have to worry about losing access to the quality medical care they need and deserve.”

Under the new regulations, DFS will require that individual and small group accident and health insurance policies, which provide hospital, surgical, or medical expense coverage, as well as student accident and health insurance policies cover the same categories of essential health benefits and be subject to the same benchmark plan rules that currently apply through the Affordable Care Act. Insurers must comply with the new regulations as a requirement of their license in New York.

  1. Ambulatory patient services, such as office visits, ambulatory surgical services, dialysis, radiology services, chemotherapy, infertility treatment, abortion services, hospice care, and diabetic equipment, supplies and self-management education;
  2. Emergency services, such as emergency room, urgent care services, and ambulance services;
  3. Hospitalization, such as preadmission testing, inpatient physician and surgical services, hospital care, skilled nursing facility care, and hospice care;
  4. Maternity and newborn care, such as delivery, prenatal and postnatal care, and breastfeeding education and equipment;
  5. Mental health and substance use disorder services, including behavioral health treatment, such as inpatient and outpatient services for the diagnosis and treatment of mental, nervous and emotional disorders, screening, diagnosis and treatment for autism spectrum disorder, and inpatient and outpatient services for the diagnosis and treatment of substance use disorder;
  6. Prescription drugs, such as coverage for generic, brand name and specialty drugs, enteral formulas, contraceptive drugs and devices, abortifacient drugs, and orally administered anti-cancer medication;
  7. Rehabilitative and habilitative services and devices, such as durable medical equipment, medical supplies, prosthetic devices, hearing aids, chiropractic care, physical therapy, occupational therapy, speech therapy, and home health care;
  8. Laboratory services, such as diagnostic testing;
  9. Preventive and wellness services and chronic disease management, such as well child visits, immunizations, mammography, gynecological exams including cervical cytology screening, bone density measurements or testing, and prostate cancer screening; and
  10. Pediatric services, including oral and vision care, such as preventive and routine vision and dental care, and prescription lenses and frames.

The Superintendent of the Department of Financial Services may issue model contract language identifying the coverage requirements for all individual and small group accident and health insurance policies that provide hospital, surgical, or medical expense coverage and all student accident and health insurance policies delivered or issued for delivery in New York State.

DFS will also mandate under existing New York law that health insurers:

  • Provide coverage for all contraceptive drugs and devices and cover at least one form of contraception in each of the FDA-approved contraceptive delivery methods without co-pays, coinsurance, or deductibles, regardless of the future of the Affordable Care Act.
  • Provide coverage for the dispensing of an initial three-month supply of a contraceptive to an insured person. For subsequent dispensing of the same contraceptive covered under the same policy or renewal, an insurer must allow coverage for the dispensing of the entire prescribed contraceptive supply, up to 12 months, at the same time.
  • Provide coverage for abortion services that are medically necessary without co-pays, coinsurance, or deductibles (unless the plan is a high deductible plan).
  • Provide full and accurate information about coverage, enforced in a letter available here.

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© 2017 News & Photo Features Syndicate, a division of Workstyles, Inc. All rights reserved. For editorial feature and photo information, go to www.news-photos-features.com, email [email protected]. Blogging atwww.dailykos.com/blogs/NewsPhotosFeatures.  ‘Like’ us on facebook.com/NewsPhotoFeatures, Tweet @KarenBRubin

Cuomo: TrumpCare Will Result in 2.7 Million New Yorkers Losing Coverage; Cost State Budget $6.9 Billion

Under TrumpCare, being a woman would be a “preexisting condition,” prenatal and maternity would be expensive add-ons to bare-bones policies and heaven forbid a baby is born with a medical condition that would quickly hit a lifetime cap. And the Republican “health care plan” punishes New York for its support for women’s reproductive rights by threatening to take away citizens’ access to tax credits that are intended to make health insurance more affordable © 2017 Karen Rubin/news-photos-features.com

By Karen Rubin, News & Photo Features

Under the Republican American Health Care Act, 2.7 million New Yorkers would lose coverage and the state’s budget would take a $6.9 billion hit, including $2.3 billion as a direct result of an amendment that targets New York State specifically. It would be devastating to New Yorkers, and the Congressional Budget Office’s report confirms that. Just how bad? New York State Governor Andrew M. Cuomo issued this statement:

“The Congressional Budget Office’s report confirms what we already knew to be true—ultra-conservatives in Washington have declared war on New York’s health care system. What’s worse is that Republican members of our own Congressional delegation have aided and abetted in Washington’s war against New York, cutting taxes for millionaires while jeopardizing care for seniors, women, the middle class and the disabled.
“The radical Republican health plan will devastate New York’s health care system, strip 2.7 million New Yorkers of their health care coverage, and roll back the progress we have made to protect vulnerable Americans. This bill will cost New York State a total of $6.9 billion, including $2.3 billion as a direct result of the disastrous amendment introduced by Congressmen Faso and Collins.

“As radical ideologues race to impose their extremist agenda on Americans, New Yorkers say no. In New York, we will stand up for our progressive principles and protect the right to affordable and quality health care for all. I will continue to work with our Congressional delegation and New York’s health care leaders to defeat this reckless legislation.”

The American Health Care Act will leave 23 million more Americans uninsured and be disastrous for New York:

  • The plan will leave 2.7 million New Yorkers without health care coverage.
  • It will cost New York a total of $6.9 billion.
  • It will put at risk a total of 7 million people who rely on Medicaid services and other programs created under the Affordable Care Act.
  • And it threatens the entire New York State health care system, which serves 19.5 million New Yorkers.

The Collins/Faso amendment, which targets only New York, stops counties from paying a share of Medicaid. It would have a devastating effect on New Yorkers:

  • It will cut $2.3 billion in Medicaid funding to the State.
  • Steep cuts would force New York State to increase taxes, slash coverage to millions of New Yorkers, or devastate health care providers. As a result of the AHCA bill:
    • Hospital payments would be cut by $944 million in total
    • Nursing Home payments would be cut by $819 million in total
    • Home care payments would be cut by $734 million in total

The bill punishes New York for its support for women’s reproductive rights by threatening to take away citizens’ access to tax credits that are intended to make health insurance more affordable:

  • New York requires that all commercial insurance policies cover abortion services. In January, Governor Cuomo took new action to ensure that contraceptive drugs and devices are covered by commercial health insurance policies without co-pays, coinsurance, or deductibles.
  • The Republican health care bill would prohibit the use of tax credits to support the purchase of insurance plans that cover abortion services.
  • As a result, the bill would effectively defund the Essential Plan, forcing 685,000 low-income people, half of whom are women, to lose their insurance and denying them $1.5 billion in tax credits.
  • In addition, roughly 143,000 lower-income New Yorkers whose income is just above the threshold for the Essential Plan, half of whom are women, would be denied $400 million more in tax credits that help them afford insurance.

This bill also includes an amendment that will enable insurers to charge more for people with preexisting conditions in some states, rolling back a key achievement of the Affordable Care Act:

  • In New York, 8.4 million people under the age of 65 have preexisting conditions.
  • The MacArthur amendment would allow states to opt out of provisions that restrict providers from raising prices on people with preexisting conditions.
  • Removing protections for people with pre-existing conditions will result in the sick paying high premiums and would force those who cannot afford it to lose coverage.
  • The health plan would also permit states to charge older people more, which would also force people who cannot afford it to lose coverage.

But here’s the thing: even though the Senate Republicans have said they are drafting its own health care law, they are still not bothering to confer with health care providers, health care insurers, patients or state and local officials. It is likely that even if the impacts are softened, any proposal which is designed to cater to healthy, young Americans (by allowing them to not buy insurance), and empower insurance companies to charge whatever they like to cover separate items like maternity, mental illness, addiction, pre-existing conditions (life is a pre-existing condition), to charge penalties for lapses in coverage and to charge older Americans up to five times what younger people pay, and no longer pay for wellness or preventive services, will result in tens of millions of Americans being unable to afford health insurance, being underinsured (making the policies useless), will bankrupt families of their ability to save for college or retirement or home ownership. Americans will find themselves trapped in horrible jobs or abusive marriages because they can’t afford to lose health insurance. It isn’t just the 20% of Americans who must purchase on the individual market: lifting the mandates will mean that employers will be free to stop offering health benefits altogether, or will require hefty pay-ins, or will offer bare-bones policies that leave people without protection and care. Children who are born with health issues will be faced with lifetime caps. A family will again face the insecurity of being just one medical emergency away from bankruptcy. Hospitals, especially in rural communities, will shut down.  Tens of thousands of people a year will die prematurely and needlessly for lack of access to health care, and tens of thousands more will suffer for lack of care. Society will suffer lost productivity while paying more money to cover those who are forced to use emergency rooms for medical care, leaving the rest of us to pick up the tab.

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© 2017 News & Photo Features Syndicate, a division of Workstyles, Inc. All rights reserved. For editorial feature and photo information, go to www.news-photos-features.com, email [email protected]. Blogging atwww.dailykos.com/blogs/NewsPhotosFeatures.  ‘Like’ us onfacebook.com/NewsPhotoFeatures, Tweet @KarenBRubin

Trump Declaring Women’s Health Week States ‘Ensuring Affordable, Accessible, Quality Healthcare is Critical to Improving Women’s Health’

Mother’s Day apparently begins Women’s Health Week, Donald Trump has proclaimed. But the Republican healthcare plan, TrumpCare, would make being a woman a pre-existing condition, make pre-natal and maternity costly add-ons, take Medicaid away from millions of women and children, and shut down access to Planned Parenthood clinics © Karen Rubin/news-photos-features.com

Who knew that Mother’s Day kicks off Women’s Health Week? In honor of the occasion, Donald Trump issued a statement that, like so many in TrumpWorld – like Orwell’s 1984 – bears little connection to reality:

Statement from President Donald J. Trump on Women’s Health Week

As we celebrate Women’s Health Week, beginning with Mother’s Day, we recognize the importance of providing women access to the best, evidence-based health information and care, and growing our medical knowledge through basic and applied research support.

Today, women are living longer, healthier lives than their mothers.  The number of women dying from heart disease and cancer – the top two killers of women in America – has been decreasing for decades.  Thanks to new breast cancer treatments, our health care professionals have saved lives and improved the quality of life for millions of women.  We must continue to foster an environment that rewards these needed advances in research.

Ensuring affordable, accessible, and quality healthcare is critical to improving women’s health and ensuring that it fits their priorities at any stage of life.  In particular, women should have access to quality prenatal, maternal, and newborn care.  Under the current healthcare system, however, the lack of choice in health insurance and in healthcare providers, along with skyrocketing premium and out-of-pocket costs, are failing our citizens, our families, and, in particular, our women.  Studies show that women are often the primary healthcare decision-maker for their family and they deserve better options.

I am committed to working with Congress to help mothers—and fathers—have paid family leave so that childcare is accessible and affordable, and to invest in the comprehensive care that women receive at community health centers.  Through these reforms, and my 2018 Presidential Budget, we will enable access to the critical healthcare services women need.